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Fan W, Zhang Q, Wei M, Zhu Y, Zhang J, Fan Z, Jiang T. Gonococcal Infection of the Glans Skin, a Rare Local Complication of Gonorrhea: A Clinical Study of 13 Cases. Am J Mens Health 2023; 17:15579883231152111. [PMID: 36718791 PMCID: PMC9893077 DOI: 10.1177/15579883231152111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
The study aimed to understand the incidence, site, skin lesion manifestations, and treatment of gonococcal infection of the glans skin. We enrolled men with gonococcal infection of the glans skin and men with gonococcal urethritis from January 2014 to February 2020. Demographic data, site of onset, and skin lesion manifestations were recorded for all patients. Ceftriaxone (1 g) was injected intramuscularly once daily for 5 days in patients with lesions comprising abscesses or nodules. A single dose of ceftriaxone (1 g) was injected intramuscularly in patients with pustules. Incision and drainage were performed in patients with nonruptured abscesses. Thirteen patients had gonococcal infection of the glans skin (0.65%; 95% confidence interval = [0.30, 1.01]) among 1,989 patients with gonococcal urethritis. Mean age was 35.48 ± 2.37 (range = 26-45) years. Nonmarital sexual behavior patterns were genital-genital in eight patients (61.54%) and genital-oral in five patients (38.46%). All skin lesions occurred on the ventral side of the glans. Eleven patients (84.62%) had a single lesion and two (15.38%) had multiple lesions. The lesions manifested as abscesses in five patients (38.46%), nodules in five patients (38.46%), and pustules in three patients (23.08%). All lesions exhibited tenderness. All 13 patients were cured after treatment. The study shows that gonococcal infection of the glans skin is a rare local complication of gonorrhea. Lesions often occur on the ventral side of the glans, presenting as abscesses, nodules, and pustules. Ceftriaxone treatment was effective for gonococcal infection of the glans skin.
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Affiliation(s)
- Wenge Fan
- Department of Dermatology, First People’s Hospital of Changshu City, Changshu Hospital Affiliated to Soochow University, Changshu, P. R. China,Wenge Fan, Department of Dermatology, First People’s Hospital of Changshu City, Changshu Hospital Affiliated to Soochow University, Changshu 215500, Jiangsu, China.
| | - Qingsong Zhang
- Department of Dermatology, Affiliated Hospital of Nantong University, Nantong, P. R. China
| | - Mei Wei
- Department of Dermatology, First People’s Hospital of Changshu City, Changshu Hospital Affiliated to Soochow University, Changshu, P. R. China
| | - Yuan Zhu
- Department of Dermatology, First People’s Hospital of Changshu City, Changshu Hospital Affiliated to Soochow University, Changshu, P. R. China
| | - Jing Zhang
- Department of Dermatology, First People’s Hospital of Changshu City, Changshu Hospital Affiliated to Soochow University, Changshu, P. R. China
| | - Zhijiang Fan
- Department of Urinary Surgery, First People’s Hospital of Changshu City, Changshu Hospital Affiliated to Soochow University, Changshu, P. R. China
| | - Tingwang Jiang
- Department of Clinical Laboratory, First People’s Hospital of Changshu City, Changshu Hospital Affiliated to Soochow University, Changshu, P. R. China
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Fan W, Zhang Q, Wei M, Ai M, Fan Z, Jiang T. Gonococcal tysonitis, a rare local complication of gonorrhea: a clinical study of 15 cases. Eur J Clin Microbiol Infect Dis 2022; 41:787-792. [PMID: 35322328 DOI: 10.1007/s10096-022-04434-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 03/15/2022] [Indexed: 11/25/2022]
Abstract
To investigate the incidence, clinical manifestations, and treatments of gonococcal tysonitis in men. We enrolled men with gonococcal tysonitis and men with gonococcal urethritis from January 2000 to December 2020. Demographic data, interval from non-marital sexual contact to the onset of symptoms of gonococcal tysonitis, occurrence sites, and manifestations were recorded for all patients. Ceftriaxone (1 g) was injected intramuscularly once daily for 5 days in patients with lesions comprising abscesses or nodules. A single dose of ceftriaxone (1 g) was injected intramuscularly in patients with sinus-like lesions. Incision and drainage were performed in patients with non-ruptured abscesses. Fifteen patients with gonococcal tysonitis (0.29%; 95% confidence interval: 0.15-0.44%) were observed among 5087 patients with gonococcal urethritis. The mean age was 38.64 years (range, 17-74 years). The mean gonococcal tysonitis incubation period was 6.02 ± 1.37 days (range, 2-11 days). Lesions were present in the right side of the preputial frenulum in seven patients (46.67%), in the left side of the preputial frenulum in six patients (40%), and in both sides of preputial frenulum in two patients (13.33%). The lesions manifested as abscesses in 7 patients (46.67%), nodules in six patients (40%), and sinus-like lesions in two patients (13.33%); all lesions exhibited tenderness. All 15 patients were cured after treatment. Gonococcal tysonitis is a rare local complication of gonorrhea. Gonococcal urethritis with concurrent gonococcal tysonitis was less common than gonococcal urethritis with concurrent paraurethral gonococcal infection or gonococcal urethritis with concurrent gonococcal epididymitis. Gonococcal tysonitis lesions manifest as abscesses, nodules, and sinus-like lesions. Treatment with ceftriaxone is effective for gonococcal tysonitis.
