More Than Just Torsion: An Unusual Case of Testicular Pain.

Abstract:

:Testicular pain has a wide differential and the nonspecific presentation should be triaged rapidly for urgent diagnosis and treatment. Scrotal pyoceles are uncommon collections of purulent fluid between the visceral and parietal tunica vaginalis, usually secondary to acute epididymo-orchitis, intra-abdominal infection, or trauma. Epididymitis and epididymo-orchitis are generally secondary to sexually transmitted infections or urinary tract pathogens. Epidymo-orchitis can compromise the testicular blood supply, leading to a microinfarction and rupture through the tunica albuginea; inflammatory and infectious material then translocate into the tunica vaginalis leading to the formation of a pyocele. Ultrasonography is the preferred method of diagnostic imaging, which can show a classic "falling snow" sign, loculations, or gas. The treatment for a scrotal pyocele is pain control, fluid resuscitation, broad-spectrum antibiotics, and early urology/general surgery consultation. In such cases, Fournier gangrene (FG) should be clinically ruled out and the presence of signs of Fournier gangrene should be met with an urgent surgical consult.

journal_name

Mil Med

journal_title

Military medicine

authors

Martin CD,Sulava E,Bloom A

doi

10.1093/milmed/usz316

subject

Has Abstract

pub_date

2020-06-08 00:00:00

pages

e900-e903

issue

5-6

eissn

0026-4075

issn

1930-613X

pii

5607595

journal_volume

185

pub_type

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