Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 16, 2021; 9(5): 1215-1220
Published online Feb 16, 2021. doi: 10.12998/wjcc.v9.i5.1215
Management protocol for Fournier’s gangrene in sanitary regime caused by SARS-CoV-2 pandemic: A case report
Agnieszka Grabińska, Łukasz Michalczyk, Beata Banaczyk, Tomasz Syryło, Tomasz Ząbkowski
Agnieszka Grabińska, Tomasz Syryło, Tomasz Ząbkowski, Department of Urology, Military Institute of Medicine, Warsaw 04-141, Poland
Łukasz Michalczyk, Beata Banaczyk, Department of Urology and Oncologic Urology, Praski Hospital in Warsaw, Warsaw 04-141, Poland
Author contributions: Grabińska A reviewed the literature, contributed to manuscript drafting, collected data, analyzed and interpreted the imaging findings; Michalczyk Ł and Banaczyk B reviewed the literature and contributed to manuscript drafting; Syryło T and Ząbkowski T were responsible for the revision of the manuscript for important intellectual content; all authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Tomasz Ząbkowski, PhD, Professor, Department of Urology, Military Institute of Medicine, 128 Szaserów, Warsaw 04-141, Poland. urodent@wp.pl
Received: December 2, 2020
Peer-review started: December 2, 2020
First decision: December 21, 2020
Revised: December 23, 2020
Accepted: January 7, 2021
Article in press: January 7, 2021
Published online: February 16, 2021
Processing time: 58 Days and 20.3 Hours
Abstract
BACKGROUND

Fournier's gangrene (FG) is a serious, aggressive and often deadly polymicrobial infection of the soft tissues of the perineum, the rectum and the external genital organs. It is an anatomical subcategory of necrotizing fasciitis, which has a similar etiology and treatment strategy.

CASE SUMMARY

A 60-year-old man was admitted to the hospital during severe acute respiratory syndrome coronavirus 2 pandemic with complaints of fever up to 38.9 °C, abdominal pain, and edema of the scrotum, the penis, the perineum, and the right gluteal region for 2 d. Computed tomography of the abdomen and the pelvis revealed extensive inflammatory infiltrations of the subcutaneous tissue of the hypogastrium, and the penis; along with liquefaction and presence of gas in the subcutaneous tissues of the scrotum, the perineum, and the right gluteal region. The patient was diagnosed with FG, and was urgently qualified to undergo surgery in the Department of Urology. After performing the necessary examinations, a resection of the necrotic tissues with bilateral orchiectomy and excision of the penile and scrotal skin was performed. After surgery, he was transferred to the intensive care unit for further management.

CONCLUSION

Early management prevents the resection of the other organs by inhibiting the contiguous spread of infection.

Keywords: Fournier’s gangrene; Management; Negative pressure wound therapy; Treatment; Orchiectomy; Case report; Necrotic tissues; SARS-CoV-2

Core Tip: Fournier's gangrene (FG) is a serious and often deadly polymicrobial infection of the soft tissues of the perineum, the rectum and the external genital organs. We present herein, a case of patient diagnosed with FG, urgently qualified to undergo surgery. After performing the examinations, a resection of the necrotic tissues with bilateral orchiectomy and excision of the penile and scrotal skin was performed. This case highlights that the mortality rate of FG can be reduced if a patient is presented early to the hospital. Early management prevents the resection of the other organs by inhibiting the contiguous spread of infection.