Fournier's gangrene (FG) is a polymicrobial aerobic and anaerobic bacterial infection with a rare occurrence of primary fungal aetiology. Here we report a case of FG caused by Candida parapsilosis as the primary organism in a 29-year-old man who presented with perineal soft-tissue infection. He had surgical debridement and colostomy for fecal diversion. He was treated with both antifungal and antibacterial drugs. This case highlights the need to consider fungal pathogens as primary aetiologic agents of FG. This further buttresses the need for antimicrobial stewardship with emphasis on targeted therapy to ensure patient safety.

Objective: The objective of the study is to report our experience with buccal mucosa harvest under local anesthetic agent infiltration for urethroplasty. Materials and Methods: All patients who had buccal mucosa graft harvest under local anesthesia (1% Xylocaine) for repair of their urethral stricture, from January 2007 to December 2016, were retrospectively studied from two public urologic service centers. The demographic data of the patient, length of graft harvested, complications recorded, among other things, were entered into a pro forma and the data were analyzed using IBM SPSS Statistics version 16. Results: A total of 102 patients underwent urethroplasty with buccal mucosa harvested under local anesthesia; however, only 88 patients had complete data for analysis. The mean age was 55.03 years (±12.30). The mean harvested graft length was 5.41 cm (±2.62 cm). There was no need for conversion to general anesthesia. The majority of them (94.3%) reported that it was “easy” or “very easy” to maintain the mouth opened during the procedure. Over 91% do not have difficulty opening their mouth after the harvest. Only a patient had bothersome primary hemorrhage that required gauze packing. No significant oral cavity pain was experience in 69.3% of patients; among those with pain, the perineal pain was more. Over 90% of the patients will be willing to undergo the procedure again under local anesthetic infiltration again. Conclusion: Buccal mucosa harvest under local anesthesia infiltration is feasible, safe, and acceptable among our patients who had urethroplasty for urethral stricture disease.

Rat bite is generally a rare form of animal bite suffered by humans. It is said to account for about 1-3% of all cases of animal bites to humans. Such bites commonly involve the limbs and rarely on the genitalia. Rat bite resulting in significant genital injury evidenced by scrotal skin loss with exposure of the testis has not been reported in the literature as far as the authors are aware. We hereby report the case of rat bite to the genitalia of an adult male with resultant significant injury.

No abstract