Fournier's gangrene in elderly men: A report of two cases

Abstract

Introduction: Fournier's gangrene, a polymicrobial infection affecting the scrotum and perineal area, predominantly affects elderly males, presenting challenges in diagnosis and management. This report examines two cases, with a focus on the rare outcome of bilateral orchidectomy.

Case presentation: A 69-year-old diabetic male presented with severe penile and scrotal pain, leading to the diagnosis of Fournier's gangrene. In another case, a 91-year-old male with a history of Benign Enlargement of the Prostate experienced scrotal pain and ulcerative lesions, resulting in a rapid progression of gangrene. The surgical approaches encompassed multiple debridement and bilateral orchidectomy, underscoring the intricate nature of managing Fournier's gangrene.

Discussion: Fournier's gangrene typically originates as a polymicrobial infection in the genitourinary or perianal regions, with common risk factors including diabetes, immunosuppression, and advanced age. Diagnosis often relies on clinical assessment, though imaging aids in complex cases. Early intervention with broad-spectrum antibiotics and repeated debridement remains the cornerstone of treatment.

Conclusion: Fournier's gangrene, a rare condition, poses diverse clinical presentations, management strategies, and outcomes. Early recognition, aggressive surgical debridement, and a multidisciplinary approach are essential in managing this condition.

Keywords: Fournier's gangrene; Necrotizing fasciitis; Scrotum; Surgical debridement.