[Extensive Fournier's gangrene: a case report].
We report a case of extensive Fournier's gangrene that could not be rescued despite emergent debridement. A 51-year-old man presented at another hospital with cough, diarrhea and abdominal pain. He was diagnosed with acute enteritis and hospitalized. The next morning, he became severely hypotensive and his scrotum was swollen and black. The perineal skin also was black. Septic shock and disseminated intravascular coagulation were suspected. He was transferred to our emergency room, and was immediately diagnosed with Fournier's gangrene and acute peritonitis. Computed tomographic scan revealed soft-tissue gas in the scrotum, the retroperitoneal cavity and the abdominal wall. Emergent debridement and laparotomy was performed. Gangrene was also seen at the intestinal wall and the peritoneum, however, resection of intestine was not done because of his poor performance status. Although potent antibiotics and catecholamine were administered, he died of multiple organ failure 29 hours after the operation. This is the first case of Fournier's gangrene extending into the abdominal cavity reported in the Japanese literature.
Department of Urology, Kobe City General Hospital.
K
K
Miura
T
T
Kobayashi
Y
Y
Matsui
K
K
Fujikawa
S
S
Fukuzawa
A
A
Soeda
H
H
Takeuchi
D000208:Acute Disease; D001442:Bacteroides Infections; D001441:Bacteroides fragilis; D003646:Debridement; D004630:Emergencies; D013293:Enterococcus faecalis; D018934:Fournier Gangrene / Q000150:complications / Q000473:pathology / Q000628:therapy*; D016908:Gram-Positive Bacterial Infections; D006801:Humans; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D010502:Perineum; D010538:Peritonitis / Q000150:complications / Q000382:microbiology; D012611:Scrotum; D013290:Streptococcal Infections; D013297:Streptococcus pyogenes