Adult Male With Scrotal Swelling and Pain

A previously healthy 36-year-old man presented to the emergency department for a 1-week history of progressive scrotal swelling and pain. He also endorsed 2 weeks of abdominal discomfort and vomiting. On examination, the patient had a temperature of 100.1°F (37.8°C), pulse rate of 93 beats/min, blood pressure of 131/76 mm Hg, swollen erythematous right hemiscrotum without crepitus, and suprapubic tenderness. Laboratory results were notable for a WBC count of 33.3 (103/μL). Scrotal ultrasonography (Figure 1) showed a right-sided complex fluid collection with internal septations.

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