Abstract
Fournier’s gangrene is an acute, rapidly progressing, potentially fatal necrotizing fasciitis affectingthe external genitalia, perineal or perianal regions and is caused by a mixed infection with aerobic/anaerobic bacteria, which commonly affects the men, but can also occur in women and children. The most common foci of infection are from gastrointestinal tract, genitourinary tract or less commonly from the cutaneous injuries. The common risk factors includediabetes mellitus,alcohol abuse, extremes of age, male gender, chronic steroid use, malnutrition and immunosuppression. Uncommonly, Fournier’s gangrene has been documented after vasectomy operation-a permanent technique for male partner sterilization. Here we present a case of Fournier’s gangrene in an adult male who had undergone bilateral standard vasectomy for permanent contraception and presenting after 7 days with gangrene in the scrotum requiring urgent debridement and broad-spectrum antibiotics.
Highlights
Fournier's gangrene is defined as synergis c, polymicrobial, necro zing fascii s of the perineum, scrotum, and penis, which is characterized by oblitera ve endarteri s of the subcutaneous arteries resul ng in gangrene of the subcutaneous ssue and the overlying skin.[1]
The pathology of Fournier's gangrene can be briefly summarized as synergis c necro zing fascii s resul ng in the thrombosis of small subcutaneous vessels of suppura ve bacterial infec on of the anorectal, perineal, or genitourinary regions, leading to the development of gangrene in the skin.[2,4]
We describe a case of Fournier's gangrene a er a standard bilateral vasectomy requiring fluid resuscita on, broad spectrum an bio cs administra on and primary surgical debridement and wound care of the scrotal and penile skin followed by delayed skin reconstruc on
Summary
Fournier's gangrene is defined as synergis c, polymicrobial, necro zing fascii s of the perineum, scrotum, and penis, which is characterized by oblitera ve endarteri s of the subcutaneous arteries resul ng in gangrene of the subcutaneous ssue and the overlying skin.[1]. We describe a case of Fournier's gangrene a er a standard bilateral vasectomy requiring fluid resuscita on, broad spectrum an bio cs administra on and primary surgical debridement and wound care of the scrotal and penile skin followed by delayed skin reconstruc on. In the last two day she started developing scrotal swelling, redness which progressed to sloughing of the scrotal skin and foulsmelling discharge He complained of fever, intermi ent type, with chills, rigors and swea ng. A er adequate stabiliza on and wound care, the pa ent was referred to ter ary centre in Kathmandu for further need of plas c/reconstruc ve surgery
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