A50-20 A Case of Candida Causing Fournier’s Gangrene

Abstract Introduction Fournier’s Gangrene is an emergent condition involving the perineal and groin areas. It leads to fasciitis with or without gas production. The most common microbiology of Fournier’s gangrene is bacterial polymicrobials. Fungi or other organisms have rarely been reported in existing literature. We present a case of Fournier’s gangrene caused in an immunosuppressed patient that was caused by candida tropicalis. Case A 55-year-old male with a past history of type 2 diabetes recently started on empagliflozin, hypertension and colon cancer s/p resection of rectum and colostomy was admitted for pain, swelling and redness in groin region. On admission white blood cell count was 17, lactic acid was 3 and scrotal ultrasound showed a 5.2 x 3.1 x 4.6 cm masslike hyperechoic left extratesticular swelling with possible internal inflow on color Doppler concerning possible abscess. Vancomycin, Zosyn and clindamycin were started and urology was consulted. The patient underwent incision and drainage with urology on the same day of admission. Abscess cultures were taken during the procedure and it eventually grew Candida tropicalis as well as Stenotrophomonas. Antibiotics were changed to micafungin and trimethoprim/sulfamethoxazole. The patient improved and was eventually discharged on a 2 week course of per oral TMP-SMX and fluconazole on post-op day 10. Discussion This case highlights the importance of understanding the extent of microbiology that can be involved in necrotising fasciitis particularly fournier’s gangrene. Internists should work closely with infectious disease and surgery for achieving a good antimicrobial regimen for patients that are suspected to be infected with organisms other than common bacteria. This abstract is funded by: None