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Case of the Month

July 2010

Patient Data: 46 year old male

Clinical Info: Painful red swollen scrotum and fever


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There is a massively swollen scrotal wall with highly reflective structures causing acoustic shadowing


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Another image of the swollen scrotal wall with highly reflective structures causing acoustic shadowing, that is caused by the presence of air in the scrotal wall.


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Detail of another part of the scrotal wall showing massive edema


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The scrotal wall shows increased vascularity


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There is also increased vascularity around the air in the scrotal wall


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Longitudinal image of the left testis. The testis and peritesicular structures are normal


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Transverse image of both normal testicles


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Axial CT scan image of the scrotal wall showing air in the wall


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Coronal CT scan image of the scrotal wall showing air in the wall

Fournier's gangrene is a type of necrotizing infection or gangrene usually affecting the perineum.
It was first described by Baurienne in 1764 and is named after a French venereologist, Jean-Alfred Fournier following five cases he presented in clinical lectures in 1883
Most cases are caused by an infection with both aerobic and anaerobic bacteria.
The presence of air in the soft tissues of the scrotal wall is one of the characteristics of Fournier's gangrene.
In this case the treatment was a wide surgical drainage procedure and treatment with antibiotics. The patient responded well to this treatment.
Fournier's gangrene is an urological emergency that when it is untreated can lead to sepsis and eventually death


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