Abstract
BackgroundFournier’s gangrene is an acute surgical emergency characterized by high mortality rates ranging from approximately 13% to 45%. Therefore, aggressive multidisciplinary management is necessary.Case presentationA 29-year-old Asian man who had undergone surgical debridement at another hospital to treat a perianal abscess 5 days earlier was admitted to our hospital for severe scrotal and perianal pain, swelling, and high fever. A physical examination revealed a perianal abscess. Furthermore, the scrotum was gangrenous and exhibited extensive cellulitis in the perineum and bilateral inguinal area. Crepitations between the skin and fascia were palpable. A diagnosis of Fournier’s gangrene was made. The patient was treated with immediate surgical debridement under general anesthesia. He received broad-spectrum antibiotics, and debridement was repeated until the wound exhibited healthy granulation. Because both testes were severely exposed, they were transpositioned back into the scrotum 1 week after surgery. The patient was discharged on the 11th postoperative day.ConclusionsThe mainstay of treatment for Fournier’s gangrene should include fluid resuscitation, broad-spectrum antibiotic therapy, intensive care, nutritional support, and early aggressive surgical debridement of all necrotic tissue.
Highlights
Fournier’s gangrene is an acute surgical emergency characterized by high mortality rates ranging from approximately 13% to 45%
We present a case of Fournier’s gangrene (FG) that occurred in a patient who had undergone perianal abscess debridement and was successfully treated following early recognition in our department despite the severity of the patient’s condition
We present a case of FG that occurred in a patient who had undergone perianal abscess debridement and who was successfully treated following early recognition despite the severity of the patient’s condition
Summary
Our patient was a young man with FG that developed following a perianal abscess debridement. The cause of the FG was considered to be a potentially inadequate perianal abscess debridement and a sexually transmitted S. agalactiae infection. Hospitalization for this disease is typically long, with a reported average of 6 weeks [10]. Mortality rates are highest in patients presenting with sepsis, diabetes mellitus, and late admission to the hospital [10, 11]. Author details 1Department of Urological Surgery, Chang Gung Memorial Hospital, 123 Avenue Xiafei, Xiamen 361028, Fujian, China. Author details 1Department of Urological Surgery, Chang Gung Memorial Hospital, 123 Avenue Xiafei, Xiamen 361028, Fujian, China. 2Department of Urological Surgery, Chang Gung Memorial Hospital, No 5 Fuxing Street, Guishan District, Taoyuan, Taiwan
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