以發燒及陰囊腫脹表現之福爾尼埃氏壞疽

Fournier’s Gangrene with Fever and Scrotal Swelling: A Case Report

福爾尼埃氏壞疽是一種罕見且危及生命的外科急症，因臨床表徵具非特異性，及病程進展兇猛，導致鑑別困難。本案例是一位63歲男性患者，曾因血糖控制不佳入院治療3次，此次主要是因持續發燒2天就醫，後續出現陰囊腫脹併疼痛症狀，經電腦斷層檢查後，確診為福爾尼埃氏壞疽，經行筋膜切開、膿瘍引流及壞疽清創手術，加上抗生素治療，感染最終獲得控制，得以順利出院。因此，針對此類以糖化血色素大於7的糖尿病患者，出現會陰部腫脹或疼痛症狀時，必須將福爾尼埃氏壞疽列入鑑別診斷，以避免錯失治療時機。

Fournier’s gangrene is a rare, life-threatening disease with a challenging diagnosis due to nonspecific symptoms and rapid progression. This case involves a 63-year-old male patient who had experienced inpatient hyperglycemia three times. This time, he experienced persistent fever for two days with scrotal swelling and pain. A computed tomography scan confirmed Fournier’s gangrene. After fasciotomy, abscess drainage and gangrene debridement, and antibiotic treatment, the infection was controlled, and the patient was discharged. Hence, when diabetic patients exhibit glycosylated hemoglobin (HbA1c) levels exceeding 7%, along with symptoms such as scrotal swelling and pain, the consideration of Fournier’s gangrene in the list of differential diagnoses becomes imperative for timely intervention.