Gangrenous balanoposthitis

gangrenous balanoposthitisGangrenous balanopostit (balanoposthitis gangraenosa) (Fig. 4) cause vibrionaceae gram-negative anaerobes (You. fusiformis) in symbiosis with the spirochaetes found in the genital and oral cavity (Spirochaeta perfringens and others). The disease occurs most often after sexual intercourse (through 36-48 h.), rarely can develop spontaneously. Appear pain, burning, swelling in the area of the glans penis and the foreskin, the pus from the hole prepucialna bag, fever (39-40 degrees), nausea, General fatigue, headache. At the beginning of the disease in domestic leaf foreskin due to necrosis of epithelial formed multiple sores with saped places towering damaged edges.
Gangrenous balanoposthitis has an extraordinary intensity of inflammatory process, fast formation of areas of necrosis. Swelling of the foreskin leads to the development of phimosis; in addition, there are limfangoita, inflammation of inguinal lymph nodes. In patients with severe swelling of the penis acquires the characteristic shape of the tongue of a bell. Necrotic process, developed on the inner leaf of the foreskin may cause perforation. Necrotic collapse and perforation, ulcers in some cases accompanied by profuse bleeding. Observed and subacute for gangrenous balanoposthitis that depends on virulence of the infection.
Differential diagnosis of gangrenous balanoposthitis with other forms of balanoposthitis, especially with balanoposthitis with soft and hard chancre, is difficult because of the attendant of phimosis. In these cases shows a cut of the foreskin with both diagnostic and therapeutic purposes (due to the wide access of air to the wounded surfaces are created unfavorable conditions for development of anaerobic infections).
Treatment of gangrenous balanoposthitis should start with the disclosure prepucialna bag; in subsequent daily washed the glans penis and the foreskin 3% solution of hydrogen peroxide. Also nominated penicillin intramuscularly in a dose of 600 000-800 000 UNITS in day.