Fukami Shota, Fukushima Masanori, Ohki Nozomi, Miuma Satoshi, Miyaaki Hisamitsu
Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, JPN.
Department of Radiological Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, JPN.
Cureus. 2025 Aug 4;17(8):e89381. doi: 10.7759/cureus.89381. eCollection 2025 Aug.
A 60-year-old man with idiopathic portal hypertension and ascites presented with fever, abdominal pain, and right scrotal swelling. He was diagnosed with spontaneous bacterial peritonitis (SBP) and a communicating right hydrocele, and antibiotic treatment was initiated. Despite treatment, his fever and elevated inflammatory markers persisted, accompanied by progressive genital pain. On day 21, he was diagnosed with a scrotal abscess. Owing to a poor response to antibiotics, and because scrotal ultrasound revealed a multiloculated abscess without any drainable cavity, an orchiectomy was performed on day 108. , identical to that identified in ascitic fluid, was isolated from the surgical specimen. Communicating hydroceles associated with ascites have been reported; however, no previous reports have described scrotal abscesses resulting from SBP. In this case, antibiotic treatment was ineffective, necessitating surgical excision. This case highlights the importance of careful monitoring of patients with SBP and hydrocele, as scrotal abscesses may develop.
一名患有特发性门静脉高压和腹水的60岁男性出现发热、腹痛和右侧阴囊肿胀。他被诊断为自发性细菌性腹膜炎（SBP）和交通性右侧鞘膜积液，并开始接受抗生素治疗。尽管进行了治疗，他的发热和炎症指标仍持续升高，并伴有进行性生殖器疼痛。在第21天，他被诊断为阴囊脓肿。由于对抗生素反应不佳，且阴囊超声显示为多房性脓肿且无任何可引流腔隙，于第108天进行了睾丸切除术。从手术标本中分离出与腹水中鉴定出的相同的病菌。与腹水相关的交通性鞘膜积液已有报道；然而，以前没有报告描述过由SBP导致的阴囊脓肿。在本病例中，抗生素治疗无效，需要进行手术切除。该病例强调了对SBP和鞘膜积液患者进行仔细监测的重要性，因为可能会发生阴囊脓肿。
