Case 79: A Case of Balanitis

Dr ASHISHKUMAR S JULME
Medical Officer, Dr M L Dhawale
Rural Homoeopathic Hospital, Palghar
Tel: 02525256933

Mr PKJ, 28 yrs, Studied upto 9^th Std (SSC failed), a Company worker, Unmarried, staying at Palghar, came on 22/12/2008 with severe acute cozmplaint.

Ulceration2 and burning pain on glans penis and at the tip of the urethra.
It started suddenly 3 days back with pustular discharge in drops.
Burning pain urethra < urination during³; < touch2, > urination after².
Hot feeling. No h/o exposure, no fever, no chilliness and no bleeding

GENERAL EXAMINATION 
PULSE: 88/ min
TEMP: 98ºF
BP: 130/80 mm of hg
RS: Clear, AEBE
CVS: S1S2 N
P/A: NAD
LYMPH NODES: Not palpable

LOCAL EXAMINATION PENIS

·         Redness and ulceration on tip of urethra and glans.

·         Pustular discharge +

·         No inflammation on prepuce

INVESTIGATIONS DATE
22/12/08: HB: 15.5, WBC: 7600, DLC: N-60, L-33, E-04, M-03, ESR: 16, URINE ROUTINE: NAD, RBS: 95 mg/dl, HIV: NEGATIVE, VDRL: NEGATIVE.

DIAGNOSIS: Acute Balanitis with ulceration

SOME UNDERSTANDING ABOUT BALANITIS

·         Balanitis is an acute or chronic inflammation of the superficial cutaneous layers of the glans penis, often involving the distal foreskin (posthitis). The combination, called balanoposthitis

·         Although the causes are verity of balanoposthitis can be classified into one of two categories: irritant and infectious.

·         The majority of authors feel that irritant balanoposthitis is the most common form and that the bulk of these cases are related to poor hygiene.

·         As a result of infection or poor hygiene, the glans penis and prepuce become inflamed, causing adherent foreskin and smegma accumulation

·         Products such as soap, bubble bath, fabric softeners and laundry detergent have been implicated as external irritants that initiate and/or worsen the condition.

·         The presenting complaints in the emergency department are usually pruritus, penile discomfort and swelling.

·         Examination of these patients reveals redness and swelling of the glans as well as a discharge from the preputial-glanular sulcus

·         Urethral discharge is not typically present.

·         Treatment for irritant balanoposthitis includes sitz baths, gentle cleansing with foreskin retraction

ACUTE TOTALITY

·         Burning pain tip of urethra

·         < Urination during³

·         < Touch²

·         > Urination after

·         Ulceration²

·         Pustular discharge

REMEDY GIVEN
22/12/2008: Merc-cor 200 4 pills x 4 hourly for 4 days.
26/12/2008: Burning reduced2 on 22/12/08 evening, next morning. No burning, no pustular discharge. Ulceration reduced.
Now on examination only redness at meatus. No complaints

Now case was defined and Lycopodium 200 was chosen as the constitutional remedy. One powder was given on 2/1/09 to avoid recurrence. Since then he has been well.