Abstract

Introduction and Importance: Scrotal pyocele is a rare but serious urological emergency characterized by the accumulation of
purulent fluid within the scrotum, often secondary to infection or trauma. Early recognition and intervention are essential to prevent
complications such as abscess formation, necrosis, or testicular loss.
Case Presentation: We report the case of a 39-year-old diabetic male with chronic alcoholism who presented with progressive
left scrotal pain and swelling following a minor motorcycle accident. Ultrasonography confirmed rupture of the tunica vaginalis and
collection of purulent fluid consistent with pyocele. Emergency incision and drainage were performed, and pus culture revealed
Staphylococcus aureus, which was managed successfully with targeted antibiotics and analgesics. The patient recovered
completely without complications.
Clinical Discussion: Scrotal pyocele is an uncommon sequela of blunt trauma, more often associated with infectious etiologies.
In this case, ultrasonography played a crucial role in differentiating pyocele from hematocele and guiding early surgical intervention.
The presence of comorbidities such as diabetes and chronic alcoholism increased infection risk, yet timely drainage and culture
directed therapy led to preservation of testicular function. The isolation of S. aureus is unusual compared to more typical urinary
pathogens reported in previous literature.
Conclusion: Traumatic scrotal pyocele is a rare but potentially life-threatening entity. Prompt diagnosis, surgical drainage, and
culture-based antibiotic therapy are critical to favorable outcomes and testicular preservation.