Spontaneous clitoral abscess in a school-age girl: A case report and literature review

Background Clitoral abscess is an exceptionally rare condition characterized by localized purulent accumulation in the clitoral or peri-clitoral tissues. If untreated, it can result in severe complications such as necrotizing fasciitis, sexual dysfunction, and psychological distress. Despite its potential for significant morbidity, clitoral abscesses remain underreported and poorly understood, with no standardized diagnostic or management guidelines available. Case presentation We report the case of an 8-year-old girl with a spontaneous clitoral abscess, the youngest documented patient in the literature. The abscess, initially managed conservatively with antibiotics, progressed rapidly to extensive necrosis and severe pain, necessitating surgical intervention. Definitive treatment included incision and drainage, and partial clitoral hoodoplasty to address extensive clitoral hood distortion. Postoperative recovery was uneventful, with complete resolution of the abscess and excellent cosmetic outcomes. Discussion A comprehensive literature review identified 24 cases of idiopathic clitoral abscesses, highlighting variability in clinical presentation, diagnostic strategies, and management approaches. While conservative therapy may be appropriate in select cases, the high recurrence rates and risk of complications often necessitate surgical intervention. Imaging modalities such as ultrasonography are essential for evaluating abscess extent and identifying underlying conditions. Conclusion This case highlights the importance of early recognition, accurate diagnostic evaluation, and timely surgical management of clitoral abscesses to reduce morbidity and improve outcomes. Incorporating clitoral hoodoplasty during incision and drainage achieved excellent cosmetic results without affecting recovery. Further research is necessary to develop evidence-based guidelines for the diagnosis and management of this rare condition.