Severe infection and necrosis of scrotum and perineum in males; 50% mortality even with aggressive treatment. Most likely cause is Clostridia infection. Diabetes is risk factor; marked by subcutaneous crepitance and skin necrosis with foul-smelling, watery, grayish fluid. Necrosis of testicles implies thrombosis of testicular artery and intra- or retroperitoneal infection. Treatment is prompt extensive debridement to several-centimeter margin of healthy tissue and broad-spectrum antibiotics. Diverting colostomy may be beneficial.