Febrile Pelvic Mass in a Man: A Seminal Vesicle Abscess as a Rare Differential Diagnosis

Introduction: Seminal vesicle abscesses (SVA) are rare and often under-recognized conditions. Their exact incidence remains unknown, but they are generally associated with predisposing factors such as diabetes mellitus, recurrent urinary tract infections, or previous urological interventions [1]. Clinically, these abscesses present with non-specific symptoms, such as fever, dysuria, pelvic or perineal pain, and sometimes a palpable mass on digital rectal examination [2]. Diagnosis relies on medical imaging, where transrectal ultrasound may suggest a retrovesical collection, but magnetic resonance imaging (MRI) offers precise lesion characterization, allowing differentiation between an abscess and other pelvic masses such as tumors or cysts [3]. Complete situs inversus, a rare congenital anomaly characterized by transposition of thoracoabdominal organs, further complicates the diagnostic process due to the reversed anatomical layout [4]. This anatomical variant can lead to misinterpretation during clinical and imaging examinations, thereby delaying appropriate management. We report the case of a 53-year-old male patient with type 2 diabetes and complete situs inversus, admitted for persistent fever and dysuria, in whom a left seminal vesicle abscess was diagnosed using MRI.