Scrotal abscess

Background

• Must differentiate scrotal wall abscess versus intrascrotal organ involvement

Differential Diagnosis

Testicular Diagnoses

• Cellulitis
• Epididymitis
• Fournier gangrene
• Hematocele
• Hydrocele
• Indirect inguinal hernia
• Inguinal lymph node (Lymphadenitis)
• Orchitis
• Scrotal abscess
• Spermatocele
• Tinea cruris
• Testicular rupture
• Testicular torsion
• Testicular trauma
• Testicular tumor
• Torsion of testicular appendage
• Varicocele

Skin and Soft Tissue Infection

• Cellulitis
  • Hand cellulitis
  • Facial cellulitis
  • Orbital cellulitis
• Erysipelas
• Lymphangitis
• Folliculitis
• Abscess
  • Anorectal abscess
  • Bartholin gland abscess
  • Scrotal abscess
• Necrotizing soft tissue infections
  • Necrotizing fasciitis
  • Necrotizing myositis
  • Necrotizing cellulitis
• Mycobacterium marinum

Look-A-Likes

• Sporotrichosis
• Osteomyelitis
• Deep venous thrombosis
• Pyomyositis

Evaluation

• Ultrasound

Management

• Simple hair follicle scrotal wall abscess
  • I+D
  • Antibiotics rarely needed (unless signs of cellulitis, systemic involvement and/or immunosuppressed)
• Intrascrotal organ involvement
  • Urology consult

See Also

• Testicular Diagnoses
• Abscess
• Incision and drainage

Authors:

Jonathan Ameli, Jordan Swartz, Neil Young, Daniel Ostermayer, Ross Donaldson