Fournier's gangrene after hemorrhoidectomy: Association with drug-induced agranulocytosis - Report of a case

An unusual case of Fournier's gangrene after hemorrhoidectomy and drug-indu ced agranulocytosis, as the predisposing condition, is described. The patie nt had severe granulocytopenia that was attributed to the recent use of dip yrone. Together with hemodynamic resuscitation, broad-spectrum antibiotic a nd recombinant human granulocyte colony-stimulating factor were started. Wi de surgical excision of all the gangrenous tissues, in addition to laparosc opic formation of a defunctioning sigmoid loop colostomy, was performed. Th e white blood cell count rose steadily and the patient experienced a rapid recovery. We emphasize that radical surgery must be accompanied by pharmaco logic interventions for a successful outcome in such cases.