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Circular Abscess Formation of the Inner Preputial Leaf as a Complication of a Penile Mondor's Disease: The First Case Report.

Wendler JJ, Schindele D, Baumunk D, Liehr UB, Porsch M, Schostak M - Case Rep Urol (2014)

Bottom Line: Conclusion.Our patient is very unusual in that he presented with a secondary preputial abscess formation due to superficial thrombophlebitis, subcutaneous lymphangitis, and local bacterial colonisation.Abscess drainage plus antiphlogistic and antibiotic medication is the treatment of choice.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology and Paediatric Urology, Medical Faculty of the University of Magdeburg, Leipziger Straße 44, 39120 Magdeburg, Germany.

ABSTRACT
Introduction. Mondor's disease of the penis is an uncommon condition characterized by thrombosis or thrombophlebitis involving the superficial dorsal veins. An accompanied lymphangitis is discussed. There is typical self-limiting clinical course. Case Presentation. This paper firstly reports a secondary abscess formation of the preputial leaf two weeks after penile Mondor's disease and subcutaneous lymphangitis as complication of excessive sexual intercourse of a 44-year-old man. Sexual transmitted diseases could be excluded. Lesions healed up completely under abscess drainage, antibiotic, and anti-inflammatory medication. Conclusion. Previous reports in the literature include several entities of the penile Mondor's disease. Our patient is very unusual in that he presented with a secondary preputial abscess formation due to superficial thrombophlebitis, subcutaneous lymphangitis, and local bacterial colonisation. Abscess drainage plus antiphlogistic and antibiotic medication is the treatment of choice.

No MeSH data available.


Related in: MedlinePlus

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Related In: Results  -  Collection


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Mentions: A 44-year-old man presented at our emergency room with a slight painful, subcutaneous, and indurated swelling at the penile dorsum and an oedematous preputium since 2 days. He told of excessive sexual activity without using a condom and fellatio with his wife but denied any penile trauma or manipulations, history of any disease, operations, allergies, or medication. The laboratory and physical examination showed no further pathological findings. B-mode and color Doppler ultrasound indicated an edema of the dorsal penile shaft skin and preputium and the suspicion of a thrombosis of the superficial dorsal penile vein. Cooling, sexual abstinence, and oral medication with ciprofloxacin, diclofenac, and pantoprazole were prescribed. Six days later, he returned because of a progressive swelling of the penile foreskin with a painless pea-sized nodule lump under the inner preputial leaf without any visible superficial lesion. Since two days he received a changed antibiosis to cefixime and doxycycline from his resident physician with doubtful suspicion of cavernitis. No further intervention and the continuation of the aforementioned therapy were recommended. Three days later, he presented an annular abscess formation with partial spontaneous abscess rupture and flush of the inner preputial leaf (Figure 1). There were eight pea- to pinpoint-sized abscesses: six of them were ulcerative after spontaneous perforation; the two remaining nodular abscess formations (Figure 1; Figure 2(a)) were incised with a needle (Figure 2(a)) followed by smears tests (Figure 2(b)), local disinfection, and continuation of the current antibiotic therapy. Three days later, the reexamination showed an improvement but syphilitic-like defects. The smear test was negative for bacterial infection. The dermatological consultant diagnosed a lymphangitis and thrombophlebitis coronarius glandis. The serological analysis was negative for HIV, syphilis, and gonorrhea but positive for mycoplasma pneumoniae (IgG 48.2 U; IgA 11.5; IgM negative). Local disinfection and the continuation of the current medication with cefixime, doxycycline, and diclofenac were recommended. After four more weeks physical and sonographic reexaminations showed a complete healing up of the penile lesions.


Circular Abscess Formation of the Inner Preputial Leaf as a Complication of a Penile Mondor's Disease: The First Case Report.

Wendler JJ, Schindele D, Baumunk D, Liehr UB, Porsch M, Schostak M - Case Rep Urol (2014)

© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4020399&req=5

Mentions: A 44-year-old man presented at our emergency room with a slight painful, subcutaneous, and indurated swelling at the penile dorsum and an oedematous preputium since 2 days. He told of excessive sexual activity without using a condom and fellatio with his wife but denied any penile trauma or manipulations, history of any disease, operations, allergies, or medication. The laboratory and physical examination showed no further pathological findings. B-mode and color Doppler ultrasound indicated an edema of the dorsal penile shaft skin and preputium and the suspicion of a thrombosis of the superficial dorsal penile vein. Cooling, sexual abstinence, and oral medication with ciprofloxacin, diclofenac, and pantoprazole were prescribed. Six days later, he returned because of a progressive swelling of the penile foreskin with a painless pea-sized nodule lump under the inner preputial leaf without any visible superficial lesion. Since two days he received a changed antibiosis to cefixime and doxycycline from his resident physician with doubtful suspicion of cavernitis. No further intervention and the continuation of the aforementioned therapy were recommended. Three days later, he presented an annular abscess formation with partial spontaneous abscess rupture and flush of the inner preputial leaf (Figure 1). There were eight pea- to pinpoint-sized abscesses: six of them were ulcerative after spontaneous perforation; the two remaining nodular abscess formations (Figure 1; Figure 2(a)) were incised with a needle (Figure 2(a)) followed by smears tests (Figure 2(b)), local disinfection, and continuation of the current antibiotic therapy. Three days later, the reexamination showed an improvement but syphilitic-like defects. The smear test was negative for bacterial infection. The dermatological consultant diagnosed a lymphangitis and thrombophlebitis coronarius glandis. The serological analysis was negative for HIV, syphilis, and gonorrhea but positive for mycoplasma pneumoniae (IgG 48.2 U; IgA 11.5; IgM negative). Local disinfection and the continuation of the current medication with cefixime, doxycycline, and diclofenac were recommended. After four more weeks physical and sonographic reexaminations showed a complete healing up of the penile lesions.

Bottom Line: Conclusion.Our patient is very unusual in that he presented with a secondary preputial abscess formation due to superficial thrombophlebitis, subcutaneous lymphangitis, and local bacterial colonisation.Abscess drainage plus antiphlogistic and antibiotic medication is the treatment of choice.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology and Paediatric Urology, Medical Faculty of the University of Magdeburg, Leipziger Straße 44, 39120 Magdeburg, Germany.

ABSTRACT
Introduction. Mondor's disease of the penis is an uncommon condition characterized by thrombosis or thrombophlebitis involving the superficial dorsal veins. An accompanied lymphangitis is discussed. There is typical self-limiting clinical course. Case Presentation. This paper firstly reports a secondary abscess formation of the preputial leaf two weeks after penile Mondor's disease and subcutaneous lymphangitis as complication of excessive sexual intercourse of a 44-year-old man. Sexual transmitted diseases could be excluded. Lesions healed up completely under abscess drainage, antibiotic, and anti-inflammatory medication. Conclusion. Previous reports in the literature include several entities of the penile Mondor's disease. Our patient is very unusual in that he presented with a secondary preputial abscess formation due to superficial thrombophlebitis, subcutaneous lymphangitis, and local bacterial colonisation. Abscess drainage plus antiphlogistic and antibiotic medication is the treatment of choice.

No MeSH data available.


Related in: MedlinePlus