Fournier’s Gangrene

• Published in: The New England journal of medicine Vol. 376; no. 12; p. 1158
• Main Author: Huang, Chih-Sheng
• Format: Journal Article
• Language: English
• Published: United States Massachusetts Medical Society 23-03-2017
• Subjects: Case reports; Diabetes; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - complications; Fournier Gangrene - etiology; Fournier Gangrene - pathology; Fournier Gangrene - therapy; Gangrene; Humans; Liver diseases; Liver Diseases, Alcoholic - complications; Male; Middle Aged; Perineum - diagnostic imaging; Perineum - pathology; Scrotum; Scrotum - diagnostic imaging; Scrotum - pathology; Tomography, X-Ray Computed
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMicm1609306

A 46-year-old man with uncontrolled type 2 diabetes and alcoholic liver disease presented with painful swelling in his scrotum and perianal region; physical examination was notable for necrotic-appearing tissue in both areas.
A 46-year-old man with uncontrolled type 2 diabetes and alcoholic liver disease presented to the emergency department with painful swelling in the scrotum and perianal region. His temperature was 37.7°C, his pulse 130 beats per minute, and his blood pressure 97/61 mm Hg. The physical examination was notable for necrotic-appearing tissue in the scrotum and perineum, with areas of induration and crepitus (Panel A). Computed tomography revealed subcutaneous emphysema in the scrotum and perianal fascia, in addition to air in the pararectal fascia and rectal wall (Panel B, arrow). A diagnosis of Fournier’s gangrene, or necrotizing fasciitis of the perineum, . . .