A Case of Fournier's Gangrene Caused by Streptococcus anginosus

Ho Jun Lee; Seouk Chan Ko; Sung Du Kim; Yoon Jeong Kim; Myoung-Sook Koo; Min-Su Kim; Jae-phil Choi

doi:10.3947/ic.2011.43.1.60

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Lee, Ko, Kim, Kim, Koo, Kim, and Choi: A Case of Fournier's Gangrene Caused by Streptococcus anginosus

Case Report

Infection & Chemotherapy

Infection & Chemotherapy 2011; 43(1): 60-63.

Published online: 28 February 2011

DOI: https://doi.org/10.3947/ic.2011.43.1.60

A Case of Fournier's Gangrene Caused by Streptococcus anginosus

Ho Jun Lee¹, Seouk Chan Ko¹, Sung Du Kim¹, Yoon Jeong Kim¹, Myoung-Sook Koo², Min-Su Kim³, Jae-phil Choi¹

¹Department of Internal Medicine, Seoul Medical Center, Seoul, Korea.

²Department of Laboratory Medicine, Seoul Medical Center, Seoul, Korea.

³Department of Urology, Seoul Medical Center, Seoul, Korea.

Correspondence to Jae-phil Choi, M.D. Department of Internal Medicine, Seoul Medical Center, 171-1 Samsung-dong, Gangnam-gu, Seoul 135-740, Korea. Tel: +82-2-3430-0618, Fax: +82-2-3430-0438, dasole@seoulmc.or.kr

Received 8 June 2010 Revised 18 August 2010 Accepted 13 September 2010

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Fournier's gangrene is a rare, rapidly progressive, necrotizing fasciitis of the genital, perianal and perineal regions. It is usually caused by a synergistic infection of aerobic and anaerobic organisms. A 51-year-old male patient with diabetes mellitus and chronic renal insufficiency on peritoneal dialysis was admitted with severe scrotal pain and swelling that lasted 4 days. An emergent non-contrast-enhanced computed tomography revealed extensive gas formation, fatty haziness and edema in the left scrotal and inguinal area. The patient was successfully treated with immediate surgical debridements and antibiotics. Streptococcus anginosus group Streptococcus anginosus was isolated from surgical wound cultures and identified with biochemical identification methods and direct sequencing of DNA. Herein, we report a rare case of Fournier's gangrene caused by S. anginosus. We also review the relevant literature

Keywords: Fournier's gangrene, Streptococcus anginosus

Figures and Tables

Figure 1

Non-contrast enhanced computed tomography shows multiple air-bubbles, fatty haziness and swelling in the left scrotum and inguinal area.

Figure 2

Pinpoint white colonies with β-hemolysis are seen on the blood agar plate after 24 hours of incubation.

Figure 3

Microscopy shows Gram positive cocci in pairs or short chains (Gram stain, ×1,000).

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