Question 14.1
A 75 year old man was admitted 3 days post prostatectomy with a febrile illness. Examination revealed lower abdominal tenderness and a clinical photograph of his groins and external genitalia is shown below.
a) What is shown in this picture below?
b) List 2 important management steps
College Answer
a) What is shown in this picture below?
Fournier’s gangrene.
b) List 2 important management steps
Urgent surgical debridement
Use of meropenem or other reasonable combinations
A clinical photograph of Fournier’s gangrene was supplied.
Discussion
The image above was stolen shamelessly from www.christem.com. No permission was asked for.
If they ask me to take it down, they do so with the knowledge that they have sent a very motivated man into the community with the explicit purpose of photographing genitals in early stages of decomposition. Cui bono?
One could get very clever about this condition, but the bottom line is simple. Surgical debridement is the only thing that saves lives in this condition. Broad spectrum antibiotics are of course mandatory, and meropenem is a good choice.
References
Eke, Ndubuisi. "Fournier's gangrene: a review of 1726 cases." British Journal of Surgery 87.6 (2000): 718-728.