Question 2 of 5

A woman brings her 19-month-old uncircumcised son to be evaluated for swelling and irritation of his penis. You see that the boy's penis and glans are edematous, erythematous, and excoriated. Retraction of the foreskin is painful and there is white cheesy material between foreskin and glans. No erosive lesions are present. There is no urethral discharge, pain with urination, or other urinary problems. He has had three prior similar episodes, all of which grew Candida albicans. The entity most commonly associated with this condition is:

Diabetes mellitus.


Asymptomatic chlamydial urethritis.


Peyronie disease.

Balanitis is an inflammation of the glans penis only, while balanoposthitis refers to inflammation of the glans penis and foreskin. Both are caused primarily by infection that leads the glans and inner prepuce to become inflamed, tender, and excoriated. Etiologic agents include group A beta-hemolytic streptococci, Neisseria gonorrhoeae, and Chlamydia trachomatis. However, chemical irritation, trauma, and poor hygiene may also contribute to this condition. Diabetes mellitus is a common underlying cause and should be suspected in a patient presenting with recurrent episodes of this disorder, especially when C. albicans has been implicated. Treatment includes daily sitz baths, washing with mild soap, topical, and antibacterial or antifungal cream. A topical steroid cream may also be helpful if there is extensive inflammation. Circumcision should be considered for severe or recurrent disease. Oral antibiotics with streptococcal coverage should be prescribed for a secondary infection.