Solution: Fournier's gangrene was first described in 1883 by a Frenchman named Jean Alfred Fournier. It is defined as a polymicrobial necrotizing fasciitis of the perineal, perianal, or genital areas. Anytime that you see evidence of air in the subcutaneous tissues of the perineum or scrotum, you should consider this diagnosis, especially in the absence of a penetrating trauma, or instrumentation. The other findings seen in this case are severe scrotal wall edema and hyperemia. It is more common in diabetics and represents a true urologic emergency that requires immediate surgical debridement and initiation of broad spectrum antibiotics. The mortality reported in the literature varies widely, but can be up to 75%. Death usually results from systemic illness, such as sepsis, coagulopathy, acute renal failure, diabetic ketoacidosis, or multiple organ failure.