[Fournier's Gangrene with M1UK-Lineage Streptococcus Pyogenes Infection : A Case Report]

A 37-year-old man with a history of chronic myeloid leukemia presented to our hospital with fever and right scrotal pain. Computed tomography (CT) revealed subcutaneous fluid in the soft tissues of the scrotum and penis. His white blood count was 3,700/μl and C-reactive protein (CRP) was 44.66 mg/dl. Broad-spectrum antibiotics were subsequently administered. The following day, the patient was diagnosed with disseminated intravascular coagulation (DIC) and showed necrotic changes in the skin of the penis and scrotum along with erythema and tenderness extending to the left flank. This led to the diagnosis of Fournier's gangrene. The patient underwent emergency debridement and right scrotal content excision and was managed in the intensive care unit. The patient recovered from DIC 2 days after the surgery, underwent wound closure and skin grafting 29 days after the first surgery, and was discharged 43 days after the first surgery. Later, an analysis by the National Institute of Infectious Diseases revealed that the causative pathogen was the M1UK strain.