Intriguing case of fistula-in-ano presenting as corpora spongiosum abscess

Abstract

A 77-year-old male, with a known history of diabetes mellitus for 10 years on alternative medication, known case of chronic constipation with hemorrhoids, and chronic lower urinary tract symptoms for many years, presented to the emergency with fever and chills for 2 days followed by acute urinary retention, which was relieved by insertion of Foley’s catheter. Eventually, he developed pain in the perianal region along with perianal discharge. On clinical examination, fistula-in-ano was evident. Magnetic resonance imaging was done for further evaluation which revealed fistula-in-ano communicating into a large abscess of corpus spongiosum of penis.