Methamphetamine abuse: The link between Immunosuppression, Fournier’s gangrene and Candida

Fournier's gangrene is a rapidly progressive and potentially fatal infective necrotizing fasciitis of the perineum, external genitalia and/or perianal regions. The most common etiology of the infection is bacterial; however, there have been published cases of Fournier's gangrene caused by yeast in patients with severe immunosuppression. Cutaneous fungal infections are often opportunistic and typically occur in immunocompromised patients with diabetes and additional chronic conditions. None of the fungal Fournier's gangrene case reports thus far present a patient with diabetes and methamphetamine abuse. This case study presents a methamphetamine abuser with uncontrolled diabetes, both of which contributing to immunosuppression, who presented to the emergency department with a rare case of Fournier's gangrene caused by unspecified yeast. Methamphetamine abuse has not yet been demonstrated to be a risk factor for FG, although it has been proven to be a causative agent of both immunosuppression and malnutrition. This case report highlights the additive effects methamphetamine abuse has on immunosuppression that eventually caused fungal Fournier's gangrene.