A 54-year-old male patient with a history of type 2 diabetes mellitus since 30 years of age, chronic renal failure for two years, treated with hemodialysis.
A supracondylar amputation of the right pelvic limb was performed 4 years ago.
He came to our service for a 1-month history, characterized by the presence of asymptomatic ampullary lesions on the glans, which progressed to ulcers a week later. He then complained of severe pain in the glans.
On physical examination, a hypochromic hypothermic glans was observed, with a necrotic lesion of approximately 1.5 cm on the ventral side, as well as transurethral purulent secretion and penile body induration.
Blood biometry reported: hemoglobin 10.1 g/dl, leukocytes 4.890, platelets 283.000; blood chemistry: glucose 55 mg/dl, creatinine 7.88 mg/dl, serum chloride 95.381 mmol/dl, serum calcium 9921 mmol/dl;
Liver function tests reported: GDT 18, GPT 14 and alkaline phosphatase 64.
A penile Doppler ultrasound with Caverject was performed, resulting in total absence of flows at 100% of the penis.
Surgical management was proposed to the patient and decided to go to another institution.
