The Nontraumatic, Acute Scrotum

An Unusual Complication of Epididymo-Orchitis: Scrotal Pyocele Extending Into the Inguinal Canal Mimicking a Strangulated Inguinal Hernia

“…Risk factors for EO caused by Escherichia coli and other Gram-negative enteric species include older age, bladder outlet obstruction, neurogenic bladder, anatomic genitourinary abnormalities, and previous genitourinary instrumentation (1). Men who engage in anal intercourse may also have a Gram-negative organism responsible for EO (2). Therefore, it is important to obtain an adequate sexual history to select appropriate antibiotics to treat patients with EO.…”

“…The differential diagnosis of such a patient includes testicular torsion, torsion of the testicular appendage, epididymitis, epididymo-orchitis (EO), and a scrotal abscess (1,2). A scrotal pyocele is a rarely occurring purulent collection within the tunica vaginalis caused by severe EO or a ruptured testicular abscess (3).…”

Training Room Management of Medical Conditions: Infectious Diseases

“…Nontraumatic scrotal pain encompasses a large array of differential diagnoses, including testicular torsion, inguinal hernia, idiopathic scrotal edema, hydrocele/ varicocele, renal colic, idiopathic testicular infarction, testicular tumor, leukemia, scrotal abscess, epididymitis, and orchitis. Although all of these diagnoses should be considered in the athlete presenting with an irritated or painful scrotum [79], this section deals with the most common infectious causes, including epididymitis and orchitis. Epididymitis is the most common cause of acute scrotum in adolescent boys and young men [80,81].…”

“…Sexually transmitted pathogens such Neisseria gonorrhea and Chlamydia trachomatis are common in men younger than 35. This is the most common cause of epididymitis or epididymo-orchitis in adolescent boys and young men [79][80][81]. Atypical sexually transmitted pathogens, such as Ureaplasma urealyticum, must be considered if no Gonococcal organisms are identified [80].…”

A Right Scrotal Abscess and Foreign Body Ingestion in a Schizophrenic Patient

“…It is the most common malignancy in men aged 20 to 34 years (6). A painless testicular mass should be considered a testicular neoplasm until proven otherwise (7). However, the clinician should keep in mind that pain may be the presenting symptom in as many as 25% of patients with testicular tumors (8).…”