A purulent collection of fluid surrounding the testicle (in the potential space of the tunica vaginalis). Characteristically it contains significant debris and septations unlike a hydrocele.
- Scrotal Pain
- Scrotal cellulitis
- Fournier gangrene
- Indirect inguinal hernia
- Inguinal lymph node (Lymphadenitis)
- Scrotal abscess
- Tinea cruris
- Testicular rupture
- Testicular torsion
- Testicular trauma
- Testicular tumor
- Torsion of testicular appendage
- Testicular malignancy
- Scrotal wall hematoma
- Testicular ultrasound - will reveal characteristic debris and septations within an existing hydrocele
- CT imaging of the abdomen and pelvis with IV contrast is only needed if associated Fournier gangrene is suspected
- Diagnosis will be made by testicular ultrasound
- Urology consult for followup and coordination of surgical drainage
- Most can have a trial of oral antibiotics outpatient prior to surgical drainage
- Ciprofloxacin 500mg PO twice daily x 10 days or Cefpodoxime 200mg PO twice daily x 10 days
- Close outpatient follow for resolution after antibiotics.
- Admission only waranted in settings of sepsis or Fournier gangrene
- Bruner BI. et al. Scrotal pyocele: Uncommon urologic emergency. J Emerg Trauma Shock. 2012 Apr-Jun; 5(2): 206.
- Lee C, Henderson SO. Emergency surgical complications of genitourinary infections. Emerg Med Clin N Am. 2003;21:1057–74.