A 35-year-old man presented at our hospital with high fever (up to 39.7 °C), and progressive edema and pain of the scrotal and perineal region for 7 days. He had received intravenous levofloxacin at local hospital since 2 days after onset of the symptoms. He has a history of unwell-controlled diabetes mellitus for the last 2 years. Clinical examination revealed a mousy odor, swelling, exudation and necrosis of the penis and scrotum (Fig. 1). The leukocyte count was 16.2 × 109/L, and neutrophil was 15.4 × 109/L (94.8%).
