Isolated Penile Fournier’s gangrene: A case report and literature review

BACKGROUND: Fournier’s gangrene(FG) is a rare, necrotizing fasciitis of the external genitalia, perineal or perianal regions. Penile FG is a very rare clinical entity. It is reported in only a few cases in the literature. CASE DESCRIPTION: We reported an unusual case of isolated penile FG of a 58-year-old man with uncontrolled diabetes. Our patient presented for blackish discoloration and painful swelling of the penis associated with high-grade fever. The patient was treated with immediate surgical debridement after he received broad-spectrum antibiotics. When the wound exhibited healthy bed, we used an unexpanded, meshed, split-thickness skin graft for penile reconstruction. The recovery phase was uneventful with satisfactory cosmetic results. DISCUSSION: FG is a rare necrotizing infection of the perineum and genital region with a high mortality rate that can reach up to 50% of cases. It is frequently due to polymicrobial infection. The diagnosis is often made clinically, although radiologic studies can be helpful to define the extent of the disease. The clinical features of FG include sudden pain and swelling in the scrotum or wound discharge. Isolated penile FG are documented in few cases where the corpora cavernosa are usually spared. Its presence are related to patients sexual habits or traumatic insult. Mainstays of treatment include rapid and aggressive surgical debridement of necrotized tissue, broad-spectrum antibiotic and early resuscitation. CONCLUSION: Only a few cases of penile FG have been reported. Early debridement of all necrotic tissue is the golden rule.