Anaerobic Balanoposthitis: Two Cases and Review of the Literature

• Published in: Anaerobe 2000-02, Vol.6 (1), p.11-14
• Main Authors: Tavakoli-Tabasi, Shahriar, Hamill, Richard J., Greenberg, Stephen B.
• Format: Article
• Language: English
• Subjects: Anaerobe, Balanoposthitis, Balanitis, Provetella melaninogenica, Bacteroides
• ISSN: 1075-9964; 1095-8274
• DOI: 10.1006/anae.1999.0314

Anaerobic balanoposthitis is an infection of the glans penis and prepuce caused by anaerobic Gram-negative rods. It is characterized by intense inflammation and edema of the prepuce, superficial ulcers on the glans penis, foul-smelling subpreputial discharge, and bilateral inguinal lymphadenopathy. Infection tends to be locally destructive with severe tenderness of the penis and can result in considerable necrosis and tissue damage. The presence of a tight foreskin and sub-optimal hygienic practices seem to be a prerequisite for this condition to develop. Anaerobic Gram-negative rods belonging to the genus Bacteroides are the most commonly incriminated in the pathogenesis. Possible modes of transmission include contact with infected mucosal surfaces, such as during sexual intercourse, contamination by colonized saliva, or extension from the perirectal area. We report the first two cases of anaerobic balanoposthitis in HIV-positive patients and review the literature. Both patients had a previous history of sexually transmitted diseases and practiced sub-optimal hygiene. In both cases response to therapy was complete within 48–72 h.