Case presentation A 56-year-old man with scrotal pain with itching and difficulty in urination presented to the emergency department during the COVID-19 pandemic. Due to the fear of contracting SARS-CoV-2 infection, the patient avoided visiting the hospital earlier.
His family doctor had prescribed ceftriaxone for seven days and NSAIDs ten days earlier over the phone. Patient’s medical history Chronic ischemic heart disease (one year earlier) BMI – 29.5 kg/m 2 Alcoholic for five years and a smoker Initial examination Temperature – 38.3°C Heart rate – 182 bpm Respiratory rate – 33 breaths/min Physical examination (Cover image) Necrosis in the penile, scrotal region, external anal sphincter, and perineal area Perineal-anal fistula formation Fecaloid odor Subcutaneous tissue crepitations with intense pain (VAS 8/10) on palpation Blood test Hb – 9.2 g/dL Leukocytes 21.17 x 10 3 /mm3…
