Fournier gangrene in an infant, complicated with severe sepsis and liver dysfunction: A case report

Abstract

BACKGROUND

Fournier gangrene is a rare, life-threatening infection characterized by necrotizing fasciitis in the perineal, genital and/or lower abdominal regions. Despite its rarity, the unfavorable prognosis associated with this disease is dependent on the timing of medical care.

CASE SUMMARY

A 3-month-old boy was admitted to our pediatric intensive care unit in critical condition after a 5-day history of fever and scrotal erythema with breaching skin lesions and swelling. Despite ambulatory antibiotic treatment, the child’s clinical condition deteriorated. At the time of admission, the child had necrotizing scrotal fasciitis that had spread to the abdomen. Following reanimation, the surgeon decided on an immediate intervention to rule out testicular torsion and to debride the affected area. Despite optimal antibiotic and supportive therapy, the patient developed severe sepsis with liver dysfunction, making treatment more challenging.

CONCLUSION

Recognizing Fournier gangrene, prompt referral to pediatric surgery, and appropriate antibiotic coverage are critical for avoiding sepsis and multiorgan dysfunction.

Keywords: Fournier gangrene; Infant; Early diagnosis; Sepsis; Liver dysfunction; Case report

Core Tip: This is a case report of an infant with Fournier gangrene. Despite its rarity, Fournier gangrene remains a disease with severe complications and high mortality. The prognosis is influenced by the timing of medical treatment. Despite receiving optimal antibiotic and supportive care after hospital admission, the patient developed sepsis with severe liver damage, making treatment more challenging. The prognosis to sepsis and liver dysfunction was influenced by delayed diagnosis. Through this case report we highlight the importance of early recognition and high clinical suspicion by all doctors (pediatricians, dermatologist, surgeons, etc.), to make an accurate diagnosis.