International Journal of Medical and Pharmaceutical Case Reports

Scrotal pyocele is an uncommon urological condition characterised by a purulent collection within the scrotal sac and may be associated with inflammatory conditions of the epididymis or testis. This case report describes a 69-year-old male who presented with progressive scrotal swelling, scrotal pain, and fever. The patient had a history of hypertension, coronary artery disease, hypothyroidism, and bronchial asthma. Haematological investigations showed an elevated white blood cell count of 23,200/cu. mm and platelet count of 575,000/cu. mm, while urine examination showed a turbid appearance with increased pus/WBC cells, RBCs, and epithelial cells. Scrotal ultrasonography demonstrated normal testicular size and echotexture without focal lesions, but revealed a gross left scrotal fluid collection with internal echoes. The encysted collection measured approximately 6.0 × 6.5 cm and compressed the left testis; minimal free fluid was also present in the right scrotal sac. The therapeutic approach included empirical antimicrobial therapy, analgesic and supportive treatment, while drainage and surgical procedures were discussed as management options. The case highlights the diagnostic value of ultrasonography in identifying an encysted purulent scrotal collection and assessing testicular compression. Timely recognition and appropriate multidisciplinary management are important because scrotal pyocele may be associated with severe infectious complications and possible testicular compromise.