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Case report
Unusual presentation of a periurethral abscess following infection with Neisseria gonorrhoea
  1. Robin Shepherd,
  2. Alexandra Crossland,
  3. Rafal Turo and
  4. Michelle Christodoulidou
  1. Urology, Mid Yorkshire Hospitals NHS Trust, Wakefield, UK
  1. Correspondence to Michelle Christodoulidou; Michelle.christodoulidou1{at}nhs.net

Abstract

We describe an unusual case of a male patient presenting with penile and testicular swelling following an unprotected and traumatic sexual encounter. It was suspected that an isolated penile injury occurred during intercourse; however, ultrasound imaging identified an intact tunical layer and right-sided epididymo-orchitis. Following screening for sexually transmitted infections (STIs), he was discharged with antibiotics and advice to attend the Sexual Health Centre for contact tracing. He represented with a periurethral abscess and an antimicrobial-resistant (AMR) strain of Neisseria gonorrhoea was identified. Appropriate antibiotic treatment was initiated. Examination-under-anaesthesia, following abscess drainage, revealed a contained collection with no urethral fistula; however, a flat urethral lesion was seen during urethroscopy. Repeat urethroscopy and biopsy of the lesion indicated polypoid urethritis. Periurethral abscess secondary to gonococcal urethritis is a rare complication, but one that we should be suspicious of, especially with the growing incidence of AMR-STIs.

  • gonorrhoea
  • urethritis
  • urological surgery
  • urinary and genital tract disorders
  • urinary tract infections

https://doi.org/10.1136/bcr-2021-246494

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    Footnotes

    • Contributors All authors contributed to the final version of this article. RS edited the case report, performed a literature review and wrote the discussion and edited submitted images. AC wrote the case presentation section with MC. RT was the supervising consultant in the management of this case and edited the final version of this article. MC edited the case report, participated in the management of this patient and obtained an informed consent from the patient to proceed with the submission. MC is the corresponding author of the article and lead author with the support of RT.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.