Yellow Fibrous Cord-Like Penile Discharge in a Preterm Neonate — Fungal Balanoposthitis

Excerpt

A 1785 g male neonate was born at 31 wk gestation, to an inadequately treated syphilitic mother. The neonate was diagnosed with congenital neurosyphilis. Injection benzathine penicillin G stat dose along with injection ceftriaxone was started through peripherally inserted central catheter. At DOL 24 he developed thick yellowish cord-like gelatinous odourless discharge from the penis, measuring 9 mm × 4 mm (Fig. 1). Physiological phimosis was present, with no signs of inflammation and urinary retention. No perianal rashes were noted. Oral thrush was present. Histopathological examination of discharge and suprapubic urine KOH mount revealed budding yeast cells with pseudohyphae. Local clotrimazole cream and injection fluconazole was started. Local hygiene was maintained. The discharge culture grew Candida albicans sensitive to fluconazole. Urine and blood culture were sterile. Ultrasound brain, abdomen and pelvis were normal. Fluconazole was stopped after 3 wk due to no associated systemic fungemia. Diagnosis of candida balanoposthitis was entertained.

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