Bilateral penile cavernosal abscess secondary to Escherichia coli: a case report of a rare diagnosis

Abstract

Cavernosal abscess is a rare diagnosis. Disparity exists in the literature but the most common colonising agents appear to be Neisseira gonorrhoea and Staphylococcus aureus. We describe a 75-year-old man who presented with sepsis and was found to have Escherichia coli positive blood and urinary cultures. Following initial treatment for sepsis of unknown origin, computed tomography demonstrated a bilateral cavernosal abscess. The patient was successfully treated with incision and drainage, multiple re-looks and a delayed closure, alongside a course of appropriate antibiotics. A defect in the bulbar urethra was identified and repaired with bladder drainage via both suprapubic and urethral catheters. Following discharge, a urethrogram showed no urethral leak or stricture and the patient is now catheter free.

Keywords: Bilateral penile cavernosal abscess; Penile abscess.

Figure 1

Computed tomography scan demonstrating a cystic abnormality related to the penis replacing the corpus callosum adjacent to the penile urethra and urethral catheter; the catheter is appropriately sited.

Figure 2

Ascending urethrogram demonstrating a well-opacified anterior urethra which appears unremarkable. No fistulous tract demonstrated. Contrast passed through the posterior urethra, in to the bladder and out of the suprapubic catheter with no adverse features demonstrated.