Fournier’s gangrene caused by accidental ingestion of a date pit: a case report

Introduction and importance: Fournier’s gangrene is a rare yet rapidly progressive necrotizing fasciitis that primarily affects the perineal, genital, and perianal regions. Mixed aerobic and anaerobic bacterial infection characterizes it. Urogenital tract infections, intestinal inflammation, or local trauma commonly trigger the condition. However, gastrointestinal foreign bodies seldom directly trigger cases in clinical practice. This paper describes such a case. HIGHLIGHTS For the first time, a rare case of gangrene caused by a foreign body in the jujube core was reported in detail, providing a new reference for the diagnosis and treatment of serious complications caused by rare foreign bodies in clinical practice. Emphasizing that this case is easily confused with vascular gangrene and idiopathic infection in diagnosis, suggesting the importance of combining dietary history and imaging tests (e.g., CT). Clarify the treatment plan of early and precise location and removal of jujube pits, combined with anti-infection and complete debridement, to provide a practical paradigm for the treatment of similar cases. Warning clinical people to be vigilant against the potential harm of small dietary foreign bodies such as jujube kernels for the elderly and people with abnormal swallowing function to help prevent similar serious complications. Case report: A 65-year-old male patient was admitted, presenting with “perianal pain for one week.” Initial examination revealed erythema and swelling around the anus and at the base of the scrotum. The condition deteriorated rapidly within 4 hours. Infection spread extensively to encompass the entire scrotum and ventral aspect of the penis. Following prompt diagnostic investigations, debridement surgery was performed. Intraoperatively, a date pit was extracted from the infected perianal lesion. This established it as the source of infection. Combined with the patient history, this confirmed a diagnosis of Fournier’s gangrene resulting from the presence of the date stone. Postoperatively, the patient underwent antimicrobial therapy and wound dressing changes. Approximately 3 months later, the patient had largely recovered. Clinical discussion: In this case, the patient’s ingestion of a date pit led to its passage through the anus. It pierced the intestinal wall and entered the perianal space. This caused a perianal infection that ultimately progressed to Fournier’s gangrene. Additionally, the patient’s long-standing hyperglycemia likely contributed to the rapid disease progression. The key to management is early diagnosis and prompt surgical debridement. The lesion required thorough drainage and daily postoperative dressing changes. This was combined with broad-spectrum antibiotic therapy to combat infection and control blood glucose within normal ranges. Conclusion: Date pits rarely cause Fournier’s gangrene. Early diagnosis and debridement are key to preventing progression and reducing mortality.