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Fournier's Gangrene. Presented by Drs. A. J. Orfuss and P. Michaelides.
The patient was a 74-year-old white man who was first admitted to the Manhattan Veterans Hospital for diabetes mellitus and a deep ulcer on the anterior aspect of the lower third of the left leg. Five days after admission, while the diabetes was being controlled and the ulcer on the leg was being treated by local cleansing and by systemically administered antibiotics (penicillin and streptomycin), the patient suddenly developed severe pain in the perineum, fever (102.4F [39.1 C]), nausea, and vomiting. Upon examination the scrotum was seen to be enlarged to three times normal size. On its anterior surface a line of demarcation of erythema and edema developed; on the posterior aspect a black line of demarcation suggesting necrosis appeared. The perineum and perianal area became erythematous and edematous; central ulceration and expanding necrosis supervened rapidly (see Fig 1). Foul-smelling
BRONX DERMATOLOGICAL SOCIETY. Arch Dermatol. 1964;90(4):440–443. doi:10.1001/archderm.1964.01600040068016
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