title: Penile discharge as a presentation of perirectal abscess.
abstract: Anorectal abscesses are a common presentation to the Emergency Department, but are frequently misdiagnosed. We report a patient in whom penile discharge was the presenting symptom of an ischiorectal abscess. A 42-year-old man presented with scrotal pain, swelling, and penile discharge. The genitourinary examination revealed a tender scrotum, and a fluctuant mass was identified on digital rectal examination. Computed tomography (CT) scan revealed an ischiorectal abscess with extension into the corpus cavernosum. We believe our patient's penile discharge was a manifestation of this abscess extension. Penile discharge is typically suggestive of sexually transmitted infections. Although rare, perirectal abscess should be considered in the differential diagnosis of penile discharge. A thorough digital rectal examination should be performed seeking the presence of mass or fluctuance.
authors.affiliation: Department of Emergency Medicine, State University of New York (SUNY) Downstate/Kings County Hospital, Brooklyn, New York 11203, USA.
authors.forename: Moshe
authors.initials: M
authors.lastname: Weizberg
authors.forename: Brian P
authors.initials: BP
authors.lastname: Gillett
authors.forename: Richard H
authors.initials: RH
authors.lastname: Sinert
mesh_terms: D000038:Abscess / Q000150:complications / Q000175:diagnosis*; D000328:Adult; D003937:Diagnosis, Differential; D005122:Exudates and Transudates; D006801:Humans; D007512:Ischium; D008297:Male; D010409:Penile Diseases / Q000000981:diagnostic imaging*; D011859:Radiography; D012002:Rectal Diseases / Q000150:complications / Q000175:diagnosis*; D014526:Urethritis / Q000175:diagnosis