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1.
Ann R Coll Surg Engl ; 103(10): e330-e334, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34414780

RESUMO

In the postantibiotic era, prostatic abscesses (PAs) are rare, affecting primarily immunocompromised men and/or caused by atypical drug-resistant pathogens, raising both diagnostic and management challenges. PA caused by methicillin-resistant Staphylococcus aureus (MRSA) is an uncommon condition and also a primary source of bacteremia. Nevertheless, the continued pattern of increase in reported cases, due especially to community-associated strains, is a growing concern regarding the significant morbidity and mortality. Besides proper antibiotics, drainage of a PA may be required, which is usually transrectal or transurethral. Herein, we describe the case of MRSA PA extending into the penis with concomitant MRSA bacteremia of unknown origin, whereupon diabetes mellitus was newly diagnosed in a previously healthy man residing in a community setting, and managed successfully by a transperineal drainage with good outcome. This case also highlights that individuals diagnosed with such rare deep-seated MRSA infections should be assessed for undiagnosed comorbidities. To the best of our knowledge, this is the first reported case of percutaneous drainage of a PA by using a double-lumen catheter.


Assuntos
Abscesso/terapia , Complicações do Diabetes/microbiologia , Staphylococcus aureus Resistente à Meticilina , Doenças do Pênis/microbiologia , Doenças Prostáticas/microbiologia , Infecções Estafilocócicas/terapia , Abscesso/complicações , Abscesso/microbiologia , Drenagem , Humanos , Masculino , Pessoa de Meia-Idade , Doenças do Pênis/complicações , Doenças do Pênis/terapia , Doenças Prostáticas/complicações , Doenças Prostáticas/terapia , Infecções Estafilocócicas/complicações
2.
BMC Urol ; 21(1): 115, 2021 Aug 24.
Artigo em Inglês | MEDLINE | ID: mdl-34429077

RESUMO

BACKGROUND: Penile enhancement with injectable agents is a rising trend and yet has received little scientific attention despite the potential for serious complications. These include cosmetic, functional and systemic complications that may require complex penile reconstructive surgery. We report a case of delayed severe infection following penile filler insertion leading to multi-organ failure and intensive care support. CASE PRESENTATION: A 31-year-old man presented with fevers and progressive pain and swelling of the penile shaft, 3 days after unprotected sexual intercourse. The patient received subcutaneous hyaluronic filler injections at a cosmetic clinic for penile enlargement two months prior to presentation. Relevant social history include polysubstance abuse and multiple sexual partners. Physical examination revealed gross penile oedema and erythema, with a ventral curvature of the penile shaft and a superficial abrasion on the distal ventral penile shaft. Within 24 h the patient developed septic shock with anuria, hypotension and fevers to 40 °C, requiring transfer to the Intensive Care Unit (ICU) for vasopressor and inotropic support. Intraoperative penile exploration revealed multiple pus stained fillers which were drained and grew Streptococcus Pyogenes on cultures. There was no abscess or evidence of necrotising fasciitis intraoperatively. The patient improved with intravenous antibiotics and was stepped down from the ICU after four days and discharged on day eight. One month post admission there was significant superficial skin loss to both ventral and lateral aspect of the penis, with healthy granulation tissue at the base. The patient opted for conservative management with regular dressings. He reported normal sexual and urinary function three months post admission. CONCLUSION: This is the first published case of sepsis from a penile infection in the context of hyaluronic acid penile fillers. In an era of escalating demand for penile cosmetic procedures, there is an increasing need for early recognition and appropriate management of penile filler infections. We report an unusual case of a localised penile infection rapidly progressing to sepsis with multi-organ failure requiring intensive care support. The case demonstrates early surgical intervention with targeted antimicrobials can result in successful eradication of infection, with satisfactory cosmetic and functional outcomes for patients.


Assuntos
Preenchedores Dérmicos/efeitos adversos , Ácido Hialurônico/efeitos adversos , Doenças do Pênis/diagnóstico , Pênis/efeitos dos fármacos , Infecções Estreptocócicas/diagnóstico , Adulto , Antibacterianos/uso terapêutico , Preenchedores Dérmicos/administração & dosagem , Humanos , Ácido Hialurônico/administração & dosagem , Masculino , Doenças do Pênis/tratamento farmacológico , Doenças do Pênis/microbiologia , Doenças do Pênis/patologia , Pênis/patologia , Pênis/cirurgia , Infecções Estreptocócicas/tratamento farmacológico , Infecções Estreptocócicas/patologia , Streptococcus pyogenes
4.
Urology ; 141: e45-e46, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32305553

RESUMO

The development and management of necrotizing cellulitis following penile constriction ring use is described. Devastating injuries such as this can be highly distressing for patients and focused counseling is often needed to address concerns regarding cosmetic outcomes. The timeframe and appearance of recovery has not been previously captured. We present a photographic timeline covering the development, management, and postoperative recovery from penile constriction ring injury over the course of 1 month.


