Posthitis in Circumcised Child: A Condition Not Previously Reported in the Literature

Background: Posthitis, an inflammation of the prepuce of the penis is associated with swelling and other inflammatory changes such as redness, itching, tenderness, and pain. It may occur in association with an inflammation of the glans penis, and in this case it is called balanoposthitis. Balanoposthitis has been reported only in uncircumcised males. Posthitis has not been reported in circumcised children. Balanoposthitis can be caused by bacteria, viruses, and fungi.

Patients and Methods: The case of a boy who revered a diagnosis of cellulites of the penis and scrotum was studied. The boy was circumcised and aged four years. He presented with fever, generalized erythematous macular rash, poor appetite, and swelling of the foreskin of the penis and scrotum. The boy was referred by the treating physician after poor response to eight days of the treatment, and the inability to determine the infective organism and the best antimicrobial agents to use.

Results: The diagnosis of posthitis of undetermined etiology was made. It was recommended to treat the boy with cefprozil and oral nystatin based on the evidence provided by Dockerty and Sonnex (1995) and Wakiguchi al (1992), or cefpodoxime proxetil plus nystatin, or cefixime plus nystatin based on the evidence provided by Schatz et al (1996). Thereafter, it was reported that the boy was improved.

Conclusion: When a condition is encountered for the first time, and there is no available experience in the medical literature, it can be useful to treat the condition with empiric therapies based on the evidence provided from the more relevant literature.

Keywords: Posthitis, circumcised child, novel occurrence.