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Rapidly progressive gangrene on the scrotum

Published:February 27, 2020DOI:https://doi.org/10.1016/j.ejim.2020.02.018
      A 35-year-old man presented at our hospital with high fever (up to 39.7 °C), and progressive edema and pain of the scrotal and perineal region for 7 days. He had received intravenous levofloxacin at local hospital since 2 days after onset of the symptoms. He has a history of unwell-controlled diabetes mellitus for the last 2 years. Clinical examination revealed a mousy odor, swelling, exudation and necrosis of the penis and scrotum (Fig. 1). The leukocyte count was 16.2 × 109/L, and neutrophil was 15.4 × 109/L (94.8%). Enterococcus faecalis and Klebsiella pneumoniae grew from the cultures of exudation and necrotizing tissues. Blood culture grewed K. pneumoniae and Escherichia coli. A plenty of Gram negative bacteria were found in the exudation. Fournier's gangrene was diagnosed. Broad spectrum antibiotics were given, and adequate debridement with excision of all necrotic tissue was done. The patient received a surgical debridement and he was stable without fever after the surgery.
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