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Affiliation(s)
- Wenge Fan
- Department of Dermatology, First People's Hospital of Changshu City, Changshu Hospital Affiliated To Soochow University, Changshu, 215500, Jiangsu Province, People's Republic of China.
| | - Qingsong Zhang
- Department of Dermatology, Traditional Chinese Medical Hospital of Changshu City, Changshu, 215500, Jiangsu Province, People's Republic of China
| | - Mei Wei
- Department of Dermatology, First People's Hospital of Changshu City, Changshu Hospital Affiliated To Soochow University, Changshu, 215500, Jiangsu Province, People's Republic of China
| | - Mongting Ai
- Department of Dermatology, First People's Hospital of Changshu City, Changshu Hospital Affiliated To Soochow University, Changshu, 215500, Jiangsu Province, People's Republic of China
| | - Zhijiang Fan
- Department of Dermatology, First People's Hospital of Changshu City, Changshu Hospital Affiliated To Soochow University, Changshu, 215500, Jiangsu Province, People's Republic of China.,Department of Urinary Surgery, First People's Hospital of Changsha City, Changsha Hospital Affiliated To Soochow University, Changsha, 215500, Jiangsu Province, People's Republic of China
| | - Tingwang Jiang
- Department of Clinical Laboratory, First People's Hospital of Changshu City, Changshu Hospital Affiliated To Soochow University, Changshu, 215500, Jiangsu Province, People's Republic of China
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Shen F, Thevarajah G, Cheng J. Streptococcus intermedius causing cellulitis of the penile shaft complicated with abscess formation and rupture after dry humping sex. BMJ Case Rep 2022; 15:e245692. [PMID: 35236673 PMCID: PMC8895888 DOI: 10.1136/bcr-2021-245692] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2022] [Indexed: 02/05/2023] Open
Abstract
Penile cellulitis with abscess formation then rupture is an extremely rare presentation. This is a case report of a penile shaft abscess caused by Streptococcus intermedius after 'dry humping' sexual activities. A 34-year-old healthy man was presented with painful penile swelling for 3 weeks after initial 'dry humping' and later penovaginal intercourse. He was admitted to the hospital for intravenous antibiotics treatment, but a penile abscess was developed and ruptured within 24 hours. Urgent penile exploration revealed localised abscess and S. intermedius was isolated. The wound healed by secondary intention. However, his admission was complicated by acute kidney injury, probably due to vancomycin. Therefore, longer inpatient supportive care was required before discharge. Given this severe complication of primary penile cutaneous infection by S. intermedius, our case would raise awareness of this normal flora in abscess development at the male genital region, and the importance for the patient seeking prompt medical advice and physicians administrating appropriate antibiotics.
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Affiliation(s)
- Fang Shen
- Urology Department, Northern Hospital Epping, Melbourne, Victoria, Australia
| | | | - Janice Cheng
- Urology Department, Northern Hospital Epping, Melbourne, Victoria, Australia
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Masutani R, Yen C, Stead W. An Unusual Presentation of Neisseria gonorrhoeae. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2021. [DOI: 10.1097/ipc.0000000000001019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Finne HA, Heal JK. Urological Manifestation of Cryptic Severe Psychiatric Illness. Mil Med 2019; 184:e489-e491. [PMID: 30462252 DOI: 10.1093/milmed/usy320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 10/16/2018] [Accepted: 10/25/2018] [Indexed: 11/13/2022] Open
Abstract
Penile cellulitis has rarely been reported in the literature and never secondary to self-injury with subsequent sexual activity. It presents a challenging diagnostic situation in that the patient will likely be less than forthcoming about the etiology of his symptoms despite his willingness to seek formal medical attention. We present a case of penile cellulitis secondary to dermatitis artefacta in a severely depressed new submarine sailor. Initial studies for a more serious etiology were negative and he was treated with PO antibiotics for "syphilis" by the local civilian emergency department. After responding well to antibiotics, he subsequently presented back to medical in order to offer up the etiology of his penile wounds. In this report, we review the published literature on penile cellulitis and genital dermatitis artefacta. This case shows that military providers should always have psychiatric causes in their differential and not hesitate to ask about genital abnormalities. Recognition of underlying psychiatric etiology may play a key role in helping the patient get the care he or she needs.
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Affiliation(s)
- Huckelberry A Finne
- Naval Special Warfare Group Two Logistics and Support Unit, Joint Base Little Creek Fort Story, Norfolk, VA
| | - Jared K Heal
- Arnot Ogden Medical Center Emergency Medicine Residency Program, 1001 Hoffman St, Elmira, NY
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