Scrotal abscess
Background
- Must differentiate scrotal wall abscess versus intrascrotal organ involvement
Differential Diagnosis
Testicular Diagnoses
- Scrotal 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
- Pyocele
- Testicular malignancy
- Scrotal wall hematoma
Skin and Soft Tissue Infection
- Cellulitis
- Erysipelas
- Lymphangitis
- Folliculitis
- Hidradenitis suppurativa
- Skin abscess
- Necrotizing soft tissue infections
- Mycobacterium marinum
Look-A-Likes
Evaluation
Management
- Simple hair follicle scrotal wall abscess
- I+D
- Be sure to palpate for the spermatic cord, urethra, and ipsilateral testicle. If possible, sweep these structures out of the way
- If you feel unable to isolate the above structures from the abscess site, it may be safest to consult urology
- Antibiotics rarely needed (unless signs of cellulitis, systemic involvement and/or immunosuppressed)
- Intrascrotal organ involvement
- Urology consult