Heiner Jason D, Eng Katisha D, Bialowas Todd A, Devita Diane
Department of Emergency Medicine, Brooke Army Medical Center, Fort Sam Houston, San Antonio, TX 78234, USA.
Case Rep Emerg Med. 2012;2012:154025. doi: 10.1155/2012/154025. Epub 2012 May 22.
Fournier's gangrene is a rare and often fulminant necrotizing fasciitis of the perineum and genital region frequently due to a synergistic polymicrobial infection. This truly emergent condition is typically seen in elderly, diabetic, or otherwise immune-compromised individuals. Here, we report an unusual case of Fournier's gangrene due to excessive masturbation in an otherwise healthy 29-year-old male who presented to the emergency department complaining of two days of fever, vomiting, and diffuse myalgias. Upon further questioning, he also endorsed severe scrotal pain and swelling and frequent masturbation with soap as a lubricant resulting in recurrent penile erythema and minor skin abrasions. Examination of the patient's perineum was consistent with Fournier's gangrene and included significant erythema, edema, and calor of the penis and scrotum with a large malodorous eschar. He was given intravenous antibiotics and immunoglobulin and promptly underwent three surgical debridements of the scrotum and penis with split-thickness skin grafting. Complications from excessive masturbation are exceedingly rare, but as this case illustrates, they can be life threatening.
福尼尔坏疽是一种罕见且常呈暴发性的会阴部和生殖器区域坏死性筋膜炎，通常由多种微生物协同感染引起。这种真正的急症通常见于老年人、糖尿病患者或其他免疫功能低下的个体。在此，我们报告一例不寻常的福尼尔坏疽病例，患者为一名29岁健康男性，因过度手淫导致发病，他到急诊科就诊，主诉发热、呕吐和全身肌痛两天。进一步询问后，他还承认阴囊严重疼痛和肿胀，经常使用肥皂作为润滑剂手淫，导致阴茎反复红斑和轻微皮肤擦伤。对患者会阴部的检查符合福尼尔坏疽表现，包括阴茎和阴囊明显红斑、水肿和发热，并有一大块恶臭焦痂。他接受了静脉抗生素和免疫球蛋白治疗，并迅速接受了三次阴囊和阴茎手术清创及中厚皮片移植。过度手淫引起的并发症极为罕见，但正如本病例所示，可能危及生命。
