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Findings that shed new light on the possible pathogenesis of a disease or an adverse effect
Case report
Impact of radiological diagnostics in the survivor of disseminated Fournier gangrene patient with septic pulmonary embolism
  1. Adeena Khan1,
  2. Mamoona Sultan2,
  3. Usman Ul Haq3 and
  4. Syed Shahid Habib4
  1. 1 Radiology and Medical imaging, King Saud University, Riyadh, Riyadh Province, Saudi Arabia
  2. 2 Internal Medicine, King Saud University, Riyadh, Riyadh Province, Saudi Arabia
  3. 3 Orthopaedic Surgery, Jarir Medical Centre, Riyadh, Saudi Arabia
  4. 4 Clinical Physiology, King Saud University, Riyadh, Riyadh Province, Saudi Arabia
  1. Correspondence to Dr Adeena Khan; khan.adeena{at}yahoo.com

Abstract

A 51-year-old diabetic man diagnosed with prostatic abscess underwent its drainage twice. Following surgery he developed fever and right-sided painless visual loss due to endophthalmitis. To rule out its endogenous source CT scan was done which showed multisystem aetiology and complications. His pelvic CT and CT cystogram revealed postsurgical urethral injury along with urinary extravasation, perineal and pelvic soft tissues air densities with fat stranding ascribed to Fournier gangrene, air in distended urinary bladder due to emphysematous cystitis and right common iliac vein air containing septic thrombus. CT chest spotted bilateral multiple septic pulmonary emboli. These radiological findings were promptly handled by uro-surgical team followed by alliance with other relevant departments. With hasty surgical drainage/debridement, urological restoration of urinary obstruction, aggressive broad spectrum antibiotics, anticoagulation and radiological follow-ups the patient withstood multisystem lethal complications and come up with excellent outcome except evisceration.

  • diabetes
  • gas/free gas
  • ophthalmology
  • radiology
  • urinary tract infections

http://dx.doi.org/10.1136/bcr-2019-231468

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    Footnotes

    • Contributors AK planned and wrote the case report, interpreted all radiological images, critical analysis of the final manuscript and did computer work. MS wrote all the clinical description of the manuscript, analysed the clinical manifestations of the patient and final review of manuscript. UUH analysed and wrote the surgical part of the manuscript and guided in writing the manuscript. SSH did critical analysis and editing of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.