Bilateral scrotal abscesses caused by Klebsiella pneumoniae in a newborn

Neonatal Escherichia coli infection in twins: clinical spectrum and management dilemma

The clinical manifestation of Escherichia coli could vary from asymptomatic bacteraemia to systemic bloodstream infection and meningitis. We describe an unusual course of E. coli infection in twins, emphasising commencement of appropriate antimicrobial therapy. A set of male dichorionic diamniotic twins were delivered at 34 weeks of gestation by caesarian section. Pregnancy was complicated by diabetes, pre-eclampsia and cholestasis. Antenatal ultrasounds noted a congenital pulmonary airway malformation in twin A. Following delivery, twin A developed respiratory distress, but twin B was asymptomatic. Partial septic work-up at admission in the neonatal intensve care unit was done. Twin A's blood culture grew E. coli, while twin B's blood culture was negative. Twin A was treated with 7 days of intravenous antibiotics. At 11 days of age, twin B acutely developed a scrotal swelling. On suspicion of testicular torsion, he was taken for urgent surgery, which revealed a scrotal abscess positive for E. coli The scrotum was irrigated and successfully treated with 4 weeks of antibiotics. Both twins were doing well at 3 months of follow-up.

Perspective in Pediatric Pathology, Chapter 24. Testicular Inflammatory Processes in Pediatric Patients

Acute scrotal pain in children represents a major diagnostic and therapeutic challenge. An important initial differentiation should be made between epididymitis and other processes that cause acute scrotal pain, such as testicular torsion and tumor. Infectious agents disseminating through the blood flow can damage the testis by causing orchitis. On the other hand, infections ascending via spermatic pathways typically lead to epididymitis [ 1 ].

Propionibacterium acnes Is an Unusual Cause of Acute Scrotal Abscess in a Preterm Infant

Acute scrotal abscess is an extremely rare condition in neonates and may mimic testicular torsion. Most of these abscesses have reportedly been due to Staphylococcus and Salmonella spp. infections. We herein report a unilateral acute scrotal abscess in a preterm infant born at 26 weeks in whom Propionibacterium acnes was isolated from the collected scrotal fluid culture. To our knowledge, this is the first case report implicating P. acnes as a causative agent of neonatal scrotal abscess. Based on such findings, P. acnes infection should be considered in differential diagnosis of acute scrotal abscess in neonates, particularly in preterm infants.

Scrotal abscess owing to Candida albicans in a newborn

Acute scrotal abscess in neonates is rare and may mimic testicular torsion. An unusual case of unilateral scrotal abscess caused by Candida albicans in a preterm infant is presented. As far as we are aware, this complication has not been reported before.