Traumatic testicular rupture complicated by pyocele: a rare case report

Scrotal pyocele is a rare but serious urological emergency characterized by the accumulation of purulent fluid within the scrotum, often secondary to infection or trauma. Early recognition and intervention are essential to prevent complications such as abscess formation, necrosis, or testicular loss.

We report the case of a 39-year-old diabetic male with chronic alcoholism who presented with progressive left scrotal pain and swelling following a minor motorcycle accident. Ultrasonography confirmed rupture of the tunica vaginalis and collection of purulent fluid consistent with pyocele. Emergency incision and drainage were performed, and pus culture revealed Staphylococcus aureus, which was managed successfully with targeted antibiotics and analgesics. The patient recovered completely without complications.

Scrotal pyocele is an uncommon sequela of blunt trauma, more often associated with infectious etiologies. In this case, ultrasonography played a crucial role in differentiating pyocele from hematocele and guiding early surgical intervention. The presence of comorbidities such as diabetes and chronic alcoholism increased infection risk, yet timely drainage and culture-directed therapy led to preservation of testicular function. The isolation of S. aureus is unusual compared to more typical urinary pathogens reported in previous literature.

Traumatic scrotal pyocele is a rare but potentially life-threatening entity. Prompt diagnosis, surgical drainage, and culture-based antibiotic therapy are critical to favorable outcomes and testicular preservation.