Abstract
Background
Fournier's gangrene (FG) is an uncommon but rapidly progressive necrotizing soft-tissue infection involving the perineum, external genitalia, and perianal region. As a time-critical urological and emergency condition, it requires prompt recognition, broad-spectrum antimicrobial therapy, metabolic stabilization, and urgent surgical source control.
Case summary
We report a 47-year-old man who developed fever, marked scrotal swelling, skin breakdown, and purulent discharge after an episode of intestinal obstruction complicated by possible intra-abdominal infection. FG was diagnosed on the basis of the clinical presentation, microbiological findings, and abdominopelvic computed tomography showing extensive gas-forming infection extending from the scrotum to the pelvis, abdominal wall, and retroperitoneal structures. Cultures from blood and wound exudate grew Klebsiella pneumoniae. The patient received integrated treatment comprising broad-spectrum antimicrobial therapy, glycaemic control, and repeated surgical debridement. After more than two months of treatment, his symptoms markedly improved, with satisfactory wound healing.
Conclusion
This case describes FG arising after intestinal obstruction complicated by suspected intra-abdominal infection, with extensive perineal and scrotal wounds already present at admission and wide anatomical spread of infection confirmed intraoperatively. The patient recovered gradually after repeated radical surgical debridement and broad-spectrum antimicrobial therapy. The diagnostic course and surgical strategy in this case may offer practical insight into the management of extensive FG.