Man with fever has part of genitals removed after scrotum swells

WARNING - GRAPHIC CONTENT: A man has had to have part of his genitals removed after his scrotum enlarged by more than three kilograms due to swelling.

The man, 43, from Panama, went to the emergency department with a fever and a fast heart, according to Urology Case Reports.

He was using a walker to get around and had been receiving care from his mother. Doctors noted he hadn’t seen a physician in 30 years and over this time he had scrotal swelling which had gradually worsened.

Such was the extent of the swelling they were sagging “past the level of his knees”.

Researchers noted it as a case of “elephantiasis”.

A man's swollen testicles are pictured as he lies in a hospital bed.
Doctors said his scrotum was swollen so much it was sagging past his knees. Source: Urology Case Reports

“He had no prior urologic history and only previous surgery was a diaphragmatic hernia repair as a child,” researcher wrote.

A diaphragmatic hernia is a birth defect where a baby is born with an opening in the diaphragm which can lead to breathing difficulties.

Researchers wrote he had two open wounds with “foul smelling, purulent fluid located at the bottom of the left hemi-scrotum”.

They noted he had “extensive” swelling on the right and thickening skin on his left leg.

The 43-year-old was found to be anaemic meaning he had a low red blood cell count.

Doctors discovered through a CT scan of his pelvis and abdomen a hernia in his groin along with fluid build-up in his left scrotum.

There were concerns for Fournier’s gangrene - a type of gangrene which affects the genitals and kills soft tissues, nerves and muscles.

He was taken into surgery to have infected tissue removed.

A CT scan of a man's abdomen shows large swollen testicles.
A CT scan of the 43-year-old's abdomen. Source: Urology Case Reports

Five days later, after suffering discomfort from dressing changes and wound cleaning, a decision was made to perform plastic surgery.

He underwent a scrotectomy and the hydrocele, or swelling of the scrotum, was found to weigh more than three kilograms.

The patient was discharged after 10 days in hospital to undergo rehab and after four weeks “was healing well” with “satisfactory cosmetic and functional outcomes”.

Researchers noted his case was “unique”.

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