Group C Streptococcal Sepsis Complicating Fournier Gangrene

Mark A. Marinella, MD, FACP, CNSP, FACN, FACGS

Disclosures

South Med J. 2005;98(9):921-923. 

In This Article

Abstract and Introduction

Fournier gangrene is a life-threatening necrotizing fasciitis of the perineal-scrotal area that occurs in diabetic males. Patients typically present with systemic toxicity and significant inflammatory changes in the scrotum and perineum. Most cases of Fournier gangrene are polymicrobic and require urgent surgical débridement and broad-spectrum antibiotic therapy. We describe a case of Fournier gangrene in a young diabetic man that was associated with group C streptococcal bacteremia, an association previously unreported in the literature to our knowledge.

Diabetic patients who present with fever should undergo a meticulous search for obvious occult infection, since infection-related morbidity and mortality is often significant in this patient population. Although diabetics may present with common infectious processes similar to patients without diabetes, several unusual infections peculiar to diabetic patients must be considered in the appropriate setting, such as mucormycosis, malignant otitis externa, and necrotizing fasciitis.[1] A specific type of necrotizing fasciitis involving the perineum known as Fournier gangrene classically afflicts diabetic males with poor glycemic control.[2] This infection spreads rapidly throughout the perineal and scrotal tissues and may begin in a perirectal abscess. Reported below is the case of a young male with type 2 diabetes mellitus who presented with Fournier gangrene and sepsis due to group C streptococci.

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