Fournier gangrene associated with Crohn disease.
A 17-year-old boy presented with Fournier gangrene associated with previously undiagnosed Crohn ileocolitis. Fournier gangrene was managed by débridement, broad-spectrum antibiotics, and hyperbaric oxygen. A diverting ileostomy was performed before skin grafting and scrotal reconstruction. Microscopy of a full-layer surgical sample from the terminal ileum revealed granulomas with multinucleated histiocytes, consistent with Crohn disease. Crohn disease was treated with mesalamine, metronidazole, 6-mercaptopurine, and infliximab. The patient was discharged on hospital day 32. At 6-month follow-up, reconstruction of his scrotum had completely healed. Ostomy output was normal.
Jiang
T
T
Hospitalist Group, Greater Baltimore Medical Center, Baltimore, MD 21204, USA.
Covington
J A
JA
Haile
C A
CA
Murphy
J B
JB
Rotolo
F S
FS
Lake
A M
AM
D000293:Adolescent; D003424:Crohn Disease / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D003937:Diagnosis, Differential; D018934:Fournier Gangrene / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007079:Ileitis / Q000150:complications / Q000175:diagnosis; D007081:Ileostomy; D008297:Male; D019651:Plastic Surgery Procedures; D016038:Skin Transplantation; D016896:Treatment Outcome