Assuntos
Celulite (Flegmão)/microbiologia , Doenças do Pênis/microbiologia , Pênis/lesões , Infecções Estreptocócicas/etiologia , Streptococcus pyogenes , Celulite (Flegmão)/diagnóstico , Celulite (Flegmão)/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Doenças do Pênis/diagnóstico , Doenças do Pênis/cirurgia , Fatores de Tempo
6.
Ann Dermatol Venereol ; 147(5): 370-372, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31952954

RESUMO

INTRODUCTION: Infectious cellulitis is a common disease, mostly affecting the lower extremities and the face but only rarely the genitalia. OBSERVATION: A 24-year-old male patient presented with acute erythematous edema of the penile shaft and foreskin present for 48hours. Gentle retraction of the foreskin revealed a short frenulum with a small area (2-3mm) of erosion. He had had unprotected genital and orogenital sex three days before with his usual female partner and reported tearing of the frenulum during intercourse. Ampicillin-sensitive Haemophilus parainfluenzae was isolated from the swab taken from the erosion of the frenulum. Clinical remission was obtained following oral administration of amoxicillin and clavulanic acid. DISCUSSION: We describe not only the first case of Haemophilus parainfluenzae-associated cellulitis of the penis but also the first report of penile cellulitis following erosion of a short frenulum during sexual intercourse.


Assuntos
Celulite (Flegmão)/microbiologia , Prepúcio do Pênis/lesões , Infecções por Haemophilus , Haemophilus parainfluenzae , Lacerações/complicações , Doenças do Pênis/microbiologia , Celulite (Flegmão)/etiologia , Coito , Infecções por Haemophilus/etiologia , Humanos , Masculino , Doenças do Pênis/etiologia , Adulto Jovem
13.
Arch Iran Med ; 21(3): 131-133, 2018 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-29688739

RESUMO

Pilonidal sinus, including one or more sinus canals and hairs, is a disease with a chronic course showing acute attacks which is often encountered in the general population, usually affecting young adults, at a rate in males twice that of females. Pilonidal sinus on the penis is so rare that very few cases have been reported in literature. A 20-year-old male presented to the urology outpatient clinic with the complaint of a suppurative lesion with discharge on the skin of the penis which had been ongoing for approximately three months. Clinical examination revealed an indurated, erythematous, ulcerative lesion, 3 cm x 2 cm in size, in the middle of the ventral aspect of the penile shaft. We present the first case in literature of recurrent pilonidal sinus related to Actinomyces israelii, located on the penis.


Assuntos
Actinomicose/complicações , Doenças do Pênis/patologia , Seio Pilonidal/patologia , Actinomyces/isolamento & purificação , Actinomicose/patologia , Actinomicose/cirurgia , Humanos , Masculino , Doenças do Pênis/microbiologia , Doenças do Pênis/cirurgia , Seio Pilonidal/microbiologia , Seio Pilonidal/cirurgia , Recidiva , Adulto Jovem
14.
J Coll Physicians Surg Pak ; 28(2): 164-165, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29394981

RESUMO

skin and subcutaneous tissue. Penis may be secondarily affected in some cases; however, primary isolated involvement of penis is rare. A 48-year male smoker presented with pain and blackish discoloration of the distal part of penis for the last 4 days which developed following rupture of a papulo-vesicular lesion over the prepuce of penis. It rapidly progressed to involve half of the skin of the penis. The patient was hospitalized and broad spectrum antibiotics were administered parenterally. Emergency wound debridement and urinary diversion by suprapubic cystostomy was done. After repeated wound debridement and dressings, the wound healed. Our case was unusual as the penis was the sole site of affection, which is very unusual and only few such cases are reported in the literature.


Assuntos
Escherichia coli/isolamento & purificação , Gangrena de Fournier/diagnóstico , Klebsiella pneumoniae/isolamento & purificação , Doenças do Pênis/diagnóstico , Antibacterianos/uso terapêutico , Desbridamento , Escherichia coli/efeitos dos fármacos , Infecções por Escherichia coli/tratamento farmacológico , Gangrena de Fournier/tratamento farmacológico , Gangrena de Fournier/microbiologia , Gangrena de Fournier/cirurgia , Humanos , Infecções por Klebsiella/tratamento farmacológico , Klebsiella pneumoniae/efeitos dos fármacos , Masculino , Pessoa de Meia-Idade , Doenças do Pênis/tratamento farmacológico , Doenças do Pênis/microbiologia , Doenças do Pênis/cirurgia , Pênis/patologia , Resultado do Tratamento , Derivação Urinária , Cicatrização
17.
Mycopathologia ; 182(3-4): 397-402, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27659805

RESUMO

Candida albicans is the most common pathogen that causes balanoposthitis. It often causes recurrence of symptoms probably due to its antifungal resistance. A significant number of balanitis Candida albicans isolates are resistant to azole and terbinafine antifungal agents in vitro. However, balanoposthitis caused by fluconazole- and terbinafine-resistant Candida albicans has rarely been reported. Here, we describe a case of a recurrent penile infection caused by fluconazole- and terbinafine-resistant Candida albicans, as well as the treatments administered to this patient. The isolate from the patient was tested for drug susceptibility in vitro. It was sensitive to itraconazole, voriconazole, clotrimazole and amphotericin B, but not to terbinafine and fluconazole. Thus, oral itraconazole was administrated to this patient with resistant Candida albicans penile infection. The symptoms were improved, and mycological examination result was negative. Follow-up treatment of this patient for 3 months showed no recurrence.


