[Fournier's gangrene: a case report]

Area of Science:

• Urology
• Infectious Diseases

Background:

• Necrotizing fasciitis of the genitalia (Fournier's gangrene) is a severe polymicrobial infection.
• It has a high mortality rate, necessitating early diagnosis and aggressive treatment.

Observation:

• A 73-year-old male with poorly controlled diabetes mellitus presented with scrotal swelling and pain.
• Initial treatment included broad-spectrum antibiotics, debridement, and insulin therapy.
• Culture results indicated Candida growth, leading to the administration of 5-fluorocytosine.

Findings:

• Despite initial medical management, gangrene persisted, requiring bilateral orchiectomy.
• Post-surgery, the gangrene resolved, the wound healed, and the patient's diabetes and general condition improved.

Implications:

• This case underscores the importance of surgical intervention, such as orchiectomy, in refractory cases of necrotizing fasciitis of the genitalia.
• Effective management of underlying conditions like diabetes is crucial for successful outcomes.
• Early and aggressive multimodal treatment is key to reducing mortality in Fournier's gangrene.