フルニエ壊疽が疑われた高齢者陰嚢壊疽

A Case of Scrotal Gangrene Suspected of Fournier's Gangrene

　陰嚢の発赤と疼痛を主訴とした87歳，男性。陰嚢表皮は剥離し，壊死を呈していた。C反応性蛋白は16.8mg／dlと著増し，血小板は3.5×10⁴／μlと著減していた。DICを併発したフルニエ壊疽を疑い，抗生物質投与，抗DIC療法，切開排膿ドレナ—ジを施行した。治療開始3か月後には全治し退院となった。細菌検査にて壊疽創，動脈血液．尿から大腸菌が検出されており，起因菌と考えられた。

A 87-year-old man presented with scrotal gangrene. Laboratory examination revealed thrombocytopenia, 35,000/ μl, with 6 points of DIC-score. Imaging studies showed scrotal edema, but neither gas nor abscess in scrotum. He did not have a history of diabetus mellitus, perineal trauma, perianal infection or urinary tract infection. We treated him with antibiotic therapy, anti-DIC therapy and surgical debridment under diagnosis of Fournier's gangrene, which was thought to be responsible for bacteremia and DIC. Wound, arterial blood and urine cultures showedEscherichia coli.