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Indian Pediatr 2010;47:
363-364 |
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Scrotal Abscess in A Newborn: Caused by
Extended-Spectrum Beta-lactamase-Producing Klebsiella
pneumoniae |
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Mehmet Mutlu and Mustafa Imamoglu,
From Faculty of Medicine, Department of Pediatrics and
*Pediatric Surgery, Karadeniz Technical University,
Trabzon, Turkey.
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We are reporting a 17-day-old male newborn, infant of a diabetic mother,
who was admitted to our hospital with abdominal distention. Bilateral
especially right side, erythematous, painful, warm swelling of the scrotum
developed on 18th day of his life (Fig. 1). White blood cell
count was 31.2×10
3/mL.
CRP and procalcitonin level were 3.85 mg/dL and 2.47 µg/mL,
respectively. Needle aspiration from the right scrotum revealed pus. The
extended-spectrum beta-lactamase–producing (ESBL) Klebsiella pneumoniae
was grown in purulent material. Antibiotics (imipenem, vancomycin,
and amikacin) were started. The isolate was sensitive to imipenem and
amikacin. The blood and urine cultures were sterile. The resolution
of abscess was shown on ultrasound and there has not been recurrence of
the scrotal swelling.
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Fig.1: Clinical appearance of the scrotum. |
Scrotal abscess could have developed secondary to
intraperitoneal infection via previously undiagnosed patent processus
vaginalis(1,2). The most common causative microorganism of the scrotal
abscess is Staphylococcus in neonates(3). It has also been
reported due to a coliform organism(4), ß hemolytic Streptococcus
and Bacteroides(5), and Salmonella enteritidis (6).
The treatment consists of antibiotics and drainage(1).
References
1. Langer JC. Red hemiscrotum in a child with abdominal
pain. CMAJ 2002; 166: 1695.
2. Breysem L, Herman M, Moerman P, Van Damme-Lombaerts
R, Bogaert G, Smet M. High-resolution sonography of a scrotal abscess in a
2-week-old infant. Pediatr Radiol 2006; 36: 1186-1189.
3. Raveenthýran V, Cenita S. Scrotal abscess mimicking
testicular torsion in infants and neonates. J Pediatr Surg 2007;
42: 597-598.
4. Briggs C, Godbole P, MacKinnon AE, Vermeulen K.
Neonatal paratesticular abscess mimicking perinatal torsion. J Pediatr
Surg 2005; 40: 1195-1196.
5. Singh D, Dutta S, Kumar P, Narang A. Mixed anaerobic
and aerobic testicular abscess in a neonate. Indian J Pediatr 2001; 68:
561-562.
6. Foster R, Weber TR, Kleiman M, Grosfeld JL.
Salmonella enteritidis: testicular abscess in a newborn. J Urol 1983;
30: 790-791.
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