Scrotal Abscess in a Patient With Chronic Kidney Disease and a Chronic Foley Catheter: A Case Report

Chronic Foley catheter use significantly increases the risk of scrotal abscesses, particularly in patients with comorbidities that impair immune function, such as diabetes and chronic kidney disease (CKD). We report a case of a 56-year-old male with type II diabetes, CKD, and a chronic indwelling Foley catheter who presented with progressive scrotal swelling and pain. Cultures identified Escherichia coli and Serratia marcescens from both urine and abscess fluid, confirming a possible urinary tract infection (UTI) as the source of scrotal abscess. The patient was found to have an abscess approximately 5 cm in size with significant drainage of abscess fluid overlying necrotic tissue of the right hemiscrotum. The management involved surgical debridement and excision of all necrotic scrotal tissue down to viable tissue, along with abscess washout to reduce the risk of further infections, and culture-directed antibiotic therapy. Outpatient and inpatient physicians, as well as advanced care providers, should prioritize proactive measures that include regular catheter care protocols to reduce the likelihood of complications arising in this vulnerable population.