The diagnosis shows that JC is suffering from Fournier’s gangrene. This is based on the patient’s systemic symptoms and physical examination, which indicates a rapid heartbeat, high fever, and blood pressure, as well as intense pain and swelling in the genital regions (Joury et al., 2019). Conversely, the differential diagnosis that narrows down this working diagnosis is centered on the patient’s family history of diabetes and obesity, as well as blood tests and a CT scan. These rule out other possible conditions that may look similar to this disease, for instance, orchitis and epididymitis.
Fournier’s gangrene often develops because of an infection in or around the genital area. The primary sources of the disease may include abscesses (a swollen body tissue that contains pus), trauma, or injury near the perineal or genital areas (Moussa & Abou Chakra, 2019). The breaks or piercings to the skin may act as a pathway by which bacteria are introduced in the body, subsequently triggering the infection’s rapid multiplication and spread.
Several risk factors are believed to increase people’s susceptibility to Fournier’s gangrene. These include habitual alcohol consumption, hypertension, diabetes, and impaired immunological defenses due to obesity, known to increase vulnerability to this disease (Joury et al., 2019). JC admits to drinking alcohol, he is 5′10″ tall and weighs 260 lb (implying that he is overweight), and his mother has diabetes. All these are the key predisposing factors for developing Fournier’s gangrene.
Fournier’s gangrene may be caused by viruses, fungi, or bacteria. Nonetheless, many cases of this infection may result from anaerobic and aerobic bacteria such as Bacteroides fragilis, Clostridium perfringens, Escherichia coli, Staphylococcus aureus, or group A Streptococcus (El-Qushayri et al., 2020). Most of these microbes are found within the genital and perineum organs. Therefore, this is a polymicrobial infection where multiple microorganisms act in synergy to affect particular body parts.
There are several treatment approaches that healthcare practitioners may recommend for Fournier gangrene, depending on its severity. One of the most common treatment options is the use of strong intravenous antibiotics aimed to cure the infection. In addition, surgical debridement, which involves sterilization of the affected areas and removing dead cells to prevent further spread, may be considered (Chernyadyev et al., 2018). In case of excess tissue or skin on the infected area, surgery may be suggested to eliminate the unwanted skin.
References
Chernyadyev, S., Ufimtseva, M., Vishnevskaya, I., Bochkarev, Y., Ushakov, A., & Beresneva, T. et al. (2018). Fournier’s gangrene: Literature review and clinical cases. Urologia Internationalis, 101(1), 91-97. Web.
El-Qushayri, A., Khalaf, K., Dahy, A., Mahmoud, A., Benmelouka, A., & Ghozy, S. et al. (2020). Fournier’s gangrene mortality: A 17-year systematic review and meta-analysis. International Journal of Infectious Diseases, 92, 218-225.
Joury, A., Mahendra, A., Alshehri, M., & Downing, A. (2019). Extensive necrotizing fasciitis from Fournier’s gangrene. Urology Case Reports, 26, 100943.
Moussa, M., & Abou Chakra, M. (2019). Isolated penile Fournier’s gangrene: A case report and literature review. International Journal of Surgery Case Reports, 62, 65–68.