Fournier’s Gangrene: A Case Report

Fournier’s gangrene is a rapidly progressive necrotizing fasciitis of penile, genital and perianal regions. Despite increasing knowledge about aetiology, diagnosis procedures and treatment, the gangrene is still destructive and potentially lethal. The case under discussion is based on a patient with diabetes mellitus and alcohol abuse who presented with pain in his scrotum. A 37-year-old Hispanic male was admitted with pain in his testicles but was discharged on the same day on oral antibiotics and referred to the urologist. However, on the same day night, he was found dead on his bed. He was a known patient with diabetes mellitus, high cholesterol, bipolar affective disorder and hypertension for more than 10 years. He was an alcoholic and known to use illegal drugs. The autopsy revealed necrosis of the skin of pubic, perineum and perianal areas. The heart was unremarkable. Liver and lungs had subtle changes. Both kidneys, bladder, ureters and prostate were normal. The testicles in the scrotum appeared normal. The skin of the scrotum and penis had hemorrhagic necrosis. Histology of the scrotum showed necrosis and acute inflammatory foci with bacterial colonisations. Toxicology of blood and urine showed non-lethal levels of alcohol and recreational drugs. Finally, the cause of death was given as Fournier’s gangrene in a subject with diabetes mellitus. There were no circumstantial evidence of foul play, suicidal or homicidal activities. Considering autopsy findings, histopathology, toxicology and circumstantial evidence the cause of death was given as Fournier’s gangrene and the contributory cause was diabetes mellitus.