Fournier's gangrene caused by accidental ingestion of a date pit: a case report

Fournier's gangrene is a rare yet rapidly progressive necrotizing fasciitis that primarily affects the perineal, genital, and perianal regions. Mixed aerobic and anaerobic bacterial infection characterizes it. Urogenital tract infections, intestinal inflammation, or local trauma commonly trigger the condition. However, gastrointestinal foreign bodies seldom directly trigger cases in clinical practice. This paper describes such a case.

A 65-year-old male patient was admitted, presenting with "perianal pain for one week." Initial examination revealed erythema and swelling around the anus and at the base of the scrotum. The condition deteriorated rapidly within 4 hours. Infection spread extensively to encompass the entire scrotum and ventral aspect of the penis. Following prompt diagnostic investigations, debridement surgery was performed. Intraoperatively, a date pit was extracted from the infected perianal lesion. This established it as the source of infection. Combined with the patient history, this confirmed a diagnosis of Fournier's gangrene resulting from the presence of the date stone. Postoperatively, the patient underwent antimicrobial therapy and wound dressing changes. Approximately 3 months later, the patient had largely recovered.

In this case, the patient's ingestion of a date pit led to its passage through the anus. It pierced the intestinal wall and entered the perianal space. This caused a perianal infection that ultimately progressed to Fournier's gangrene. Additionally, the patient's long-standing hyperglycemia likely contributed to the rapid disease progression. The key to management is early diagnosis and prompt surgical debridement. The lesion required thorough drainage and daily postoperative dressing changes. This was combined with broad-spectrum antibiotic therapy to combat infection and control blood glucose within normal ranges.

Date pits rarely cause Fournier's gangrene. Early diagnosis and debridement are key to preventing progression and reducing mortality.