Partial penectomy after debridement of a Fournier’s Gangrene progressing with an isolated penile necrosis

Fournier’s gangrene is a rare and often fulminant necrotizing fasciitis of the perineum and genital region frequently due to polymicrobial infection. This truly emergent condition is typically seen in elderly, diabetic and immune compromised patients. Here, we report an unusual case of Fournier’s gangrene with isolated glans penis necrosis in a diabetic 77years old male who presented to the emergency department complaining of 5 days of pain, black color on glans penis. Examination of the patient’s glans penis was consistent with Fournier’s gangrene and included significant erythema, and infectious discharge. He was given intravenous antibiotics and emergency debridement was done. On following days the necrotic area spread to distal parts of both cavernosal areas. We performed partial penectomy. Isolated penile involvement in FG is very rare. Performing partial penectomy in appropriate cases can save penile length, stop the progression of disease and increase the quality of life.

Fournier gangreni debridmaný sonrasý devam eden izole penis nekrozunda parsiyel penektomi

Fournier Gangreni (FG) perine ve genital bölgenin nadir görülen ve sýklýkla kötü seyirli nekrotizan fasiitidir. Genellikle polimikrobial enfeksiyona baðlýdýr. Acil olan bu durum sýklýkla yaþlý, diyabetik ve immun sistemi zayýf hastalarda görülür. Bu vaka sunumunda size FG'nin nadir bir formu olan izole glans penis tutulumu ile baþvuran bir hasta sunacaðýz. 77 yaþýnda erkek hasta 5 gündür glans peniste aðrý ve siyah renk deðiþikliði ile baþvurdu. Glans penisin muayenesinde belirgin eritem ve iltihabi akýntý mevcuttu ve görünümü FG ile uyumlu idi. Antibiyoterapisi baþlanýp erken debridmaný yapýldý ancak takibin ilerleyen günlerinde nekrotik bölge kavernozal cisimlerin distaline doðru ilerledi. Hastaya parsiyel penektomi yapýldý. FG de izole penis tutulumu nadir olarak görülür ve uygun vakalarda zamanýnda parsiyel penektomi yapmak kalan penis boyutunu koruyup, hastalýðýn ilerlemesini önleyerek hayat kalitesini arttýrabilir.