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Suggest treatment for infection of the glans penis and foreskin

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Posted on Mon, 14 Jul 2014
Question: i have pus cells and epithelial cells occasionally along with yeast forms among the other findings in my routine urine test .
also my blood sugar fasting is 280 and post lunch is 380 . this is the latest report and do not know what sort of infection is there neither my sugar is coming down despite having medicines for the same. In my CBC count WBC is 17,000/ rest all are normal . just 15 days back i have developed rashes on my penis skin with the inside itching and the skin also cannot be folded due to pain . Kindly advise on the same .
doctor
Answered by Dr. Johny Chacko (29 minutes later)
Brief Answer:
Candidial balanoposthitis

Detailed Answer:
Hello,
Welcome to healthcare magic.

I understand from your query that you are having uncontrolled sugars and have now developed itching and rashes on penis.

From your history and description, I would consider the diagnosis of " Candidial balanoposthitis". This is an infection of the glans penis and the foreskin by Candida - a fungal yeast,commonly seen in diabetic patients. This is also the cause for the presence of yeast forms in your urine test.

I would advise you to apply a cream containing 2% Ketoconazole ( e.g- Nizral cream) twice a day. Wash the area with hot water and try to gently pull the foreskin down. Take a tablet containing Fluconazole 150 mg (e.g- Flucos ) single dose after lunch. ( only 1 dose has to be taken)

As far as your blood test report is concerned, a raised WBC count indicates an infection in the body. You also have pus cells in your urine test.( less than 5 pus cells with few epithelial cells is normal. You should be concerned only if the pus cells are more than 5-8 in number). These 2 together could indicate an urinary tract infection, which is common in uncontrolled diabetes. I suggest you to get a urine culture and sensitivity test done. Please show the reports to a physician who will prescribe an antibiotic depending on the culture and sensitivity reports.

Hope this helps you.

If you have any more queries, I will be glad to assist.

Wishing you good health,
Dr. Johny Chacko
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Johny Chacko (18 minutes later)
SIR,
THXS FOR THE REPLY
MY PUS CELLS ARE 0-2/h p f.
do i still need to take the urine culture test .
Also would u suggest any medicines for infection in the body
my IGe levels are also very high .
so any change of medications would u suggest for blood sugar , infection and ige levels to bring them down
doctor
Answered by Dr. Johny Chacko (12 hours later)
Brief Answer:
Physician's evaluation

Detailed Answer:
Hello,

0-2 pus cells / HPF is normal. However, in view of your raised WBC count and uncontrolled sugars, it is better to do a culture test.

Raised IgE indicate that you have an allergic tendency. You may have either had allergic problems in childhood ( like asthma, nasal allergies, eye allergies, etc) or at present. Raised IgE levels per se does not warrant any treatment. It is only a marker for allergies either in the past or present. If you have no allergic symptoms, you can just ignore it.

Management of diabetes requires constant monitoring of blood sugars and follow up with an endocrinologist or a physician. In your case, you have mentioned that the sugars are not coming down with treatment. I advise you to follow up with your treating doctor. Please show him/her your current sugar values so that they can adjust your anti- diabetes medication dose or even start you on new medication/ insulin if required.

Once you get the urine culture test, you can take an appropriate antibiotic for the infection.
Since you also have an infection on your glans penis, treating that will also bring down the WBC count down.

You can start the treatment that I have mentioned earlier.

Hope I have addressed all your concerns.

Wishing you good health,
Dr. Johny Chacko
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Johny Chacko

Dermatologist

Practicing since :2005

Answered : 1916 Questions

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Suggest treatment for infection of the glans penis and foreskin

Brief Answer: Candidial balanoposthitis Detailed Answer: Hello, Welcome to healthcare magic. I understand from your query that you are having uncontrolled sugars and have now developed itching and rashes on penis. From your history and description, I would consider the diagnosis of " Candidial balanoposthitis". This is an infection of the glans penis and the foreskin by Candida - a fungal yeast,commonly seen in diabetic patients. This is also the cause for the presence of yeast forms in your urine test. I would advise you to apply a cream containing 2% Ketoconazole ( e.g- Nizral cream) twice a day. Wash the area with hot water and try to gently pull the foreskin down. Take a tablet containing Fluconazole 150 mg (e.g- Flucos ) single dose after lunch. ( only 1 dose has to be taken) As far as your blood test report is concerned, a raised WBC count indicates an infection in the body. You also have pus cells in your urine test.( less than 5 pus cells with few epithelial cells is normal. You should be concerned only if the pus cells are more than 5-8 in number). These 2 together could indicate an urinary tract infection, which is common in uncontrolled diabetes. I suggest you to get a urine culture and sensitivity test done. Please show the reports to a physician who will prescribe an antibiotic depending on the culture and sensitivity reports. Hope this helps you. If you have any more queries, I will be glad to assist. Wishing you good health, Dr. Johny Chacko