Scrotal abscess

Case contributed by Dr Henry Knipe


Perineal pain.

Patient Data

Age: 85 years
Gender: Male

Centered on the left scrotum is a 4.7 x 6.2 x 6.8cm cystic lesion with peripheral contrast enhancement. There is fat stranding associated with the remainder of the scrotum extending posteriorly in the subcutaneous tissues to towards the anus and superiorly towards the base of the penis. No associated gas. The spermatic cords on both sides are thickened and are hyperdense (~50HU) and this more likely represents venous engorgement rather than infection.

Prostatomegaly. Centered on the right bladder is a lobulated, enhancing mass that indents into the bladder. The bladder itself is collapse. Colonic fecal loading. No enlarged lymph nodes. No suspicious bone lesions.


  1. Superficial Scrotal abscess. Fat stranding indicative of associated cellulitis.
  2. Mass lesion projecting into the left inferior bladder likely arises from an enlarged prostate. Cystoscopy could help clarify this.

Case Discussion

Clinically, this case presented as Fournier gangrene but subsequent investigation demonstrated a superficial scrotal abscess. Ultrasound (not shown) demonstrated normal testicular Doppler flow and this abscess separate to the testes. 

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Case information

rID: 30162
Published: 23rd Jul 2014
Last edited: 16th Dec 2020
System: Urogenital
Inclusion in quiz mode: Included

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