Swollen, red penis with pus

[RachelGS]

Okay, what do I do? My three year old's penis is swollen and red, and there's pus at the tip. He is complaining that it hurts. I put bacitracin on it and gave him a warm bath with baking soda, but what else should I do? What would have caused this?

[Quirky]

It could be that he had dirty fingernails or something and scratched or yanked too hard, and got some germs into some open skin. I would do a warm salt water soak if possible. If it's still looking bad and doesn't clear up in 24 hours with warm salt soaks and bacitracin I'd take him in. Especially if it gets worse or he starts running a fever. Get a culture for specific typing of the bug but don't allow any retraction.

[l_olive]

It's very likely that it's not pus you're seeing, it's smegma. Please read this really excellent thread for more information on normal separation, because it really sounds like that's what's going on with your son.

http://www.mothering.com/discussions...d.php?t=764732

[RachelGS]

Thanks. I'm pretty well read on it, but nervous about our ped practice, which is hit or miss. It is pus that I'm seeing-- yellow and oozy, not at all like the smegma pictures I've seen. I haven't had any problems at all with his foreskin before now, and my guess is that he was pulling at it and scratched it somehow, but now it's looking pretty bad.

[Cavy]

If he were my lad I'd like to have a doctor's opinion, OP.

[MCatLvrMom2A&X]

What I did when ds had a bacterial infection and I took him to the Dr. I never let the dr even touch it I moved his penis for the dr to see ie raised the whole thing up. To do a culture all that is needed is swabbing the very tip and seeing what grows. So if you are worried about retracting do all the holding yourself dont let them touch it except with the swab. Dont let them tell you it is yeast or bacterial without that swab.

If you want to and you dont see improvement after the bacatracin then go and get some OTC 7 day monistat and try that and see if it helps. Nothing wrong with trying to treat it before going in.

[Cavy]

Oh dear! I just realised that there are countless accounts on this site of doctors trying to pull back foreskins on very little boys. That just would (virtually) never happen where I live.
So what McCatLovr said makes sense.
Sometimes I think medical care in the USA is completely nutty.

[RachelGS]

Agreed. It's ridiculous. I did put in a call this morning, but I specifically requested to hear back from the person over there who knows me best and listens to me consistently. If we decide to go in, I'll do what McCat suggested. I'm definitely not comfortable with the idea of other people handling his penis.

[robertandenith]

epsom salt baths eliminated the oozing I got after tearing in my last birth, have you tried that?

[eepster]

Originally Posted by RachelGS

It is pus that I'm seeing-- yellow and oozy, not at all like the smegma pictures I've seen.

That could be smegma, there isn't a single way it always looks. When I saw something in DS's underwear, I wasn't sure if it was smegma or melted icecream. I'm pretty sure it was smegma, since there was more another day when he wan't eating icecream, but it really isn't all that obvious what is smegma and what isn't.

[l_olive]

:

With my son it was red-brown thick goop and smelly.

[RachelGS]

I really am very confident that it's infected. It's bloody-oozy-yellow-gross. I got the doctor today who is both foreskin-friendly and who trusts me, so that was helpful. He called in a topical antibiotic cream and will see him if it gets worse. Poor little guy, though. He has been whimpering for 24 hours.

[l_olive]

I'm sorry he's not doing better, but really glad you are lucky enough to have a foreskin-friendly doctor. I hope everything clears up quickly and easily.

[tutucrazy]

Originally Posted by RachelGS

Thanks. I'm pretty well read on it, but nervous about our ped practice, which is hit or miss. It is pus that I'm seeing-- yellow and oozy, not at all like the smegma pictures I've seen.

Yup smegma in young boys can be all colors and smells. Unlike adult men it is trapped there longer so it tends to have more color and odor. Here is another thread that could help:
http://www.mothering.com/discussions...893&highlight=

He probably scratched himself or pulled himself causing some separation. Give him some time to see if it heals. Bacterial infections get worse and swelling extends into the groin. They usually only happen after a wound to the penis. Fever will also be present.

I would not let a doc touch his penis. If you got to a doctor, just have them look and swab. Don't let them retract or hold the penis. Make it clear to them that they are not to manipulate the foreskin.

[l_olive]

Are there any updates to this, Rachel?

[RachelGS]

He's doing better with topical abx. He developed a red streak moving up his penis, which we watched very closely, but it is improving. The swelling and discharge are better, and he's in less pain.

I want to say this delicately, because I'm grateful for all the feedback and because the issue of genital integrity is very important to me, but when I said two or three different ways that I was confident we were dealing with an infection and kept getting told that it wasn't one, that was frustrating. I'm not new to the parenting scene, or the penile one, either. I want to be sure that in giving advice to new posters here, we're not ignoring medical issues when they crop up. I will bang the drums for this cause as loudly as anybody, but I don't want to cross the line into thinking that being intact means being guaranteed a life without problems. This was a diagnosed balanitis, and if I had ignored it, it would have caused my son a lot more pain for a lot more time. Sometimes the instinct that something is wrong is on target.

[georgia]

Happy to hear things are improving!

[georgia]

This brings up an important point. It obviously can be very dangerous to ignore signs of infection and MDC does not wish to provide medical advice for anyone. It can be very important to seek in-person care when things seem "off," prepared with helpful information, BTDT experience and personal advice gained from our discussions. In the end, we recognize parents as experts and seek to provide truly helpful information upon which parents can make informed choices.

I would like to direct everyone to our TCAC disclaimer:

The opinions offered at Mothering.com and MotheringDotCommunity are for informational purposes only and are not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of a qualified healthcare provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking care because of something you have read here.

Thanks, everyone!

[MCatLvrMom2A&X]

I hear you loud and clear Rachel and I agree 100%. I also went through and infection with my ds when he was 2 and I knew right away it was infection not just smegma. It is easy to tell if you see it along with other signs like you did.

I am glad you decided to talk about it and remind everyone that sometimes there is a real issue there. Not just normal separation.

FTR when ds had the bacterial infection the only thing affected was his foreskin and down the shaft of his penis it did not continue down into the fat pad or scrotum but I took him in the very next day for meds so it didnt have a change to progress that far. It actually only took about 6 hours from slight swelling to OMG : but once treatment started it was only another 6 hours from OMG to nearly normal again.

[PuppyFluffer]

Originally Posted by RachelGS

He's doing better with topical abx. He developed a red streak moving up his penis, which we watched very closely, but it is improving. The swelling and discharge are better, and he's in less pain.

I want to say this delicately, because I'm grateful for all the feedback and because the issue of genital integrity is very important to me, but when I said two or three different ways that I was confident we were dealing with an infection and kept getting told that it wasn't one, that was frustrating. I'm not new to the parenting scene, or the penile one, either. I want to be sure that in giving advice to new posters here, we're not ignoring medical issues when they crop up. I will bang the drums for this cause as loudly as anybody, but I don't want to cross the line into thinking that being intact means being guaranteed a life without problems. This was a diagnosed balanitis, and if I had ignored it, it would have caused my son a lot more pain for a lot more time. Sometimes the instinct that something is wrong is on target.

I would venture a guess that almost always the instinct that something is wrong is right on target! I think we should always listen and respond to that instinct.