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01.12.2011 | Case report | Ausgabe 1/2011 Open Access

Journal of Medical Case Reports 1/2011

Neonatal scrotal wall necrotizing fasciitis (Fournier gangrene): a case report

Journal of Medical Case Reports > Ausgabe 1/2011
Oskar Zgraj, Sri Paran, Maureen O'Sullivan, Feargal Quinn
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1752-1947-5-576) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors' contributions

OZ gathered patient data, performed a literature search, calculated data from previous articles, and wrote the core of the manuscript. SP analyzed the patient's presentation in detail and made a major contribution to the manuscript, especially the Discussion section. MO'S performed a histological examination of specimens, photographed them, prepared the figure and legend, contributed in interpreting histological findings in view of the clinical presentation, and made corrections to the manuscript with special consideration to international histological nomenclature.
FQ was the consultant in charge of this case, made the intra-operative diagnosis, directed the management, and finalized the manuscript, shaping the final conclusions. All authors read and approved the final manuscript.



Necrotizing fasciitis in neonates is rare and is associated with almost 50% mortality. Although more than 80 cases of neonates (under one month of age) with necrotizing fasciitis have been reported in the literature, only six of them are identified as originating in the scrotum.

Case presentation

We report the case of a four-week-old, full-term, otherwise-healthy Caucasian baby boy who presented with an ulcerating lesion of his scrotal wall. His scrotum was explored because of a provisional diagnosis of missed torsion of the testis. He was found to have necrotizing fasciitis of the scrotum. We were able to preserve the testis and excise the necrotic tissue, and with intravenous antibiotics there was a successful outcome.


Fournier gangrene is rarely considered as part of the differential diagnosis in the clinical management of the acute scrotum. However, all doctors who care for small babies must be aware of this serious condition and, if it is suspected, should not hesitate in referring the babies to a specialist pediatric surgical center immediately.

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