Contents

SynopsisCodesLook ForDiagnostic PearlsDifferential Diagnosis & PitfallsBest TestsManagement PearlsTherapyDrug Reaction DataReferences

View all Images (2)

Balanoposthitis - Anogenital in
Other Resources UpToDate PubMed

Balanoposthitis - Anogenital in

Contributors: Eric Ingerowski MD, FAAP, Paritosh Prasad MD
Other Resources UpToDate PubMed

Synopsis

Pediatric balanoposthitis is inflammation of the glans of the penis and foreskin that affects 10%-20% of uncircumcised male children. Balanoposthitis occurs most often between 2 and 5 years of age, but it may occur at any age.

Balanoposthitis is usually classified based on etiology: infectious, traumatic, allergic, irritant, and nonspecific. The presenting symptoms may include genital pain and/or tenderness, dysuria, groin rash, swelling and redness of the foreskin and glans, inguinal lymphadenopathy, and possibly pruritus. A foul-smelling, purulent discharge from the foreskin, but not the urethra, may be present. Urinary retention can be seen in more severe cases. In more chronic cases, scarring between the prepuce and glans may be present with or without meatal stenosis and/or phimosis.

Balanoposthitis is a clinical diagnosis, with laboratory data and patient history used to help determine etiology, which will then guide treatment.

In young, diapered infants, it is commonly caused by Candida albicans and is seen in association with diaper dermatitis. Irritant causes are also common in this age range and may result from poor hygiene or forced foreskin retraction. Escherichia coli is the most common bacterial cause in this age range.

In prepubertal boys, nonspecific balanoposthitis is most common, usually as a result of poor hygiene. Group A streptococcal balanoposthitis must be considered and may be seen in association with group A streptococcal infection in other parts of the body, including pharyngitis, impetigo, and perianal infections. Staphylococcus aureus is another common bacterial cause. Irritant and traumatic etiologies are also common in this age range.

In pubertal adolescent males, the etiologies are more diverse. Common infectious causes include Gardnerella and anerobic infections with Bacteroides spp. Other infectious etiologies include chlamydial and gonococcal infections, group B Streptococcus, and mixed anerobic infections. Chemical, irritant, and allergic reactions to condoms, spermicides, and lubricants must also be considered. Poor hygiene and other irritant etiologies are common as well. Viral etiologies, including human papillomavirus (HPV) and herpes simplex virus (HSV), while uncommon, have been described. Diabetes mellitus is a risk factor for C albicans infection as are other immunocompromising conditions such as HIV disease / AIDS. Fixed drug eruptions, while an uncommon cause, can occur at any age.

Codes

ICD10CM:
N47.6 – Balanoposthitis

SNOMEDCT:
46090001 – Balanoposthitis

Look For

Subscription Required

Diagnostic Pearls

Subscription Required

Differential Diagnosis & Pitfalls

Best Tests

Subscription Required

Management Pearls

Subscription Required

Therapy

Subscription Required

Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

Subscription Required

References

Subscription Required

Last Reviewed:02/06/2022
Last Updated:02/20/2022
Copyright © 2023 VisualDx®. All rights reserved.
Balanoposthitis - Anogenital in
A medical illustration showing key findings of Balanoposthitis : Foreskin, Glans of penis, Inguinal lymphadenopathy, Urinary retention, Dysuria, Pruritus, Penile discharge
Clinical image of Balanoposthitis - imageId=2045951. Click to open in gallery.
Copyright © 2023 VisualDx®. All rights reserved.