Can ascending lower extremity (leg) cellulitis lead to scrotal swelling?

From the Guidelines

Ascending leg cellulitis can lead to scrotal swelling due to the spread of infection through connected tissue planes and lymphatic channels. This complication is a concern in patients with significant leg cellulitis, especially when there is inadequate or delayed treatment. According to the European Association of Urology guidelines on urological infections 1, Fournier’s gangrene is an aggressive and frequently fatal polymicrobial soft-tissue infection of the perineum, perianal region, and external genitalia, which can be a potential consequence of untreated or severe infections in the leg.

Key points to consider in the management of ascending leg cellulitis to prevent scrotal swelling include:

• Prompt medical attention to initiate broad-spectrum antibiotics, such as cefazolin or clindamycin, for 7-14 days, depending on severity 1
• Elevation of the affected limb and proper wound care if applicable
• Monitoring for systemic signs of infection
• Additional supportive measures like scrotal elevation and cool compresses may provide symptomatic relief in cases where scrotal swelling develops

It is crucial to prioritize the management of leg cellulitis, especially in patients with risk factors like diabetes, venous insufficiency, or immunocompromise, to prevent ascending complications and potential development of Fournier’s gangrene, as highlighted in the guidelines 1.

From the Research

Ascending Leg Cellulitis and Scrotal Swelling

• There is no direct evidence in the provided studies that links ascending leg cellulitis to scrotal swelling 2, 3, 4, 5, 6.
• The studies focus on the management, morbidity, and risk factors associated with cellulitis of the leg, but do not mention scrotal swelling as a complication or associated condition.
• However, it is possible that severe or untreated cellulitis could lead to systemic infection or inflammation, which may potentially cause swelling in other areas of the body, including the scrotum, although this is not supported by the provided evidence.
• Further research would be needed to determine if there is any connection between ascending leg cellulitis and scrotal swelling.

Related Complications of Cellulitis

• The studies do report on various complications and risk factors associated with cellulitis, including:
  • Abscess formation 4
  • Chronic oedema 2, 5
  • Leg ulceration 2, 5
  • Recurrent episodes 2, 5
• These complications can have a significant impact on patient morbidity and quality of life, and highlight the importance of proper management and treatment of cellulitis.