Fournier's Gangreneの1例

Abstract

Since necrotizing fasciitis of the genitalia was first described by Fournier in 1883, approximately 400 cases have been reported. It has been seldom reported in Japan. Because its mortality rate is still high, the importance of early diagnosis and the subsequent vigorous treatment has been emphasized. A 73-year-old man who had poor controlled diabetes mellitus was admitted to our hospital with painful swelling of scrotum. Chemotherapy using broad spectrum antibiotics and debridement of scrotal skin was performed combined with insulin therapy. As culture of pus and excised tissue from the gangrenous patches yielded the growth of candida, we used 8 g/day of 5-fluorocytosine. Because the gangrene was not healed, we performed bilateral orchiectomy. After the operation, the gangrene was healed and the wound was closed. Diabetes mellitus was controlled well and his general condition was improved.