Scrotal envenomation from modern water-closet, a rare cause of Fournier’s gangrene and post-acute complications: A Case Report

Case Report

J Venom Res (2022), Vol 12, 1-4

Published online: 14 March 2022

Mahamudu Ayamba Ali1,2, Mawuenyo Oyortey1, Yaw Otchere Donkor2, Raymond Saa-Eru Maalman2

1Departments of Surgery, School of Medicine, University of Health and Allied Science
2Departments of Basic Medical Science, School of Medicine, University of Health and Allied Science


*Correspondence to: Mahamudu Ayamba Ali, E-mail: aayamba@uhas.edu.gh


Received: 03 Jan 2022 | Revised: 27 Feb 2022 | Accepted: 11 Mar 2022


© Copyright The Author(s). This is an open access article, published under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0). This license permits non-commercial use, distribution and reproduction of this article, provided the original work is appropriately acknowledged, with correct citation details.

ABSTRACT

Introduction: Snake venom and bacterial inoculation of the scrotum resulting from bites in a modern water closet
are rare. As such, the severity, course, duration, and treatment outcome of a complicating Fournier Gangrene(FG) or
post-acute manifestations are less known with scarce treatment guidelines. Clinical Presentation: A 46-year-old man presented after 24-hours of scrotal envenomation with a progressively worsening painful swollen bleeding scrotum and symptoms of haemolysis. Examination revealed fever (Temperature 38.9 C), pallor, jaundice, swollen and tender weeping scrotum with patchy necrotic areas. Laboratory investigation was significant of consumptive coagulopathy, acute kidney injury, liver function derangement, and elevated post-acute fasting blood sugar. Clinical discussion: The repeated wound breakdowns following secondary closures, weight loss, elevated blood pressure and erectile dysfunction were unusual despite the best acute state management response. We believe the high blood sugar later detected prolonged the wound healing which is a rare sequelae related to the envenomation since he had no prior co-morbidities. Conclusion: In the management of scrotal envenomation, diabetes mellitus and hypertension must be anticipated as the post-acute complication.

KEYWORDS: Fournier’s Gangrene, Scrotal Snakebite, Water Closet, Domestic Snakebite, Case report