A Case of Fournier’s Gangrene (Fulminating Gangrene of the Male Genitalia) Associated with Eruptions Appearing as Pyoderma Gangrenosum

Abstract

We treated a man with Fournier’s gangrene (fulminating gangrene of the male genitalia) associated with eruptions appearing as pyoderma gangrenosum. This 64-year-old man was admitted to the hospital with painful penile gangrene. He had no apparent history of previous infection. Significant in the history was therapy with diaminodiphenyl sulphone (DDS) for eruptions appearing as pyoderma gangrenosum on the extremities and buttock of 8 months duration. Cultures yielded Pseudomonas aeruginosa, Staphylococcus aureus and Streptococcus faecalis. Despite serial débridement of all necrotic tissue of the penis, combined with systemic administration of broadspectrum antibiotics his condition continued to deteriorate. His body temperature was high and gangrene progressively developed in the penis and scrotum, necessitating bilateral orchiectomy and amputation of the penis. The clinical course and pathological feature were compatible with those reported as Fournier’s gangrene. Preexisting eruptions and DDS administration seemed to be the predisposing conditions, but the source of infection may be difficult to identify in this case.