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Patient case: Balanoposthitis

Discussion

A 7-year-old boy is brought to the clinic by his mother due to swelling, redness, and discomfort in his genital area for the past two days. The mother reports that the boy has complained of pain during urination and that his foreskin appears inflamed. There is no history of trauma or recent illness. The mother mentions that she noticed some yellowish discharge from under the foreskin.

On physical examination, the boy has a swollen and erythematous foreskin with visible inflammation of both the glans (head of the penis) and the foreskin, consistent with balanoposthitis. A mild amount of discharge is present, and the boy experiences tenderness upon examination.

The pediatrician diagnoses balanoposthitis, likely caused by poor hygiene and bacterial infection. The treatment plan includes improving hygiene practices, such as regular gentle cleaning under the foreskin, and a course of topical antibiotic ointment. The mother is also advised to encourage the boy to avoid scratching the area, and a follow-up visit is scheduled to assess his response to treatment.

Questions
1. What symptoms prompted the mother to bring her 7-year-old son to the clinic?

A) Frequent urination

B) Redness, swelling, and discomfort in the genital area

C) Blood in the urine

D) Abdominal pain

2. What diagnosis did the pediatrician make based on the physical examination?

A) Phimosis

B) Paraphimosis

C) Balanoposthitis

D) Urethral stricture

3. What was likely the underlying cause of the balanoposthitis in this case?

A) Poor hygiene and bacterial infection

B) Trauma to the genital area

C) Viral infection

D) Urinary tract infection

4. What initial treatment plan did the pediatrician recommend?

A) Circumcision

B) Topical steroid cream

C) Improved hygiene and topical antibiotic ointment

D) Oral antibiotics

Reveal answers

Answers

1. B) Redness, swelling, and discomfort in the genital area

2. C) Balanoposthitis

3. A) Poor hygiene and bacterial infection

4. C) Improved hygiene and topical antibiotic ointment

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