University of Wisconsin–Madison Medical College of Wisconsin

Acute Myelomonocytic Leukemia Presenting as Fournier’s Gangrene

Sofie Kjellesvig, MD; Emelyn Zaworski, MD; Antoine N. Saliba, MD

WMJ. 2024;123(2):131-134

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Introduction: Acute myelomonocytic leukemia is a type of acute myeloid leukemia with monocytic expansion. Both the disease and its treatment can be immunocompromising. Immunocompromised patients are more susceptible to infections, such as Fournier’s gangrene, a rare necrotizing infection of the groin.

Case Presentation: A 56-year-old male presented to the emergency department with abdominal pain, leukocytosis, and perineal ecchymosis. Overnight, his perineal discoloration and tenderness worsened. He underwent irrigation and debridement for Fournier’s gangrene and received broad-spectrum antimicrobial therapy. Subsequent workup revealed acute myeloid leukemia with leukemia cutis and central nervous system involvement, necessitating chemotherapy initiation prior to complete wound healing.

Discussion/Conclusions: This case highlights the challenges in the diagnosis and management of acute leukemia in the setting of a concomitant life-threatening soft tissue infection, as both the hematologic disease and treatment thereof can exacerbate infectious complications.

Author Affiliations: Medical College of Wisconsin – Central Wisconsin, Wausau, Wisconsin (Kjellesvig, Zaworski); Division of Hematology, Mayo Clinic, Rochester, Minnesota (Saliba).
Corresponding Author: Sofie Kjellesvig, MD; email; ORCID ID 0000-0003-3338-0647
Funding/Support: None declared.
Financial Disclosures: None declared.
Consent: Patient signed a standard Mayo Clinic authorization to use deidentified photos for educational and publication purposes.
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