ballooning, red/swollen, and now a fever

[jenveg618]

I have 2 sons, both intact. My younger son, who is 21 months, experienced for the first time a ballooning of his penis yesterday and seemed to be in a lot of discomfort. DH was very concerned and I took him to the ER (it was evening) and by the time we got there the penis was swollen and red, but no more ballooning. They kept us long enough to make sure he could urinate (he did, after LOTS of nursing ) So they sent us home with some bacitracin, info on how to do sitz baths, and a prescription for antibiotics.

Now, I'm determined to avoid antibiotics unless ABSOLUTELY NECESSARY. So I took a wait-and-see approach last night, giving him a sitz bath, putting on a little bacitracin, and giving him lots of probiotics before going to bed. Around 3am he woke up and was definitely feverish, so I gave him some motrin. Later this morning he developed a fever again, so now I'm thinking this must be a bacterial infection, right? If it was yeast (my initial suspicion) then he wouldn't have a fever, I'm assuming. So I went ahead ahead and filled the Rx and gave him his first does of antibiotics. He has a follow-up appt. with his ped this afternoon; I'm thinking of asking for a culture swab to confirm bacterial infection. Fortunately his dr. is very supportive of our choice not to circ. and isn't going to try and convince us to do that (which I would REFUSE).

Sorry if this is long-winded. I'm just wondering if anyone else has been in this boat or if it sounds like I'm handling it the right way.

THanks!

Jennifer

p.s. I did read the sticky about normal development of an intact penis; it's all very reassuring but the fever part is what has me concerned.

[MCatLvrMom2A&X]

The fever says there is infection. It could have come from germs getting into the newly seperated areas of his foreskin. Sometimes that happens though it is rare. Definatly have the ped do a swab to make sure it is bacterial and not yeast. Because if it is yeast the abx will make it worse.

The ballooning totally normal and a sign he is becoming retractable.

Make sure the Dr. dosnt retract any if he does have an infection messing with it can make it spread plus it is just not necessary to do so.

[jenveg618]

Well, he just woke up from his nap with a definite fever, so I'm pretty convinced it's an infection. But now my question is (and I'll ask the dr. too), would the bacitracin be enough, or will he need to do the oral antibiotics? The thing about the bacitracin is that I can only get it onto the outside of the foreskin, and it would seem that the infection would be up inside the foreskin, where no ointment can reach it.

[MCatLvrMom2A&X]

When my ds had a bacterial infection just putting it on the tip was enough and I mean I slathered it on big time I made sure to get it on the tip and it worked through the skin just fine. I did give him the oral abx as well because he was sooo swollen it was every bit as big around as his wrist seriously. But he never did have trouble using the bathroom other than it burned some.

[eepster]

Is the swelling and redness getting worse? Could the fever be unrelated? Fever means infection yes, but if the infection was on the penis I would think the swelling and redness would be getting worse. If it's separation it should start looking better soon.

If he has been playing with himself a lot lately that could explain both his separating (indicated by the ballooning, swelling, redness) and having an infection (suggested by fever, swelling, redness) down there. Sometimes little boy try to stick things in there.

Did they take a urine sample?

At this point I would think the anti-bx were a good idea b/c he seems to have some kind of infection, unless you have reason to suspect it's a viral infection; if he were sniffling or coughing, or some such. He might have picked up a virus at the ER.

[jenveg618]

Well, we went to the ped yesterday and he did a culture swab from the tip of his penis (no retraction whatsoever; there was what looked like pus coming out the tip; asked dr. if it could be smegma and he said smegma had a different appearance). Anyway, now we're waiting to see what the culture tells us. In the meantime, I went ahead an started him on the oral antibiotics, which I'll stop if we find out there's no bacterial infection.

His penis looks a bit better, but I'm wondering if that's from using the bacitracin for 2 days now, plus sitz baths and keeping him very clean and dry. I can't imagine that he had the chance to put anything in there, since he's in diapers all the time with the exception of bathtime. I do believe that separation was/is taking place, and possibly the urine that pooled inside (causing the ballooning the other day) stayed in there long enough to cause an infection?

His fever got pretty high yesterday evening, and he had a milder fever in the late morning today, plus his glands are swollen. I certainly am wondering if this is a virus instead, and where/how he caught it (we were in an enclosed room in the ER, separate from any other children; was really crossing my fingers that we weren't going to be exposed to anything!).

Anyway, now we have to wait till tomorrow afternoon before we know anything, which is frustrating. As I mentioned, his penis does look better; it's less red, but the glans does seem a little bigger than it usually looks.

Thanks for the replies; I'll keep you posted!

[Quirky]

As my mom's doctor says, you can have fleas and flies at the same time -- it is possible to have some separation going on and a virus or some other cause for the fever! So the penis and the fever might be related, or not....it's hard to say.

Just as a for example, my dd2 had pneumonia a couple of weeks ago, and started on abx - she threw up the first one we tried, so we switched and put her on a second one, which she immediately threw up as well and then proceeded to throw up all night long. So of course we assumed it was the second antibiotic -- until the rest of us started throwing up as well! Rotavirus, most likely.

I really don't think urine inside the foreskin with ballooning would cause an infection --- urine is sterile exiting the body, and even with ballooning it's not being retained -- just delayed in getting out. If you think about it, if you go camping and pee without benefit of TP for a week or two, you're going to get stinky, but you're not going to get infected most likely. I also think that if it were truly a penis infection you'd have seen more and worse penis symptoms, like green discharge, a very swollen penis, etc. and a lot more pain and discomfort.

[eepster]

Originally Posted by jenveg618

plus his glands are swollen.

Do you mean the glands in his throat? Which would indicate a coincidental virus. Or, did you mean the lymph nodes in his groin? Which would strongly indicate infection down there.

Pus and smegma look practically identical, and both are somewhat variable in appearance..

[MCatLvrMom2A&X]

I thought she meant his penis glans.

[jenveg618]

Well, it looks like the mystery has been solved. After continuing to have a fever today, he started having diarrhea throughout the afternoon. Just over a week ago I had a bad 24 hr bug with fever and diarrhea. I didn't suspect that initially b/c I figured if he was going to catch that from me he would have gotten it by now. But the symptoms are identical to the ones I had. AND, his penis looks completely normal today with no swelling or redness. So, out with the antibiotics!

Thanks for all the info/help. It looks like it was a case of bad timing! But glad to know that things are doing what they should be doing down there

[MCatLvrMom2A&X]

Sorry your ds is sick but glad you where able to figure out what all was going on. Bad timing indeed.

[Quirky]

Yep, fleas and flies at the same time.....if you haven't already stop the abx as they will only make the diarrhea worse!

Hope your little guy is better soon.

[tutucrazy]

My honest opinion...
I think your son happens to have a cold virus (causing the fever) and separation at the same time. Here is why:

http://www.drmomma.org/2010/01/painf...g-prepuce.html