Fulminant Fournier's gangrene following perineal trauma in a patient with suspected chronic inflammatory bowel disease: a case report.

Fournier's Gangrene (FG) is a rare, fulminant, and necrotizing inflammation of the perineal fascia. We present a case of 35-year-old Men who have Sex with Men (MSM) man with severe gangrene (Fournier's Gangrene Severity Index (FGSI) ≥ 17) due to atypical etiology: mechanical damage to the perineum resulting from sexual intercourse and ingestion of a vasoconstrictor substance, with the background of an active, chronic inflammatory process of the intestines. In the described patient, due to severe sepsis and diverse microbiology, four radical urological interventions were initially performed, following one more reconstructive surgery. The defects were reconstructed using split-thickness skin grafts and flaps - sixth surgery. The discussion focuses on the management of the defects without orchidopexy, conventional wound management (without vacuum assisted closure (VAC) or Hyperbaric Oxygen Therapy (HBOT)), and multi-stage complications (urethral fistula and limited erections), which are noticeable on the quality of patient's life (QoL).