Isolated Penile Fournier's Gangrene: A Rare Case

Batmaz, Orkun; Uçar, Murat; Caylan, Ahmet Ender; Gök, İsmail B; Vural, Veli

doi:10.7759/cureus.7953

Cited by 3 publications

(2 citation statements)

References 6 publications

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“…The majority of cases are polymicrobial and require emergent debridement and wide-spectrum antibiotic treatment [ 4 ]. Colorectal sources (30–50%), urogenital sources (20–40%), cutaneous infections (20%), and local trauma are the main causative agents for Fournier’s gangrene [ 5 ]. It is usually seen in immunocompromised patients such as those with diabetes or end-stage renal disease [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…Colorectal sources (30–50%), urogenital sources (20–40%), cutaneous infections (20%), and local trauma are the main causative agents for Fournier’s gangrene [ 5 ]. It is usually seen in immunocompromised patients such as those with diabetes or end-stage renal disease [ 5 ]. Penile gangrene is a rare entity that can manifest in two forms: dry or wet, each of which requires different processing [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

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Penile gangrene due to improper application of a condom catheter: a case report

et al. 2023

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Background Fournier’s gangrene is a rare, fulminant, and usually localized necrotizing soft tissue polymicrobial infection of the perineum, with occasional extension up to the abdominal wall. Case presentation We describe an unusual case of penile gangrene in a 64-year-old Tunisian man suffering from urinary incontinence secondary to cerebrovascular accident. Gangrene developed due to continuous tourniquet effect on the penis caused by a condom catheter. Although source control was achieved with aggressive debridement, careful wound care, and wide-spectrum antibiotherapy, the patient died due to septic shock. Conclusion Use of condom catheters is not without complications. Careful placement, strict hygiene, and regular monitoring of the local condition are necessary.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Penile gangrene due to improper application of a condom catheter: a case report

et al. 2023

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Management of Fournier’s gangrene during the Covid-19 pandemic era: make a virtue out of necessity

Paladini

Cochetti

Tancredi

et al. 2022

Basic Clin. Androl.

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Background Fournier’s gangrene (FG) is a necrotizing fasciitis caused by aerobic and anaerobic bacterial infection that involves genitalia and perineum. Males, in their 60 s, are more affected with 1.6 new cases/100.000/year. Main risk factors are diabetes, malignancy, inflammatory bowel disease. FG is a potentially lethal disease with a rapid and progressive involvement of subcutaneous and fascial plane. A multimodal approach with surgical debridement, antibiotic therapy, intensive support care, and hyperbaric oxygen therapy (HBOT) is often needed. We present the inpatient management of an FG case during the Covid-19 pandemic period. A narrative review of the Literature searching “Fournier’s gangrene”, “necrotizing fasciitis” on PubMed and Scopus was performed. Case presentation A 60 years old man affected by diabetes mellitus, with ileostomy after colectomy for ulcerative colitis, was admitted to our Emergency Department with fever and acute pain, edema, dyschromia of right hemiscrotum, penis, and perineal region. Computed tomography revealed air-gas content and fluid-edematous thickening of these regions. Fournier’s Gangrene Severity Index was 9. A prompt broad-spectrum antibiotic therapy with Piperacillin/Tazobactam, Imipenem and Daptomycin, surgical debridement of genitalia and perineal region with vital tissue exposure, were performed. Bedside daily surgical wound medications with fibrine debridement, normal saline and povidone-iodine solutions irrigation, iodoform and fatty gauze application, were performed until discharge on the 40th postoperative day. Every 3 days office-based medication with silver dressing, after normal saline and povidone-iodine irrigation and fibrinous tissue debridement, was performed until complete re-epithelialization of the scrotum on the 60th postoperative day. Conclusions FG is burdened by a high mortality rate, up to 30%. In the literature, HBOT could improve wound restoration and disease-specific survival. Unfortunately, in our center, we do not have HBOT. Moreover, one of the pandemic period problems was the patient’s displacement and outpatient hospital management. For all these reasons we decided for a conservative inpatient management. Daily cleaning of the surgical wound allowed to obtain its complete restoration avoiding surgical graft and hyperbaric oxygen chamber therapy, without foregoing optimal outcomes.

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