Perforated appendicitis as a source of Fournier’s gangrene in an immunocompetent male

Abstract

Fournier’s gangrene is a synergetic polymicrobial necrotizing fasciitis of the perianal, perineal and genital areas, it is a rare condition and it has a high mortality rate of up to 67%. Acute appendicitis has been identified as another cause of Fournier’s gangrene. This case demonstrates the critical importance of considering a diagnosis of Fournier’s gangrene because of a missing diagnosis of appendicitis even if the patient is young, healthy, immunocompetent and without a background of abdominal pain. We discuss a case of 35-year-old male, immunocompetent and medically free, who was presented to Emergency Department with a clinical picture of Fournier’s gangrene due to acute perforated appendicitis without a history of abdominal pain, and within 48 hours of the onset of bilateral scrotal swelling. Our case demonstrates the importance of considering Fournier’s gangrene as a complication of an intra-abdominal septic process, even in a young, healthy, immunocompetent patient.