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Suggest Treatment For Infection In Glans Of Penis
Question: I am a 61 year old Caucasian male, married, and uncircumcised. No allergies, no chance I have a sexually transmitted disease, taking liptor, omeprzole, and welbutrin. I have experienced in infection of my glans of my penis twice a year for the last 3 years. There is no urethral discharge. It starts around the corona and then goes further into the glans if not treated right away. I have been treated with oral and cream type antifungals which have had no effect. The thing that has worked is 874 mg augmentin twice a day and Mupiricin Cream. for two weeks. If not treated right away it gets very painful, swollen, and edematous that forms a dark scab. If treated right away before it gets to this point it normally is gone in 5-7 days.
It seems that it normally starts when there is a slight abrasion of the skin near the corona after sexual intercourse. There no painful urination and other then being treated for gerd, depression, and high cholesterol I have no medical issues.
The problem is that this has come back again 5 weeks ago. The difference now is that after my regimen of Augmentin it keeps coming back. I start a regimen of Augmentin and after the course it either disappears or has a very small edematous part is remaining. After two or three days it flares back up. I have seen three different providers and they all say I should see an urologist but I can't get an appointment for another 5 weeks.
I am currently on day 6 of my current regimen of Augmentin. It is starting to clear up but I am afraid it will come back again in three days or maybe not even clear up
I think this is a skin problem not a urological problem. What is your opinion? Am I waiting five weeks for the wrong specialist?
It seems that it normally starts when there is a slight abrasion of the skin near the corona after sexual intercourse. There no painful urination and other then being treated for gerd, depression, and high cholesterol I have no medical issues.
The problem is that this has come back again 5 weeks ago. The difference now is that after my regimen of Augmentin it keeps coming back. I start a regimen of Augmentin and after the course it either disappears or has a very small edematous part is remaining. After two or three days it flares back up. I have seen three different providers and they all say I should see an urologist but I can't get an appointment for another 5 weeks.
I am currently on day 6 of my current regimen of Augmentin. It is starting to clear up but I am afraid it will come back again in three days or maybe not even clear up
I think this is a skin problem not a urological problem. What is your opinion? Am I waiting five weeks for the wrong specialist?
Brief Answer:
Upload photograph; provide more information
Detailed Answer:
Hello. Thanks for writing to us at healthcaremagic.
I am Dr. Kakkar. I have gone through your query.
I would like you to upload a digital photograph of the affected area so that I am able to guide you better.
The salient points in your history are: Recurrent genital lesions, of 3 years duration.
What I can judge from your history is that it starts as a level lesion but it breaks down to form an erosion/ulcer with scab/crust formation. There is associated pain, swelling.
I would also like to gather more information from you regarding your query.
-Tell me about your sexual history. Your sexual partners? single or multiple sexual partners?
Regards
Upload photograph; provide more information
Detailed Answer:
Hello. Thanks for writing to us at healthcaremagic.
I am Dr. Kakkar. I have gone through your query.
I would like you to upload a digital photograph of the affected area so that I am able to guide you better.
The salient points in your history are: Recurrent genital lesions, of 3 years duration.
What I can judge from your history is that it starts as a level lesion but it breaks down to form an erosion/ulcer with scab/crust formation. There is associated pain, swelling.
I would also like to gather more information from you regarding your query.
-Tell me about your sexual history. Your sexual partners? single or multiple sexual partners?
Regards
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Dr. Kakkar
Only one sexual partner last two years and I am pretty sure she has no sexual disease hitory. Year and a half prior I had no sexual partners. I had one prior sexual partner four years ago. The answer is no , I have not had multiple sexual partners.
Enclosed are four photos. Most of the swelling and erythema is subsided to the left side where it started. Right side of corona was swollen and erythematous until last couple of days. It is starting to look much better but this is how it has gone the last five weeks. It flares back up after stopping the Augmentin. It has never done this before. 10 days of Augmentin has always gotten rid of it before.
In between these times of the infection I have had no problems.
thanks
XXXX
Only one sexual partner last two years and I am pretty sure she has no sexual disease hitory. Year and a half prior I had no sexual partners. I had one prior sexual partner four years ago. The answer is no , I have not had multiple sexual partners.
Enclosed are four photos. Most of the swelling and erythema is subsided to the left side where it started. Right side of corona was swollen and erythematous until last couple of days. It is starting to look much better but this is how it has gone the last five weeks. It flares back up after stopping the Augmentin. It has never done this before. 10 days of Augmentin has always gotten rid of it before.
In between these times of the infection I have had no problems.
thanks
XXXX
Brief Answer:
Would like to rule out herpes
Detailed Answer:
Hi.
Thank you for additional information. I have gone through the photographs.
I can still see a few erosions on the corona of glans penis in one of the photographs. There is some surrounding redness.
I would like to keep a possibility of recurrent herpes genitalis. Even if we suppose that it not the diagnosis here, it is one of the possibility that I would certainly like to rule out.
Recurrence of lesions is a strong point in favor of herpes genitalis and more so because the lesions break down to form erosions, which is classical of herpes.
Oral antibiotics for 7-10 days seems to benefit this condition but that may just be a spurious association because recurrent herpes anyway resolves by itself in about 5-7 days.
Have you ever tested for Herpes?
Regards
Would like to rule out herpes
Detailed Answer:
Hi.
Thank you for additional information. I have gone through the photographs.
I can still see a few erosions on the corona of glans penis in one of the photographs. There is some surrounding redness.
I would like to keep a possibility of recurrent herpes genitalis. Even if we suppose that it not the diagnosis here, it is one of the possibility that I would certainly like to rule out.
Recurrence of lesions is a strong point in favor of herpes genitalis and more so because the lesions break down to form erosions, which is classical of herpes.
Oral antibiotics for 7-10 days seems to benefit this condition but that may just be a spurious association because recurrent herpes anyway resolves by itself in about 5-7 days.
Have you ever tested for Herpes?
Regards
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
I have never been tested for herpes and I would not have a problem being tested for it. I will get it done just to objectively exclude it.
I disagree that there is a spurious association between antibiotic treatment and resolution of the symptoms.
There is a direct association. I have waited several days in the past before being treated and it only resulted in a raging painful infection that took longer to resolve. When I started the antibiotics right away at the earliest symptoms it has resolved in as little as 4 days.
Assuming herpes is ruled out, what do you think of the possibility of if being a more Augmentin resistant Staphylococcus aureus?
XXXX
I disagree that there is a spurious association between antibiotic treatment and resolution of the symptoms.
There is a direct association. I have waited several days in the past before being treated and it only resulted in a raging painful infection that took longer to resolve. When I started the antibiotics right away at the earliest symptoms it has resolved in as little as 4 days.
Assuming herpes is ruled out, what do you think of the possibility of if being a more Augmentin resistant Staphylococcus aureus?
XXXX
Brief Answer:
Testing for herpes is advisable
Detailed Answer:
Hi.
It is very likely that the lesions become more painful because they develop secondary bacterial infection.
I think the antibiotic only resolves the secondary bacterial infection that may superimpose on to herpetic erosions.
Testing for herpes is advisable. HSV ELISA for type 1 & 2 (IgG and IgM levels).
It is unlikely to be just a simple staph aureus infection.
Regards
Testing for herpes is advisable
Detailed Answer:
Hi.
It is very likely that the lesions become more painful because they develop secondary bacterial infection.
I think the antibiotic only resolves the secondary bacterial infection that may superimpose on to herpetic erosions.
Testing for herpes is advisable. HSV ELISA for type 1 & 2 (IgG and IgM levels).
It is unlikely to be just a simple staph aureus infection.
Regards
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Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
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