A man developed an “unusual” case of gangrene, or tissue death, after an improperly placed external catheter cut off blood flow to his penis and led to a serious bacterial infection. Unfortunately, despite aggressive treatment, the man ultimately died of septic shock, a condition in which a person’s blood pressure drops dangerously and organs fail.
Before developing gangrene, the 64-year-old man had lost control of his bladder due to a stroke that cut off blood flow to part of his bladder Brainaccording to a report on the case published Jan. 31 in the Journal of Medical Case Reports (opens in new tab). After the stroke was treated, he was prescribed blood thinners to prevent blood clots from forming and given a condom catheter, a device that fits over the penis like a condom and suctions urine into a bag attached to it. He was then released from the hospital.
Ten days later, the man returned to the hospital with a fever, pain and a brownish-black discoloration of his penis. Doctors found that the end of the patient’s penis was “swollen” and “gangrenous,” meaning there was a significant amount of dead tissue. In addition, his blood contained a remarkably high concentration of white blood cells—infection-fighting immune cells—so he was given a broad spectrum dose antibiotics.
Later tests revealed that he was infected with Klebsiella pneumoniaeKind of bacteria which can sometimes infect healthcare patients and poses the highest risk to vulnerable individuals immune systemsaccording to the Centers for Disease Control and Prevention (opens in new tab). (In addition to a history of stroke, the man had Type 2 diabetesthat may impair immune function, the case report authors noted.)
Related: 10 whimsical medical case reports from 2022
To treat the man’s gangrene, doctors first removed all dead tissue from the affected area; This involved a penectomy and urethrectomy to remove the penis and the duct that carries urine from the bladder out of the body. After the procedure, a new internal catheter was placed.
“Although source control was achieved through aggressive debridement” — meaning tissue removal — “meticulous wound care and broad-spectrum antibiotic therapy, the patient died of septic shock,” the doctors wrote.
Tissue-damaging infections of the genital area are known as “Fournier’s gangrene” because the condition was first described by dermatologist and sex specialist JA Fournier in the late 1800s, the case report said.
“The time between diagnosis and treatment has a major impact on morbidity and mortality, and it can quickly lead to sepsis. Therefore, it remains a life-threatening disease,” the authors write. In the past, successful treatments for the condition included immediate antibiotic treatment and removal of dead tissue, followed by reconstructive surgery. Doctors followed suit, “but in our case the septic complication was fatal,” they wrote.
“Medical professionals should be aware that improperly placed condom catheters can lead to penile gangrene, a rare but serious condition,” the authors concluded. “Prevention is key by maintaining strict hygiene and monitoring the device frequently.”