Pasteurella bettyae Infections in Men Who Have Sex with Men, France.

Pasteurella bettyae is a gram-negative bacillus sporadically involved in human infections; its main reservoirs are cats and dogs. A recent publication suggests the possibility of sexual transmission leading to genital infections in men who have sex with men. We report 9 cases in France of genital infection among this population.

Reply to: Erosive balanitis caused by Staphylococcus haemolyticus in a healthy, circumcised adult male.

In this short letter of correspondence, we provide our specialist interpretation of what has been described in a previously published case report. We argue that this case describes a patient with chronic, undertreated male genital lichen sclerosus. If left unchecked, as in this case, lichen sclerosus can cause permanent architectural changes and damage to the affected tissues, and can thus predisposes to secondary infections, including bacterial, such as with Staphylococcus haemolyticus.

Balanoposthitis in children: Analysis of treatment diversity and development of a treatment proposal.

INTRODUCTION: Balanoposthitis in boys with physiological phimosis is common. Publications on the topic are rare and literature provides no evidence-based guidelines on treatment efficacy. With this study, we aim to analyze treatments currently used, physicians' experience regarding the success and thus derive a treatment proposal. STUDY DESIGN: An online questionnaire was created to evaluate practice patterns and experience. A case scenario, open questions and multiple-choice questions were used to allow multilayered answers. Pediatricians, pediatric surgeons, pediatric urologists, and family practitioners were invited to participate. Demographic data and answers to multiple choice questions were analyzed descriptively. Free text comments were analyzed quantitively by coding the text entries and identifying relevant themes. The themes were then grouped into categories. RESULTS: Three-hundred-and-one data sets were analyzed. Predominantly, participants were from Germany and Switzerland, and most were specialized in either pediatrics or pediatric surgery. The analysis revealed a wide variability of treatments. Three main treatment forms were identified: baths, topical antiseptic treatment (wraps, gels), and topical antibiotics. Many participants use combinations of the above. Altogether, 53 treatment varieties and 27 categories were identified, including oral antibiotics and local irrigation. Treatment success was reported to be good for all treatment forms, baths were reported to be the best perceived treatment by the majority of participants. DISCUSSION: The online questionnaire generated valuable data on the wide variety of treatment used for posthitis. The fact that all treatments are reported to be highly effective suggests that little is necessary to treat the condition or that it might even be self-limiting. Further studies will be needed to prove this conclusion. Until those are available, three main concepts should be considered when choosing a treatment: avoid (traumatizing) manipulation, apply antibiotic stewardship and adhere to families' preferences and feasibility. CONCLUSION: We propose baths or local antiseptics, depending on the practitioner's and family's choice as the least invasive alternative. A prospective study to back our recommendation is scheduled.

Camel filariasis (Dipetalonema evansi) and its association with clinical balanoposthitis with reference to prominent changes in clinical findings, serum testosterone, semen analysis, and testicular histopathology.

