“Literature review revealed 14 total reported cases of isolated penile Fournier’s gangrene …”
Man’s penis starts rotting after rough oral sex |
Dec 27, 2019 |
Gizmodo – A harrowing medical case reported by doctors this month should remind everyone to keep their teeth away from each other’s genitals.
It details how an accidental love bite during sex left a man’s penis on the verge of rotting away, though thankfully doctors intervened in time to save it.
The 43-year-old man visited the emergency room with a painful wound festering near the tip of his penis.
His significant other had mistakenly bit it while having sex five days earlier, and by the time he sought care, the 3-centimeter wound had turned pitch black—a sign the infected tissue surrounding it had become necrotic and died off.
All things considered, though, the situation could have been way worse. The man didn’t have any signs of a systemic infection, such as fever. In other words, the infection was limited to his dick.
But given the risk of a life-threatening, flesh-eating gangrene on his penis, doctors quickly hospitalized the man and gave him intravenous antibiotics … Read more.
“Rare” Gangrene of the Penis following a Human Bite Wound
25 October 2018
Copyright © 2018 Tyler Overholt et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Fournier’s gangrene isolated to the penis is exceedingly rare. [Sadly, what is not rare is men doing stupid things with their favorite plaything. – Ed.]
It is an urologic emergency that requires emergent parenteral antibiotics as well as aggressive irrigation and debridement. While human bite wounds can be overlooked as a serious cause of injury and infection, they can result in highly dangerous, polymicrobial infections in affected patients.
Here, we report a case of penile Fournier’s gangrene caused by a human bite wound managed with broad spectrum antibiotics, irrigation and debridement, penile reconstruction, and skin grafting with successful preservation of a normal penile structure and function.
Fournier’s gangrene is defined as necrotizing fasciitis involving the external genitalia, scrotum, or perineum, and involvement isolated to the penis is extremely rare.
It is a surgical emergency in which rapid onset of management with broad spectrum intravenous antibiotics and surgical irrigation and debridement is necessary to prevent potentially fatal consequences. Human bite wounds, while often overlooked as a cause of a serious life threatening injury, can result in a fulminant, polymicrobial infection.
We present a case of Fournier’s gangrene isolated to the dorsal glans and shaft of the penis following a human bite wound.
2. Case Presentation
A 44-year old male with medical history of morbid obesity, diabetes mellitus, end stage renal disease, and osteomyelitis presented to our emergency department (ED) with the chief complaint of penile swelling.
Nine days prior to presentation, the patient sustained an unintentional bite injury to the penis while receiving oral intercourse. Following the injury, he described worsening swelling, redness, penile discharge, pain, and inability to retract foreskin due to pain.
The patient was initially treated for suspected balanitis with a seven-day course of an oral first generation cephalosporin, Keflex, and an oral anti-fungal, fluconazole, with plans for outpatient follow-up in the urology clinic.
When the patient presented to the urology clinic the following week, he was found to have worsening tenderness and induration of his penis with phimosis and purulent drainage.
An urgent computed tomography (CT) scan was performed showing subcutaneous emphysema involving the dorsal aspect of the penis concerning for a necrotizing soft tissue infection. The patient was subsequently taken to the operating room urgently for penile exploration and debridement.
Examination under anesthesia demonstrated phimosis with purulent drainage from the phimotic ring as well as induration of the penile shaft (Figure 1).
A dorsal midline incision was made through the foreskin to expose the glans of the penis and the penis was completely degloved down to the base. There appeared to be necrotic, nonviable tissue involving the dorsal aspect of the glans and shaft of the penis (Figure 2).
All nonviable tissue was sharply debrided and the remaining tissue of the proximal shaft and ventral aspect of the penis appeared viable (Figure 3). The penis was irrigated using a PulsaVac and the edges of the foreskin were reapproximated with running 3-0 chromic suture.
The penis was dressed with Xeroform gauze and Kerlix moistening in saline.
Preliminary culture results obtained from the necrotic tissue collected during the surgery revealed a likely polymicrobial infection. Therefore, treatment with intravenous clindamycin, cefepime, and vancomycin was initiated. Read more.