Gardnerella vaginalis-associated balanoposthitis

Area of Science:

• Urology
• Microbiology
• Dermatology

Background:

• Balanoposthitis, inflammation of the glans and prepuce, can have various causes.
• Gardnerella vaginalis is a known cause of bacterial vaginosis in women, but its role in male genital infections is less understood.

Observation:

• Three male patients presented with similar symptoms: erythema, pruritus, prepuce irritation, and a characteristic fishy odor in urethral discharge.
• Microbiologic investigation confirmed Gardnerella vaginalis in all patients, with clue cells present in two. Other common pathogens were ruled out.

Findings:

• Gardnerella vaginalis was identified as the causative agent in this cohort of balanoposthitis cases.
• Patients initially responded to metronidazole and partner treatment, but two relapsed and later responded to clindamycin.
• The clinical presentation and etiology are analogous to bacterial vaginosis in women.

Implications:

• This study suggests a polymicrobial and synergistic etiology for balanoposthitis involving Gardnerella vaginalis and anaerobic bacteria in males.
• Recognizing Gardnerella vaginalis as a potential cause of balanoposthitis is crucial for accurate diagnosis and effective treatment.
• Further research into the role of Gardnerella vaginalis and anaerobic bacteria in male lower genital tract infections is warranted.