Diabetes presenting as Balanitis

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HISTORY

  • 50 year old bisexual man
  • Penile itch for 3 weeks
  • Using Hydrozole for a week before presenting, without improvement

 

EXAMINATION

Balanoposthitis with skin fissuring and phimosis

 

Microscopy of subprepuce:

  • +++ polymorphs
  • budding yeasts

 

URINALYSIS

  • ++++ glucose

 

INVESTIGATIONS

  • blood glucose: 21.7 mmol/L
  • subprepuce culture: Candida albicans, Candida glabrata and Streptococcus agalactiae isolated
  • STI tests negative

 

URINALYSIS

  • ++++ glucose

 

DIAGNOSIS:

  • Diabetes mellitus  presenting as candidal balanoposthitis

MANAGEMENT

  • Fluconazole 150 mg daily for 5 days

THE LESSON

Always consider the possibility of underlying diabetes in cases of candidal balanitis (and vuolvovaginitis in women), particularly in middle aged and overweight patients

 

Dated February, 2007