Scrotal hematoma and subsequent abscess following urethral catheterisation

A man in his early 70s with advanced Lewy body dementia was admitted to the hospital for treatment of aspiration pneumonia and a severe sacral pressure ulcer. An indwelling urinary catheter was placedto manage urinary retention and to prevent urine contamination of the sacral ulcer.On the 25th day of hospitalisation, swelling and tenderness developed in the patient's left scrotum. CT and ultrasonography suggested a scrotal hematoma without testicular abnormalities. Clinical monitoring was initially chosen. However, on the 37th day, the scrotum became red and swollen again. Ultrasound and needle aspiration revealed a scrotal abscess, cultures identified Klebsiella pneumoniae The abscess was successfully treated with drainage and ceftriaxone (2 g every 24 hours for 2 weeks). Despite recovery from the abscess, the patient later died from recurrent aspiration pneumonia on the 120th day of hospitalisation.