BALANITIS AND INFECTIOUS AGENTS - A PROSP ECTIVE-STUDY OF 100 CASES

Introduction. The aim of this study was: 1) to evaluate the rate of mi cro-organism isolation in 100 patients consulting for balanitis at the Centre of sexually transmitted diseases at the St. Louis Hospital in Paris in comparison with that of micro-organisms isolated in 60 men wi thout balanitis; 2) to search for a possible correlation between the c linical aspect of the disease and the nature of the infectious agent i dentified. Methods. One hundred consecutive patients were included in the study. All underwent a clinical examination and samples were taken for bacteriology, mycology and virology examinations. Sixty healthy v olunteers served as controls. Two samples were taken from the balanopr eputial groove in search for fungi and bacteria. Results. Candida albi cans (CA) was isolated in 33 p. 100 of the patients. A pathogenic bact eria (beta-haemolytic streptococci, Staphylococcus aureus, Klebsiella) , or a potentially pathogenic germ (Haemophilus parainfluenzae, anaero bic bacteria, Gardnerella vaginalis, Streptococcus milleri, group HB5) was found without CA in 28 p. 100 of the cases, a commensal flora (en terobacteria, group D streptococci) was found without CA in 8 p. 100 a nd in 31 p. 100 of the cases non causal agent could be identified. Dis cussion. This series confirms the non-pathogenic nature of commensal b acteria: the number of isolations was similar in the subjects with and without balanitis (p < 0.9). The role played by the other bacteria in the development of balanitis is discussed: saprophytic association or direct pathogenesis? The significant difference in the rate of bacter ia isolations in patients with balanitis compared with controls (p < 0 .001) is in favour of a pathogenic role. The clinical presentation was not predictive of the presence of any particular micro-organism excep ting the presence of pustules which were highly suggestive of candidia sis.