A 39 yrs old man felt unwell overnight with swelling and pain in his scrotum and penis. In the morning he felt BREATHLESS and had blood-stained fluid oozing from his penis. He called 108 & ambulance took him to casualty. The patient neglected fever,pain n redness of scrotum which was since 5 days, he had not visited hospital earlier because he was frightened & because he was sole guardian of his teenage son, who had to come with him. The patient had NO significant Medical or Sexual history, Not on any regular medications or No allergies, &his last sexual contact was over two years ago. Not K/c/o HTN Or DM ON GP EXAMINATION , RR = 39 Cycles/minute BP = 120/75mmhg, Oxygen saturations of 97% temperature = 98.7°F ABG showed a marked compensated alkalosis with a lactate 3.9mmol/l. Venous blood results showed a CRP of 535 mg/l, urea of 11 mmol/l &creatinine 200 µmol/l. **ECG shows SINUS TACHYCARDIA with Rate of 140bpm blood is sent for culture and all possible investigations. WHAT WOULD BE THE PROBABLE Diagnosis and management of this condition ???



Infective origin scrotal and penile inflammation leading towards Fournier's gangrene. It is a surgical emergency. To be treated earliest before severe septicaemia and complete exposure of scrotal contents occur. Surgical debridement, Iv fluids and correction of dehydration amd electrolyte disturbances, antibiotics parenteral Piperacillin 4gms + Tazobactum 500 mg BD for 7 days followed by oral antibiotics should be immediately resorted to. Mortality rate is high in such cases if not promptly treated. Rule out DM and alcoholism. Other supportive treatment including O2 inhalation is required

I agree with Dr P Yograj

Minor trauma, sometimes even trivial itching can lead to cellulitis of the scrotum. Once the cellulitis progresses it leads to necrotising fascitis called fourniers gangrene that has to be managed aggressively with debridement, intravenous antibiotics, oxygen support and regular dressings. Mortality is as high as 10 to 30 %

Fournier's gangrene Rx. Debridement & washing of wound with H2O2 + povidene 5% solution. C& S. Antibiotics Inj imipenem , Inj metronidazole Putting the patient on ventilator if there's any breathing problem.

Patient is suffering from fourniers gangrene He needs urgent surgical treatment for debridement or else he may land into septicemia and multiorgan failure

Fourniers gangrene needs triple antibiotics good hyigen and later on debridments and excision of dead tissues if it was progressing

Fournier' s gangrene . 3rd generation cephalosporins and amoxyclav, adequate debridement and skin grafting at a later date.

Fourniers gangrene Antibiotics Surgical debridment Supportive measures

Fourniers gangrene. Debridement under GA. Urinary diversion for few weeks

Was he diabetic Looks like forniers Debribment and antibiotics

Non diabetic sir.

Fourniers gangrene broad spectrum. Antibiotics

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