Original Contributions| Volume 48, ISSUE 4, e93-e96, April 2015

Download started.


Idiopathic Infant Pyocele: A Case Report and Review of the Literature

Published:September 29, 2014DOI:



      Pyocele is a rare emergent urologic condition that requires rapid recognition and treatment to prevent testicular loss. Cases of pediatric pyocele have not been previously reported in the emergency medicine literature.

      Case Report

      We describe a case of a 6-week-old male who presented to the emergency department for a sepsis evaluation. The patient displayed subtle scrotal findings but had an otherwise benign physical examination. Subsequent sonographic imaging suggested a possible scrotal abscess and surgical exploration revealed a pyocele. A literature review of previously reported cases of patients with pyocele is also presented.

      Why Should an Emergency Physician Be Aware of This?

      A pyocele is a rare cause of both an acute scrotum and neonatal fever. It is important for emergency physicians to consider this entity when evaluating pediatric patients with fever, particularly those with symptoms related to the scrotum.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Emergency Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Kraft K.H.
        • Lambert S.M.
        • Snyder H.M.
        • et al.
        Pyocele of the scrotum in the pediatric patient.
        J Pediatr Urol. 2012; 8: 504-508
        • Lim G.Y.
        • Lim S.A.
        • Jeong Y.J.
        • et al.
        Infantile scrotal pyocele simulating missed testicular torsion on sonography.
        J Clin Ultrasound. 2003; 31: 116-118
        • Kutin N.D.
        • Schwartz D.L.
        • So H.B.
        • et al.
        Idiopathic infant pyoceles.
        J Pediatr Surg. 1986; 21: 441-442
        • Lynch D.F.
        • Peterson N.R.
        • Powell R.W.
        Pseudotorsion of testis.
        Urology. 1983; 30: 68-69
        • Jones W.G.
        • Deeths H.J.
        Infected hydrocele in a neonate.
        Urology. 1975; 5: 526-527
        • Patcher E.M.
        • Horowitz M.
        • Glassberg K.I.
        Infected hydrocele in neonate.
        J Urol. 1997; 157: 1464-1465
        • Waldbaum R.S.
        • Green J.L.
        Infected hydrocele.
        Urology. 1973; 2: 73-74
        • Yang Y.J.
        • Liu C.C.
        • Lin Y.J.
        • et al.
        Idiopathic infected hydrocele in infants: a case report and review.
        Pediatr Infect Dis. 1996; 15: 545-546
        • Huang C.B.
        • Chuang J.H.
        Acute scrotal inflammation caused by salmonella in young infants.
        Pediatr Infect Dis. 1997; 16: 1091-1092
        • Sagar J.
        • Kumar S.
        • Mondal D.
        • et al.
        Idiopathic infected hydrocele in a toddler: a case report with review.
        ScientificWorldJournal. 2006; 6: 2396-2398
        • Chiang M.C.
        • Wang T.M.
        • Fu R.H.
        • et al.
        Early-onset Escherichia coli sepsis presenting as acute scrotum in preterm infant.
        Urology. 2005; 65: 389.e22-389.e23
        • Shanks G.D.
        • Anderson R.T.
        • Lazoritz S.
        • Hemming V.G.
        Bilateral neonatal group A streptococcal hydrocele infection associated with maternal sepsis.
        Pediatr Infect Dis. 1986; 5: 107-108
        • Chrysostomou A.A.
        • Pheils P.J.
        • Price B.A.
        Infected hydrocele following acute appendicitis.
        Br J Urol. 1990; 65: 211
        • Malkin R.B.
        • Joshi V.V.
        • Koontz Jr., W.W.
        Bacterial orchitis, abscess and sepsis in a newborn: a case report.
        J Urol. 1974; 112: 530-531
        • Langer J.C.
        Red hemiscrotum in a child with abdominal pain.
        CMAJ. 2002; 166: 1695
        • Shahrudin M.D.
        Scrotal abscess: an unusual complication of perforated appendix.
        Med J Malaysia. 1994; 49: 172-173
        • Cos L.R.
        • Linke C.A.
        • Valvo J.R.
        Inflammatory communicating hydrocele.
        Urology. 1982; 20: 528-529
        • Andrews B.T.
        Infected hydrocele complicating acute appendicitis.
        Br J Urol. 1995; 49: 160
        • Ku J.H.
        • Yim Y.S.
        • Lee N.K.
        • Park Y.H.
        Infected hydrocele in a neonate.
        Urol Int. 2000; 65: 216-217
        • Slavis S.A.
        • Kollin J.
        • Miller J.B.
        Pyocele of scrotum: consequence of spontaneous rupture of testicular abscess.
        Urology. 1957; 5: 526-527
        • Lewis A.G.
        • Bukowski T.P.
        • Jarvis P.D.
        • et al.
        Evaluation of acute scrotum in the emergency department.
        J Pediatr Surg. 1995; 30: 277-282
        • McAndrew H.F.
        • Pemberton R.
        • Kikiros C.S.
        • Gollow I.
        The incidence and investigation of acute scrotal problems in children.
        Pediatr Surg Int. 2002; 18: 435-437
        • Anderson P.A.M.
        • Giacomantonio M.J.
        The acutely painful scrotum in children: review of 113 consecutive cases.
        Can Med Assoc J. 1985; 132: 1153-1155
        • Schalamon J.
        • Ainoedhofer H.
        • Schleef J.
        • et al.
        Management of acute scrotum in children-the impact of Doppler ultrasound.
        J Pediatr Surg. 2006; 41: 1377-1380