Genital gangrene in a patient with type II diabetes mellitus, treated with dapagliflozin: a case report

Abstract

Fournier gangrene (FG) is a necrotizing soft tissue infection initiated from the genital area or perineum, irrespective of the sex of the patient. A patient presented in the hospital with the chief complaints of inflammation in the scrotum from the past three days, which finally led to a rise in the body temperature. He also observed the discharge from the scrotum for two days. Six days back, he got mildly injured on the left side of his scrotum after falling off from his two vehicle and did not take any treatment. Local examination revealed that the size of the scrotum is slightly enlarged, tender, and oedematous, along with palpable crepitations. There were very observable patches of gangrene all over the scrotum, with no past of Diabetes Mellitus (DM). After the investigation, broad-spectrum antibiotics cefoperazone with sulbactam along with metronidazole were prescribed. After that, the patient was prepared for surgery immediately. After the surgery, the patient was prescribed appropriate antibiotics, followed by a wet dressing. The antibiogram results interpretation confirms that the combined form sulbactam and cefoperazone cause sensitivity towards Staphylococcus Aureusand Escherichia coli. His response was positive towards the treatment. The morbidity and mortality of this medical condition have declined over time due to improvements in diagnostic methods, surgical procedures, powerful antibacterial, and intensive care. This is advised to use an advanced approach while handling FG cases to reduce morbidity and mortality, mainly when concomitant conditions like diabetes and multiple organ failure are present.