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Testicular abscess and pyocoele

Case contributed by Matthew Lukies
Diagnosis certain

Presentation

Follow-up ultrasound of the scrotum performed 8 days after the diagnosis of left epididymitis and a simple hydrocele on ultrasound.

Patient Data

Age: 70 years
Gender: Male
ultrasound

Left testicle:

  • left testicular abscess measuring 2.3 x 1.6 x 1.9 cm
  • left testis measures 5.0 x 3.5 x 3.2 cm, larger than the right (4.7 x 3.1 x 2.1 cm)
  • left testis and epididymis are hyperemic, consistent with epididymo-orchitis
  • scrotal free fluid with heterogeneous echogenicity and septa, consistent with pyocoele

Right testicle:

  • 3 mm cyst in the right testis
  • normal vascularity
  • small hydrocoele

Case Discussion

The patient clinically improved after conservative management with antibiotics, and a repeat ultrasound eight days later showed a slight reduction in the size of the testicular abscess and a more liquefied less complex appearance, consistent with gradual resolution.

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