Clinical value of PET/CT in the diagnosis of a hidden corpus cavernosum abscess

Abstract

Case description: A 55-year-old man with a history of urinary catheterization due to benign prostatic hyperplasia presented with a corpus cavernosum abscess. The diagnosis was confirmed by FDG-PET/CT. Streptococcus anginosus and Parvimonas micra were isolated in blood cultures. Initial abdominopelvic CT did not clearly define the abscess, but PET/CT revealed intense radiotracer uptake (SUVmax 32.6) throughout the penis, which guided both surgical drainage and targeted antibiotic therapy.

Clinical implications: Cavernosal abscesses can present as fever of unknown origin without obvious findings on conventional imaging techniques such as ultrasound or CT. In such cases, advanced imaging methods like PET/CT may be required to localize the infectious focus. The clinical-radiological discordance observed in this case highlights the value of PET/CT in diagnosing deep or atypical infections.

Relevance: PET/CT can serve as a key diagnostic tool for identifying infectious foci within the corpus cavernosum that may not be visible with other imaging modalities.

Conclusions: Although corpus cavernosum abscess is rare, it should be considered in patients presenting with perineal pain, persistent fever, and a history of urological interventions such as urinary catheterization. This case demonstrates the diagnostic challenges that can arise when conventional imaging fails to identify the source of infection. In this context, FDG-PET/CT proved fundamental for localizing the abscess and guiding appropriate management. The case underscores the importance of advanced imaging and a multidisciplinary approach in the diagnosis and treatment of complex infections.