Vol. 7, Issue 1, Part A (2025)

The article is a review of clinical and laboratory cases of a rare and serious disease, Fournier's gangrene. Three patients with Fournier's gangrene (necrotizing fasciitis) were observed. The patient was 55 years old in the emergency department of Basra General Hospital in Basra, Iraq. The patient with Fournier's gangrene (necrotizing fasciitis) was admitted to the clinic with different directional diagnoses, "severe epididymitis", "testicular abscess", "scrotal pus" and scrotal cyanosis. Standard clinical and laboratory tests, examinations, X-ray examination and ultrasound examination of the abdominal cavity and genitourinary system were performed. A high-resolution linear sensor (6-16 MHz) was used for ultrasound examination of the genital organs. Fournier's gangrene and necrotizing fasciitis were diagnosed by radiological diagnosis. Ultrasound examination revealed marked thickening of the testicular lobes (more than 15 mm), fluid accumulation between the testicular membranes and in the scrotal cavity, and severe hypercoagulability of the testicular membranes. Scrotal swelling was detected by ultrasound examination in all patients, and by X-ray examination and physical examination in the patient. Because the case was an emergency, the surgeons were satisfied with blood analysis and radiological diagnosis.

After the surgery was completed, everything was fine. On the second day after surgery, the patient's condition worsened and the symptoms began to return, which was a surprise to the doctors. There were two visions.

First vision was to admit the patient to the operating room and remove the testicle and scrotum in order to save the patient's life and prevent the spread of septis.

Second vision was to involve laboratory diagnosis to determine the reasons for the failure of surgical treatment and give the laboratory a period not exceeding 3 days only, while monitoring the patient in intensive care and after the expiration of the period the surgical intervention is performed again.

In this article i will focus on the laboratory diagnostics in a big way and how the researcher was able to work in the time allotted to him and how he determined the cause of the infection and the reason for the failure of surgical treatment from the first time.