THE SUMMER PENILE SYNDROME - SEASONAL ACUTE HYPERSENSITIVITY REACTIONCAUSED BY CHIGGER BITES ON THE PENIS

Objective: To describe the seasonal acute hypersensitivity reaction of the penis due to chigger bites, known as the summer penile syndrome. Design: A consecutive series of patients. Setting: The emergency depar tment of an urban academic children's hospital in the midwestern Unite d States. Participants: Male pediatric patients with an acute hypersen sitivity reaction of the penis. Results: Ninety-four patients were tre ated for summer penile syndrome during the four-month period from June through September. Patients ranged in age from seven months to 11 yea rs (mean = 5.1, SD = 2.5), Twenty-one percent of patients had also exp erienced a similar prior episode of penile swelling. Symptoms included pruritus in 84% of cases, dysuria in 33%, and decreased strength of u rine stream in 8% of patients. Eighty-four percent of patients had rec ent exposure to the woods, park, lawn, or poison ivy. In addition to e dema, findings on physical examination included a papule or bite punct ure mark in 50% of patients, erythema in 32%, and excoriation in 6% of patients. Fifty-six percent of patients had bites on other areas of t he body. The emergency physician attributed the penile edema to an ins ect or chigger bite in 98% of cases. Treatment consisted of an oral an tihistamine and cold compresses in most cases. The reported duration o f penile swelling ranged from one to 18 days with a mean of 4.1 days ( SD = 3.5), and the reported duration of pruritus ranged from 0 to 14 d ays with a mean of 3.0 days (SD = 2.6). Conclusion: This study provide s an understanding of the summer penile syndrome for pediatric care pr oviders. To our knowledge, this study is the first to describe this se asonal syndrome in the medical literature.