Assuntos
Antifúngicos/farmacologia , Candida albicans/efeitos dos fármacos , Candidíase Mucocutânea Crônica/diagnóstico , Farmacorresistência Fúngica , Fluconazol/farmacologia , Naftalenos/farmacologia , Doenças do Pênis/diagnóstico , Adulto , Antifúngicos/uso terapêutico , Candida albicans/isolamento & purificação , Candidíase Mucocutânea Crônica/tratamento farmacológico , Candidíase Mucocutânea Crônica/microbiologia , Candidíase Mucocutânea Crônica/patologia , Humanos , Itraconazol/farmacologia , Itraconazol/uso terapêutico , Masculino , Testes de Sensibilidade Microbiana , Técnicas Microbiológicas , Técnicas de Diagnóstico Molecular , Doenças do Pênis/tratamento farmacológico , Doenças do Pênis/microbiologia , Doenças do Pênis/patologia , Recidiva , Terbinafina , Resultado do Tratamento
18.
BMJ Case Rep ; 20162016 Jul 14.
Artigo em Inglês | MEDLINE | ID: mdl-27417990

RESUMO

A 69-year-old male patient who was treated with intravesical BCG for carcinoma in situ of the bladder, went on to develop systemic features of BCG-osis. This diagnosis was supported by significant radiological and clinical findings. These systemic features include pulmonary miliary lesions, a mycotic abdominal aortic aneurysm and penile lesions. Owing to a breakdown in the relationship between the patient and the National Health Service, the patient has declined BCG treatment. This case highlights the potential rare side effects of intravesical BCG treatment and the risk associated with non-treatment of BCG-osis.


Assuntos
Aneurisma da Aorta Abdominal/microbiologia , Vacina BCG/efeitos adversos , Granuloma/microbiologia , Nódulos Pulmonares Múltiplos/microbiologia , Doenças do Pênis/microbiologia , Tuberculose Bovina/etiologia , Tuberculose Miliar/microbiologia , Administração Intravesical , Idoso , Aneurisma Infectado/etiologia , Animais , Vacina BCG/uso terapêutico , Carcinoma in Situ/tratamento farmacológico , Bovinos , Humanos , Masculino , Neoplasias da Bexiga Urinária/tratamento farmacológico
19.
Ann Dermatol Venereol ; 143(11): 697-700, 2016 Nov.
Artigo em Francês | MEDLINE | ID: mdl-27174716

RESUMO

INTRODUCTION: Donovanosis (granuloma inguinale) is a bacterial infection caused by Klebsiella granulomatis that occurs mainly in the genital area and is primarily sexually transmitted; it is seen predominantly in the tropics. Herein, we report a case of the disease contracted in metropolitan France. PATIENTS AND METHODS: A 47-year-old man presented with painless ulceration of the glans, present for one month, with progressive extension; there was no history of any recent trip abroad. Skin biopsy with Whartin-Starry and Giemsa staining revealed Donovan bodies in the cytoplasm of macrophages. Based on these findings, further questioning of the patient revealed unprotected sexual contact two months earlier in France. Treatment was initiated with azithromycin 1g on the first day followed by 500mg per day for three weeks. The clinical outcome was spectacular, with almost complete regression of the ulcer at 7 days. DISCUSSION: This case demonstrates that donovanosis can occur in metropolitan France.


Assuntos
Granuloma Inguinal/diagnóstico , Doenças do Pênis/microbiologia , Citoplasma/microbiologia , França , Humanos , Macrófagos/citologia , Macrófagos/microbiologia , Masculino , Pessoa de Meia-Idade
20.
S Afr Med J ; 106(5): 49-51, 2016 Apr 19.
Artigo em Inglês | MEDLINE | ID: mdl-27138664

RESUMO

An inguinal lymph node was discovered incidentally during surgery for a suspected strangulated inguinal hernia. The patient had recently been treated for candidal balanoposthitis and was known to have a paraphimosis. A new foreskin ulcer was discovered when he was admitted for the hernia surgery. The lymph node histology showed stellate abscesses suggestive of lymphogranuloma venereum (LGV). Chlamydial serologic tests were negative. As the histological appearance and clinical details provided were thought to suggest LGV, tissue was also sent for a real-time quadriplex polymerase chain reaction assay. This was used to screen for Chlamydia trachomatis in conjunction with other genital ulcer-related pathogens. The assay was negative for C. trachomatis, but positive for Treponema pallidum. Further histochemical staining of the histological specimen confirmed the presence of spirochaetes.


Assuntos
Linfadenite/diagnóstico , Linfogranuloma Venéreo/diagnóstico , Sífilis/diagnóstico , Diagnóstico Diferencial , Humanos , Linfadenite/microbiologia , Linfadenite/patologia , Masculino , Pessoa de Meia-Idade , Doenças do Pênis/microbiologia , Sífilis/patologia , Úlcera/microbiologia
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