BACKGROUND: Camel filariasis induced variable clinical syndromes characterized by fever, lethargy, localized dermal lesions, loss of condition, and testicular and scrotal swelling. The objective of the present work focused on clarifying the diagnostic importance of clinical findings, serum testosterone, and semen analysis as well as blood smear and testicular histopathology as a differential tool between only balanoposthitis without filariasis male camels group (OnlyBpgr) and balanoposthitis-filariasis infected male camels group (BpFlgr). The study also monitored the associations between the severity of ticks' infestations in investigated male camels and the occurrence of balanoposthitis only or balanoposthitis with filariasis. RESULTS AND CONCLUSIONS: The study reported significant correlation between serum testosterone, serum cortisol, and sperm vitality and abnormalities percentages. The study included male camels (n = 250) classified into three groups: healthy control group (Contgr; n = 30), OnlyBpgr (n = 210), and BpFlgr (n = 10). These male camels were clinically and laboratory examined, and skin scraping tests and testicular histopathology were conducted. The study confirmed the association of the changes in clinical findings, whole blood picture, serum testosterone, serum cortisol, and semen analysis, with OnlyBpgr and BpFlgr. These changes were more prominent in BpFlgr than in OnlyBpgr. Skin scraping test results revealed a higher severity of live ticks' infestation in BpFlgr than in OnlyBpgr because, unlike OnlyBpgr, all camels in BpFlgr (n = 10) were suffering from live ticks' infestation. It also concluded the higher efficacy of histopathology of testicular tissues in male camels as a diagnostic tool for adult filaria in balanoposthitis-affected male camels than blood smear because all cases of camel filariasis in the current work were negative for microfilaria on microscopic examination of diurnal blood smear as well as testicular histopathology revealed detection of adult filaria in all camel filariasis associated with balanoposthitis. Strong correlation relationships were demonstrated between serum testosterone, serum cortisol, and semen analysis results. Positive correlations were reported between serum testosterone levels and sperm vitality percentages. However, negative correlations were stated between serum testosterone and each of serum cortisol and sperm abnormalities either in Contgr, OnlyBpgr, or BpFlgr.

[Balanoposthitis in the clinical practice of a urologist and dermatovenereologist: an interdisciplinary problem].

Balanoposthitis is a common inflammatory disease of the male genitals, which occurs more often in uncircumcised men. The cause of balanoposthitis can be an infectious, inflammatory or autoimmune process, as well as traumatization. In most cases, after proper intimate hygiene and the use of neutral moisturizers, the symptoms of balanoposthitis are completely stopped. In the case of torpid course of balanoposthitis and in the absence of improvement after drug therapy, it is necessary to exclude the malignant process. In the review article, the authors present the data of modern scientific research on the qualitative and quantitative composition of the microbiome in balanoposthitis. Differences in the composition of the microbiome were revealed in patients with balanoposthitis and healthy patients from the control group with excess foreskin. It was found that in patients with balanoposthitis, a impaired in hydration of the skin of the glans penis was revealed. Staphylococcus warneri and Prevotella bivia are the most common species associated with balanoposthitis and positively correlate with the severity of the disease. Candida infection, as an etiological factor of balanoposthitis, often occurs in children and may be associated with diaper rash. The prevalence of Gardnerella vaginalis as a pathogen in the male urogenital tract has not been fully studied. Currently, there are no reliable scientific studies that make it possible to attribute G. vaginalis to the etiological factor of balanoposthitis in men. However, it should be borne in mind that balanoposthitis may have a polymicrobial and synergistic etiology with the participation of G. vaginalis and anaerobic bacteria in the lower genital tract of men. The review article is clearly illustrated with clinical examples of the disease from the personal practice of the authors.

Isolation and identification of Neisseria gonorrhoeae strain from a balanoposthitis patient and drug resistance mechanism of the isolate / 中国人兽共患病学报

We isolated and identified the bacterial pathogen in a pyogenic balanoposthitis patient and investigated the drug resistance and its mechanism of the isolate.Urethral secretions and balanus pustule liquids were collected for microscopic examination after Gram-staining and detection of mycoplasma using Mycoplasma IST 2 kit.The two samples were inoculated on Columbia blood plate,N.gonorrhoeae selective plate and chromID Candida plate for isolation.The obtained colonies were identified by VITEK 2-compact automatic bacterial detection and analysis system.Moreover,PCR was performed to detect 16S rRNA gene of N.gonorrhoeae in the samples and colonies.KB method was applied for detecting susceptibility of five common antibiotics against the isolate.The β-lactamase and extended spectrum β-lactamase confirmatory tests were used to investigate the enzyme production of the isolate as well as drug resistance-associated tetM,TEM,mefA and ermF genes in the isolate were detected by PCR.Results showed that all the clinic samples showed negative for mycoplasma.All the isolating cultivation results of urethral secretions were negative while the balanus pustule liquids provided positive isolating cultivation in the blood and selective plates.The VITEK 2-compact system and 16S rRNA-PCR revealed that the isolated strain belongs to N.gonorrhoeae.The isolate can produce β-lactamases and resist to penicillin G,ciprofloxacin and tetracycline.The tetM,TEM,mefA and ermF genes could be found in the isolate's genome.The patient's balanoposthitis is caused by infection of N.gonorrhoeae.The multidrug resistance of Neisseria gonorrhoeae isolate is closely associated with its carried resistant genes.

