title: Fournier's gangrene: diagnosis and management aided by repeated clinical examination and ultrasound.
abstract: We describe a case of a man aged 57 years admitted to our tertiary centre via his general practitioner, presenting with a 1-week history of scrotal pain, testicular swelling and fluctuance. He was initially managed in the community with flucoclaxacillin for 1 week, but failed to respond to treatment. Clinical history was suggestive of Fournier's gangrene, but initial examination was not conclusive. Repeated examination over the next hour aided diagnosis and helped to track the progression of the condition. The patient was treated with intravenous antibiotics and prepared for theatre. Since there was a delay in getting the patient to theatre, an ultrasound scan was performed to help ascertain the extent of the disease to aid surgical planning. Following successful debridement and skeletalisation of the testicles and ward recovery, he was transferred for plastic reconstruction.
authors.affiliation: Department of Urology, Cardiff and Vale University Health Board, Cardiff, UK.
authors.forename: Jayan
authors.identifier: http://orcid.org/0000-0001-8899-6620
authors.initials: J
authors.lastname: George
authors.affiliation: Department of Urology, Cardiff and Vale University Health Board, Cardiff, UK.
authors.forename: Aditya
authors.initials: A
authors.lastname: Raja
authors.affiliation: Cardiff University School of Medicine, Cardiff, UK.
authors.forename: David
authors.initials: D
authors.lastname: Chun Hei Li
authors.affiliation: Department of Urology, Cardiff and Vale University Health Board, Cardiff, UK.
authors.forename: Hrishi
authors.initials: H
authors.lastname: Joshi
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003646:Debridement; D018934:Fournier Gangrene / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012611:Scrotum; D013733:Testicular Diseases / Q000209:etiology / Q000628:therapy*; D014463:Ultrasonography
chemical_list: D000900:Anti-Bacterial Agents