Internal Medicine Flashcard| Volume 75, P97-98, May 2020

Rapidly progressive gangrene on the scrotum

Published:February 27, 2020DOI:
      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.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to European Journal of Internal Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • El-Qushayri A.E.
        • Khalaf K.M.
        • Dahy A.
        • Mahmoud A.R.
        • Benmelouka A.Y.
        • Ghozy S.
        • et al.
        Fournier’s gangrene mortality; a 17-year systematic review and meta-analysis.
        Int J Infect Dis. 2020; 92: 218-225
        • Kawahigashi T.
        • Kawabe T.
        • Iijima H.
        • Takagi M.
        • Suno Y.
        • Noda T.
        • et al.
        Beware of perianal pain: Fournier's gangrene.
        Am J Med. 2020; ([Epub ahead of print])
        • Bersoff-Matcha S.J.
        • Chamberlain C.
        • Cao C.
        • Kortepeter C.
        • Chong W.H.
        Fournier gangrene associated with sodium-glucose cotransporter-2 inhibitors: a review of spontaneous postmarketing cases.
        Ann Int Med. 2019; 170: 764-769