A case of hydrocele infection secondary to a cutaneous b-hemolytic group A streptococcal infection is described in a renal transplant recipient. Sepsis and renal failure occurred in the setting of this severe, life-threatening infection. This case represents the first description of a group A streptococcal hydrocele infection in an adult. This type of infection can progress rapidly to sepsis and its attendant complications, especially in an immunocompromised patient. Early diagnosis and treatment is crucial in order to optimize the outcome.