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Patient referred from primary care due to orchiepididymitis with poor outcome after being treated with ciprofloxacin during the previous 3 days. At the Emergency Room, a temperature of 36.3<span class="elsevierStyleHsp" style=""></span>°C with significant general condition deterioration, generalized oedema of penis and scrotum with spontaneous purulent urethral discharge, in addition to patched scrotal necrosis (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>) was observed. Lab tests carried out at that time highlighted a blood glucose of 347<span class="elsevierStyleHsp" style=""></span>mg/dl, 23.65<span class="elsevierStyleHsp" style=""></span>mil/mm<span class="elsevierStyleSup">3</span> total leukocytes with 87% neutrophils, and PCR of 32.4<span class="elsevierStyleHsp" style=""></span>mg/dl. After the urgent necrotic material debridement and resection (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>) combined intravenous antibiotic therapy was initiated with imipenem 1<span class="elsevierStyleHsp" style=""></span>g/6<span class="elsevierStyleHsp" style=""></span>h plus metronidazole 500<span class="elsevierStyleHsp" style=""></span>mg/8<span class="elsevierStyleHsp" style=""></span>h. After 12 days of treatment, the patient was discharged, having experienced a recovery of his general and local condition (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>). In the microbiological assays, <span class="elsevierStyleItalic">Enterococcus faecalis</span>, <span class="elsevierStyleItalic">Enterococcus faecium</span> and <span class="elsevierStyleItalic">Prevotella (B.) bivia</span> were isolated from the urethral discharge samples. Fournier's gangrene is a urological emergency of paucisymptomatic presentation. It can rapidly progress in predisposed patients, such as diabetic males. It is associated with a significant mortality rate unless treated early.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Sanz García FJ, Pinzón Navarrete I, Tenza Tenza JA, Giner Galvañ V. Gangrena de Fournier. 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