Scrotal emphysema with characteristics of Fournier's gangrene in a community setting

Abstract

Fournier's gangrene is a life-threatening type of necrotizing fasciitis associated with a high rate of morbidity and mortality. The patient is a 29-year-old incarcerated male who presented to the ED with left-sided scrotal crepitus extending into the axilla and testicular swelling. The patient endorsed a pimple on his left scrotum accompanied with groin pain. He had a prior history of foreign body removal and self-mutilating behaviors. The patient was taken for surgical exploration out of concern due to a subcutaneous emphysema secondary to a necrotizing soft tissue infection.

Coexistence of human immuno deficiency virus, diabetes mellitus, epididymal cysts, and Fournier's gangrene: A case report

“…In addition to comorbidities, accompanying diseases have also taken their place in the etiology of Fournier gangrene. Unalp et al, found in their study that anorectal abscess and primary scrotal abscess accompany Fournier gangrene (11). In a case report reported by Cook et al, epididymal cysts were found to be present along with epididymis (12).…”

Pneumoscrotal Emphysema

“…The first one derives from the scrotum itself. This mechanism includes either self mutilation/injury of the scrotum where the air entry is direct [6] or infectious processes such as in perinephric abscess or Fouriner's gangrene that often presents with scrotal emphysema and leads to disruption of the scrotal skin allowing the entrance of microorganisms and air production within the scrotum [7].…”