Urgent surgical management in a patient with bilateral scrotal abscess and necrotizing fasciitis: A case report

Rationale: Bilateral scrotal abscess complicated by necrotizing fasciitis is a rare but severe clinical emergency that can lead to life-threatening complications such as sepsis and multiorgan failure. Due to its rapid progression and diverse clinical presentation, early diagnosis and treatment are critical to improving patient outcomes. Patient concerns: A 67-year-old Asian male patient of Chinese nationality presented with bilateral scrotal swelling, pain, and fever. The patient reported severe, persistent scrotal pain accompanied by systemic symptoms, including fever and malaise. Diagnoses: Physical examination revealed significant scrotal swelling, erythema, and tenderness, with a fluctuant sensation. Laboratory findings showed leukocytosis and elevated C-reactive protein levels, while ultrasound confirmed the presence of bilateral scrotal abscesses and evidence of fascial necrosis. Interventions: The patient underwent urgent surgical intervention, including bilateral scrotal incision and drainage, and debridement of necrotic tissue. Outcomes: Postoperatively, the patient was managed with broad-spectrum antibiotics and supportive therapy, leading to gradual improvement and eventual recovery. Lessons: This case highlights the rarity and urgency of bilateral scrotal abscess complicated by necrotizing fasciitis, emphasizing the importance of heightened clinical suspicion, prompt imaging, and surgical intervention. Early recognition and aggressive treatment are essential for optimizing patient outcomes in such cases.