A 58-year-old man with diabetes arrives with severe scrotal pain. Triage acuity is ESI 1; T 102.5 F, BP 86/50 mm Hg, HR 132/min. The perineum is

Question

A 58-year-old man with diabetes arrives with severe scrotal pain. Triage acuity is ESI 1; T 102.5 F, BP 86/50 mm Hg, HR 132/min. The perineum is swollen with crepitus, dusky skin, and foul drainage. Pain extends beyond visible erythema. Which of the following is the most likely diagnosis?

Accepted Answer

Fournier gangrene

Answer

Testicular torsion

Answer

Scrotal cellulitis without necrosis

Answer

Inguinal hernia

Answer

Epididymitis

Fournier gangrene — ABEM Board MCQ

A 58-year-old man with diabetes arrives with severe scrotal pain. Triage acuity is ESI 1; T 102.5 F, BP 86/50 mm Hg, HR 132/min. The perineum is swollen with crepitus, dusky skin, and foul drainage. Pain extends beyond visible erythema. Which of the following is the most likely diagnosis?