MEDizzy
MEDizzy
Yasir
Yasirover 3 years ago
Fornier's gangrene
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Fornier's gangrene

27-year-old male patient reported to the hospital with complaints of painful swelling of the scrotum for 3 days and fever with discharge from the scrotum for 2 days. There was history of minor injury over left side of the scrotum 6 days back, for which he had not taken any treatment. There was no history of diabetes mellitus. Patient was not an alcoholic. He was not from a filarial endemic zone. On examination, he was conscious. There was no pallor, icterus, and lymphadenopathy. He was mild dehydrated. His pulse was 110/min, regular, and good volume. His blood pressure was 110/78 mm Hg. Systemic examination revealed no abnormality. Local examination of the scrotum revealed that scrotum was enlarged, edematous, and tender along with palpable crepitations. There was patchy gangrene all over the scrotum more over left side with foul-smelling purulent discharge . A provisional diagnosis of FG was made. The patient was resuscitated and investigated. Broad-spectrum antibiotics in form of cefoperazone and sulbactum along with metronidazole were started. He was prepared for emergency surgical debridement. Blood haemogram revealed hemoglobin (Hb%)—14 gm%, white cell count—19,500/cmm with polymorph nuclear leucocytosis (N-85%). Biochemical parameters were essentially normal (blood urea: 40 mg%, serum creatinine: 1.0 mg%, random blood sugar: 110 mg%, and LFT: within normal range). He was taken up for emergency debridement. All the devitalized tissue was excised . Pus was sent for culture and sensitivity test. Postoperatively patient was managed with broad-spectrum antibiotics and wet dressing. Culture revealed Staph.aureus and E. coli sensitive to cefoperazone and sulbactum. He responded to the treatment very well . Regular wet dressing was done along with topical application of povidone iodine. On 10th postoperative day, his wound was reconstructed with secondary suturing . He was discharged on 22nd postoperative day. A review after six weeks revealed the patient to be symptom free.

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Top rated comment
over 3 years ago

Does it have any consequences on fertility?

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over 3 years ago

Since you have to remove all the dead tissue and scrotal skin, the testicles get exposed and therefore the ideal temperature for sperm production is no longer attainable.Therefore the gonads are no longer productive.

over 3 years ago

I see. Makes sense. Thanks for the info.

over 3 years ago

great question and answer !!

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