Fournier's Gangrene and Intravenous Drug Abuse: an Unusual Case Report and Review of The Literature.

Michele Del Zingaro,Gianluca Gaudio,Roberto Cirocchi,Alessio Paladini,Pietro Ursi,Jacopo Adolfo Rossi De Vermandois,Morena Turco,Ettore Mearini,Andrea Nogara,Emanuele Lepri,Andrea Boni

doi:10.1515/med-2019-0114

Michele Del Zingaro, Gianluca Gaudio + Show 9 more

Open Access

https://doi.org/10.1515/med-2019-0114

Copy DOI

Abstract

Fournier’s gangrene is a potentially fatal emergency condition characterized by necrotizing fasciitis and supported by an infection of the external genital, perineal and perianal region, with a rapid and progressive spread from subcutaneous fat tissue to fascial planes.In this case report, a 52-year-old man, with a history of hepatitis C-virus (HCV)-related chronic liver disease and cocaine use disorder for which he was receiving methadone maintenance therapy, was admitted to the Emergency Department with necrotic tissue involving the external genitalia.Fournier’s gangrene is usually due to compromised host immunity, without a precise cause of bacterial infection; here it is linked to a loco-regional intravenous injection of cocaine. A multimodal approach, including a wide surgical debridement and a postponed skin graft, was needed. Here we report this case, with a narrative review of the literature.

Highlights

Fournier’s gangrene was described for the first time in 1764 by Baurienne as an idiopathic, necrotizing lethal process in a man affected by gangrene of the genitalia
Fournier’s gangrene is a potentially fatal condition; it is characterized by necrotizing fasciitis and supported by an infection of the external genital, perineal and perianal region, with a rapid and progressive spread from subcutaneous fat tissue to fascial planes [2]
Fournier’s gangrene, we describe an unusual case due to injection of cocaine into the superficial dorsal vein of the penis, followed by a comprehensive literature review

Summary

Introduction

Fournier’s gangrene was described for the first time in 1764 by Baurienne as an idiopathic, necrotizing lethal process in a man affected by gangrene of the genitalia. Alfred Fournier who described a series of fatal cases of idiopathic gangrene of the genitalia with a sudden onset in 5 young men in 1883 [1]. Fournier’s gangrene is a potentially fatal condition; it is characterized by necrotizing fasciitis and supported by an infection of the external genital, perineal and perianal region, with a rapid and progressive spread from subcutaneous fat tissue to fascial planes [2]. This emergency condition always requires a multimodal approach: antibiotic therapy, surgery followed by intensive care, and oxygen hyperbaric therapy [3]. Fournier’s gangrene, we describe an unusual case due to injection of cocaine into the superficial dorsal vein of the penis, followed by a comprehensive literature review

Material and methods

Discussion

Findings

Conclusion