Vulvovaginitis y balanopostitis pustular sugerente a herpesvirus caprino-1 en cabras (Querétaro, México) / Pustular vulvovaginitis and balanoposthitis suggestive of caprine herpesvirus-1 infection in goats (Queretaro, Mexico)

Infectious pustular vulvovaginitis and balanoposthitis in goats is caused by caprine herpesvirus 1 (CpHV-1), from the Herpesviridae family Alphaherpesvirinae subfamily, sometimes produces abortion, neonatal enteritis and respiratory disease in adult goats. In a herd of 244 dairy and meat goats, physical examinations were performed in does and bucks, presenting vulvar and preputial lesions. Necropsies were done in four discarded animals (one male and two females) and one stillborn; immunohistochemistry (IHC) with bovine herpesvirus 1 (BHV-1) antibodies in prepuce and vulva samples was carried out. Penis and prepuce exfoliative cytology was carried out in six bucks. Prepuce biopsies were collected for electron microscopy and viral isolation. Macroscopically, moderate to severe coalescent multifocal pustular and ulcerative vulvovaginitis was observed; and severe coalescent multifocal pustular and ulcerative balanoposthitis. Microscopically, different degrees of inflammatory lesions with presence of eosinophilic and amphophilic intranuclear inclusion bodies were present. In electron microscopy, the prepuce samples and MBDK cell culture showed several intranuclear viral particles of 150 to 230 nm size. There was slight epithelial cell positivity in IHC with BHV-1 antibodies in vulva and prepuce histological cuts made at necropsy. In the viral isolate was observed a cytopathic effect and the presence of viral particles by microscopy electronic suggesting herpes virus. This is the first documented report suggesting the presence of herpes virus outbreak in caprine herds in Mexico.

La vulvovaginitis y balanopostitis pustular infecciosa en cabras es producida por herpesvirus caprino 1 (CpHV-1), de la familia Herpesviridae subfamilia Alphaherpesvirinae, que ocasionalmente produce aborto, enteritis neonatal y enfermedad respiratoria en las cabras adultas. En un rebaño de 244 cabras de genotipo lechero y cárnico; se realizaron exámenes físicos de hembras y sementales en los que se observaron lesiones vulvares y prepuciales. Se realizó la necropsia de cuatro animales adultos de desecho (dos hembras y un macho) y un neonato muerto; se realizó inmunohistoquímica (IHQ) con anticuerpos de herpesvirus bovino 1 (BHV1) en muestras de prepucio y vulva. Se analizaron las citologías exfoliativas de pene y prepucio de 6 sementales. Se recolectaron y analizaron biopsias de prepucio para microscopía electrónica y aislamiento viral. Macroscópicamente, en las hembras se observó vulvovaginitis pustular y ulcerativa de moderada a grave multifocal coalescente, además de balanopostitis pustular y ulcerativa grave multifocal coalescente en los machos. Microscópicamente, se presentaron lesiones inflamatorias en diferentes grados, con presencia de cuerpos de inclusión intranucleares eosinofílicos y amfofílicos. En microscopía electrónica, las muestras de prepucio y cultivo celular de MBDK presentaron numerosas partículas virales intranucleares de un tamaño de 150 a 230 nm. En los cortes histológicos de prepucio y vulva de las necropsias se detectó una ligera positividad en las células epiteliales con anticuerpos BHV-1. En el aislamiento viral se observó efecto citopático, y la presencia de partículas virales mediante microscopía electrónica sugerentes a herpes virus. Este es el primer informe documentado que sugiere la presencia de herpes virus en rebaños caprinos de México.