title: Unusual presentation of necrotizing fasciitis in a patient who had achieved long-term remission after irradiation for testicular cancer.
abstract: We report a case of a 60-year-old man with necrotizing fasciitis complicated by streptococcal toxic shock syndrome. The patient had received high-dose chemotherapy and radiotherapy to the pelvis for relapsed seminoma 7 years previously. He had been in long-term remission. He was admitted to the Tsukuba University Hospital, Tsukuba-City, Ibaraki, Japan, with complaints of fever and localized erythema over the foreskin. The patient suffered from septic shock and multiple organ failure. Despite intensive care, he died 18 h after admission. Streptococcus pyogenes was isolated from both the wound and blood culture. To our knowledge, this is the first description of necrotizing fasciitis primarily affecting the penile skin.
authors.affiliation: Department of Urology, Institute of Clinical Medicine, University of Tsukuba, Tsukuba-City, Ibaraki, Japan. tomoaki.miyagawa@ibabyo.hitachi.co.jp
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Miyagawa
authors.forename: Koji
authors.initials: K
authors.lastname: Kawai
authors.forename: Mizuki
authors.initials: M
authors.lastname: Onozawa
authors.forename: Kazunori
authors.initials: K
authors.lastname: Hattori
authors.forename: Toru
authors.initials: T
authors.lastname: Shimazui
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Akaza
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D019115:Fasciitis, Necrotizing / Q000209:etiology*; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology; D011878:Radiotherapy; D012074:Remission Induction; D018239:Seminoma / Q000628:therapy*; D012772:Shock, Septic / Q000209:etiology; D013290:Streptococcal Infections / Q000150:complications*; D013297:Streptococcus pyogenes; D013736:Testicular Neoplasms / Q000628:therapy*
chemical_list: D000970:Antineoplastic Agents