
The patient had no other predisposing factors such as immunosuppressive systemic diseases, usage of chronic urethral catheter and other interventions to the urethra. Fournier gangrene severity index score was measured as 11 points. A necrotizing soft tissue infection with large amounts of gas throughout the perineum was revealed at ultrasound. Leukocytosis (15000/μl), elevated hematocrit (47.3%) and elevated C-reactive protein (138mg/dl) were detected in laboratory tests.
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On physical examination, erythema and tenderness in the inguinal region, lesions containing vesicles on the inguinal, perineal and scrotal skin and periurethral abscess were detected (Figure1). His initial body temperature was 39.1 ☌, blood pressure was 90/65mmHg, heart rate was 115 beats/min, and oxygen saturation was 94% on room air. After the second dose of docetaxel, the patient was presented with fever, swelling and severe pain in perineum and scrotum. Androgen deprivation therapy (LHRH analogue) and concomitant chemotherapy (docetaxel) was planned because of diffuse bone involvement. Biopsy was reported as prostate adenocarcinoma (Gleason 5 + 4) and extensive bone metastasis were determined in the clinical evaluation. Selecting a region changes the language and/or content on 72-year-old man with lower urinary tract symptoms was performed transrectal prostate biopsy four months ago due to PSA level was 64 ng/ml.



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