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Although scrotal inflation by saline infusion has been widely publicised on websites, 1, 2 this procedure has rarely been reported in the medical literature. We report an HIV positive man who presented with severe scrotal cellulitis following an infusion of saline into his scrotum. Clinicians should be aware of unusual causes of scrotal cellulitis and should warn patients about potential complications of this hazardous practice. To our knowledge, this has never previously been reported in an HIV positive patient.
CASE REPORT
A 52 year old homosexual white man, HIV positive since 1996, presented in April 2005 with a 2 day history of painful scrotal swelling. He had obtained information and a disposable scrotal infusion toolkit from a website). There was no inguinal lymphadenopathy or ulceration. The cellulitis resolved after a week's course of co-amoxiclav 375 mg (amoxycillin 250 mg and clavulanic acid 125 mg) three times a day. Despite the severity of his illness, the patient declined to stop this practice and he was therefore advised on how to reduce the risk of complications. Advice included using alcohol swabs to clean the scrotum and to use Venflon (plastic needle in situ for infusion) rather than a metal needle that could damage surrounding soft tissue.
Shows previous infusion scars (arrow), Prince Albert ring, and marked cellulitis. (Reproduced with permission of patient.)
Showing diffuse symmetrical tense scrotal swelling. Photograph taken by the patient's friend on a previous occasion. (Reproduced with permission of patient.)
DISCUSSION
Causes of painful scrotal swelling include torsion of the testis and its appendages, epididymitis,...