| Author | Affiliation |
|---|---|
| Christopher Coyne, MD | Los Angeles County + USC Medical Center, Department of Emergency Medicine, Los Angeles, California |
| Thomas Mailhot, MD | Los Angeles County + USC Medical Center, Department of Emergency Medicine, Los Angeles, California |
| Phillips Perera, MD | Stanford University, Division of Emergency Medicine, Stanford, California |
A previously healthy 48 year-old male presented to the hospital with a 4-week history of “pimples” on his scrotum. This condition had progressively worsened, resulting in increased pain, swelling and redness to the genital region and buttocks. On physical examination, the patient was persistently tachycardic. The scrotum, penis, perineum and left buttock were erythematous, swollen and markedly tender to palpation. Furthermore, the patient’s suprapubic region contained an area of necrotic tissue.
As part of the initial assessment, the patient received a bedside ultrasound (US) that demonstrated marked thickening of the scrotal fascia with edema, as well as discrete areas of subcutaneous gas (Video). Based on these ultrasound findings, in conjunction with the clinical evaluation, the patient was diagnosed with Fournier’s Gangrene and intravenous antibiotics were started. He was then emergently transferred to the operating room without further advanced imaging, where he received aggressive surgical therapy with a good outcome.
Video. Ultrasound of scrotum demonstrating thickening of scrotal fascia.
Footnotes
Address for Correspondence: Christopher Coyne, MD, Los Angeles County + USC Medical Center, Department of Emergency Medicine, 2051 Marengo Street, Inpatient Tower-Room C1A100, Los Angeles, CA 90033. Email: coyne.usc@gmail.com. 3 / 2014; 15:122 – 122
Submission history: Revision received September 6, 2013; Submitted September 16, 2013; Accepted October 28, 2013
Conflicts of Interest: By the WestJEM article submission agreement, all authors are required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. The authors disclosed none.
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