Document Type : Case Report

Authors

1 Trauma Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

2 School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

3 Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Objective: Necrotizing fasciitis of the perinea, referred to as Fournier’s gangrene, is a necrotizing infection of the perinea. To the best of our knowledge, there is no report on the Fournier’s gangrene following an ant bite and this is a rare case report of this type.
Case Presentation: In this rare case report we describe a 20-year-old man who developed Fournier’s gangrene following an ant bite which resulted in his death. He sustained numerous ant bites in the perinea. Subsequently, he suffered from itching of the area and had scratched the area frequently leading to dermal ulcers and laceration, pain, and swelling of the scrotal area followed by fever and diminished consciousness. Finally, he presented to the emergency room (ER) after 72 hours of ant bites with a shock. Physical examination revealed extensive necrosis of scrotum. The primary treatments including antibiotic therapy, normal saline solution, and dopamine were not effective.
Conclusion: Even a simple nonpoisonous insect bite can lead to Fournier’s gangrene and death. Paying greater attention to the site of bite, especially in the perinea which is anatomically more susceptible to infection, observing hygienic principles, and quick access to healthcare centers may prevent the patient’s death

Keywords

Main Subjects

1. Aghaeeafshar M, Shahesmaeili A. Necrotizing fascitis in a 47-year old diabetic man: case Report. Journal of Kerman University of Medical Sciences 2009; 16(4): 405-9. [InPersian].
2. Mahdizadeh F, Safari S. Concurrent hand and penile gangrene following prolonged warfarin use; a case report. Emerg (Tehran) 2017; 5(1): e71.
3. Jafari M, Biuki AA, Hajimaghsoudi M, Bagherabadi M, Zarepur E. Intravenous haloperidol versus midazolam in management of conversion disorder; a randomized clinical trial. Emerg (Tehran) 2018; 6(1): e43.
4. Sasannejad P, Rezaei F, Bidaki R, Zarepur E. Rare presentation of moyamoya disease with sub acute presentation in Iran. Iran J Child Neurol 2018; 12(1): 89- 93.
5. Yeniyol CO, Suelozgen T, Arslan M, Ayder AR. Fournier’s gangrene: experience with 25 patients and use of Fournier’s gangrene severity index score. Urology 2004; 64(2): 218-22.doi: 10.1016/j.urology.2004.03.049.
6. Korkut M, Içöz G, Dayangaç M, Akgün E, Yeniay L, Erdoğan O, et al. Outcome analysis in patients with
Fournier’s gangrene: report of 45 cases. Dis Colon Rectum 2003; 46(5): 649-52. doi: 10.1007/s10350-004-6626-x.
7. Singh G, Sinha SK, Adhikary S, Babu KS, Ray P, Khanna SK. Necrotising infections of soft tissues--a
clinical profile. Eur J Surg 2002; 168(6): 366-71. doi:10.1080/11024150260284897.
8. Aimoni C, Cilione AR, Grandi E, Lombardi L, Merlo R, Pastore A. Cervical necrotizing fasciitis. Eur Arch
Otorhinolaryngol 1999; 256(10): 510-3. doi: 10.1007/s004050050201.
9. Schmidt GA, Mandel J. Evaluation and management of severe sepsis and septic shock in adults.UpToDate; 2013.Available from: https://www.uptodate.com/contents/evaluation-and-management-of-suspected-sepsis-andseptic-shock-in-adults.
10. Imanian M, Ghasemzadeh MJ, Zarepur E, Zarepur A, Sarbandi Farahani R, Sarbandi Farahani R. The Relationship between Pneumonia with parental smoking in children under 10 years old: a case- control study. Int J Pediatr 2018;6(6): 7791-6. doi: 10.22038/ijp.2016.7801.
11. Unuigbe EI, Ikhidero J, Ogbemudia AO, Bafor A, Isah AO. Multiple digital gangrene arising from traditional therapy: a case report. West Afr J Med 2009; 28(6): 397-9.
12. Verma SB. Necrotizing fascitis induced by mosquito bite. J Eur Acad Dermatol Venereol 2003; 17(5): 591-3. doi:10.1046/j.1468-3083.2003.00819.x.
13. Poitelea C, Wearne MJ. Periocular necrotising fasciitis--a case report. Orbit 2005; 24(3): 215-7. doi:
10.1080/01676830590930634.
14. Jones AE, Brown MD, Trzeciak S, Shapiro NI, Garrett JS, Heffner AC, et al. The effect of a quantitative resuscitation strategy on mortality in patients with sepsis: a metaanalysis. Crit Care Med 2008; 36(10): 2734-9. doi: 10.1097/CCM.0b013e318186f839.