Fournier's gangrene with retroperitoneal extension in an immunocompetent patient

A male patient in his 80s presented with the classic signs of Fournier's gangrene. At his initial debridement, an unusual florid involvement of the right cord was noted requiring a right inguinal orchidectomy in addition to extensive debridement. Although he subsequently stabilised in the intensive care unit, his inflammatory markers were noted to uptrend again requiring a relook procedure which revealed evidence of progressive necrosis in the right inguinal region. After further debridement, a CT scan of the abdomen and pelvis revealed intra-abdominal extension of the disease process with a retroperitoneal collection adjacent to the caecum-a rare complication of Fournier's gangrene. This required open surgical drainage for adequate disease control. He subsequently underwent split skin grafting prior to discharge to a rehabilitation facility.