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October 1990

Fournier's Gangrene: The Human Counterpart of the Local Shwartzman Phenomenon?

Author Affiliations

Department of Dermatology

Department of Urology

Department of Dermatology

Department of Plastic Surgery

Department of Internal Medicine

Department of Surgery Medical Center Leeuwarden Henri Dunantweg 2 89344 AD Leeuwarden, the Netherlands

Department of Bacteriology

Department of Pathology Laboratory for Public Health Jelsumerstraat 6 8917 EN Leeuwarden, the Netherlands

Arch Dermatol. 1990;126(10):1376-1377. doi:10.1001/archderm.1990.01670340128034

To the Editor.—  Fournier's gangrene of the penis and scrotum is a rare disease with a high mortality and is of unknown nature. We treated a patient successfully with high doses of prednisone, assuming that inflammatory mediators are essential for its pathophysiology.

Report of a Case.—  A previously healthy 39-year-old man was referred to us because of fever (39.9° C) and severe pain and swelling of the scrotum and penis. On admission the scrotum was swollen, red, and tender. The next day a bluish-black necrotic patch 3 cm in diameter was seen on the dorsum of the penis and multiple small necrotic areas developed on the scrotum. The surrounding redness and tenderness of the skin spread rapidly over the lower abdominal wall (Fig 1).Cultures of the lesions revealed Streptococcus pyogenes, Bac-teroides melaninogenicus, other Bacteroides species, peptococci, and eubacteria. Histologie findings showed erythrocyte extravasation, moderate inflammatory infiltrate with neutrophils throughout the dermis, and fibrin thrombi-occluded blood vessels.

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