A 43-year-old man presented to the emergency department with swelling and preputial edema associated with swelling of the penile dorsum of 3 weeks duration.
The patient denies risky sexual relations, voiding syndrome, or fever.
She complains of pain in the back of her penis in relation to an indurated cord that is palpable in that region, which accentuates with erection.
In her clinical history, she only highlights being a smoker of 20 cigarettes/day, without any underlying disease or usual treatment; in her family history, no history of interest was found.
During physical examination, an intense preputial inflammation with whitish erosions suggestive of candidiasis was observed.
On the dorsum of the penis, a painful hard cord extending from the base to the balanoprepucial groove is evident, associated with inflammation of the adjacent tissue.
The rest of the physical examination was normal.
Diagnosis was confirmed by Doppler ultrasound of the penis.
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The treatment instituted was topical Fluconazole 1 application /12h, Amoxicillin-Clavulanic 875 mg/8h and Ibuprofen 600 mg/8h for 10 days, associated with resolution of sexual activity.
During the first week, progressive distal reduction of the dorsal cord and pain were observed.
Candidiasis-related lesions.
At this moment a punctiform phimosis that prevents preputial retraction is revealed to the exploration, and for which it must be circumcised.
Six weeks later, a penile Doppler ultrasound was performed, showing the repermeabilization of the superficial dorsal vein of the penis in the absence of venous thrombus.
