Freak sepsis death that began with ‘penile gangrene’ revealed by scientists

Patient had returned with ‘engorged’ and ‘gangrenous’ penis after being discharged from hospital

A rare case of death due to penile gangrene has been documented in a 64-year-old man by scientists.

The man, who was being treated for a stroke at the La Rabta Hospital in Tunisia, was given a device called a condom catheter that fits over the penis and collects urine onto an attached bag.

The gangrene occurred as the catherter was improperly applied and had cut off blood supply to the penis, leading to a bacterial infection.

The man was also treated with blood thinners, according to the study, published recently in the Journal of Medical Case Reports.

About 10 days after the patient was discharged from hospital, he returned with symptoms of fever, pain and discolouration of his penis, which was also “engorged” and “gangrenous”.

Lab examinations revealed the man’s blood had high white blood cell counts, indicating his body was fighting off an infection.

To treat the patient’s tissue-killing infection of the genital area – known as Fournier’s gangrene – doctors started him on broad-spectrum antibiotics tazobactam and amikacin.

They found that his penis was infected with the bacteria Klebsiella pneumoniae – known to infect patients in health-related environments.

Studies have shown that it poses the highest risk to people with weakened immune systems.

Along with antibiotics, doctors also treated the patient by removing dead tissue from the affected area, which involved the removal of the penis and the duct that carries urine from the bladder out of the body.

Despite careful wound care and wide-spectrum antibiotic therapy, however, the patient died due to septic shock, the study noted.

“Healthcare professionals should be aware that improperly applied condom catheters can lead to penile gangrene, a rare but serious condition,” the study authors wrote.

For this type of gangrene, researchers said the time between diagnosis and treatment can have a great effect on morbidity and mortality, adding that the condition “can quickly progress to sepsis”.

“Prevention is the key, by maintaining strict hygiene and frequent monitoring of the device,” they added.

The study also noted that the use of condom catheters does not come without complications.

“Careful placement, strict hygiene, and regular monitoring of the local condition are necessary,” the authors concluded in the case report.