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Streptococcus pyogenes balanoposthitis.

Yuta Norimatsu1,2, Yuki Ohno1

  • 1Department of Dermatology, JR Tokyo General Hospital, Japan.

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Group A Streptococcus (Streptococcus pyogenes) can cause balanoposthitis in adults, though it is rare in adolescents. This case highlights the importance of considering this pathogen in differential diagnoses for penile foreskin infections.

Keywords:
BalanoposthitisGroup A beta-hemolytic Streptococcus pyogenesOral sexVentral incision

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Area of Science:

  • Infectious Diseases
  • Dermatology
  • Urology

Background:

  • Balanoposthitis, inflammation of the glans and foreskin, commonly affects adolescents and is often linked to Group B hemolytic streptococcus.
  • While Group A streptococcal infections are documented in children, their role in adult balanoposthitis, particularly in sexually active individuals, is less frequently reported.

Observation:

  • A 31-year-old male presented with a 6-day history of penile foreskin pain and swelling, indicative of balanoposthitis.
  • Clinical examination and subsequent diagnosis confirmed infection by *Streptococcus pyogenes* (Group A streptococcus).

Findings:

  • Successful treatment involved surgical intervention (ventral incision of the foreskin) combined with targeted antimicrobial therapy (amoxicillin 750 mg/day).
  • The case demonstrates that *Streptococcus pyogenes* is a viable causative agent for balanoposthitis, even in adult patients.

Implications:

  • Clinicians should include Group A beta-hemolytic *Streptococcus pyogenes* in the differential diagnosis for balanoposthitis, irrespective of patient age.
  • Prompt diagnosis and appropriate management, including surgical decompression and antibiotic therapy, are crucial for favorable outcomes in severe balanoposthitis cases.