Balanitis
Balanitis is inflammation of the glans (head) of the penis. If the foreskin is also inflamed, the condition is called balanoposthitis. Symptoms of balanitis can include penile pain, swelling and itching, a rash on the penis, and a strong-smelling discharge from the penis. The most common cause of balanitis is poor hygiene in uncircumcised males. If the penis isn't properly cleaned underneath the foreskin, bacteria, sweat, dead skin cells, and debris can build up around the glans and lead to inflammation. If an uncircumcised male has phimosis (foreskin that is difficult to retract) and cannot clean under the foreskin, risk of inflammation increases. Other causes of balanitis include dermatitis and infection (yeast infection or sexually transmitted infection). If infection is the cause, treatment will include antibiotic or antifungal medication. If balanitis is severe or recurrent, circumcision may be the best treatment option.
Epispadias
Epispadias is a rare birth defect characterized by a urethra that doesn't fully develop, which results in the inability to pass urine from the body properly. Both boys and girls can be born with epispadias. When it occurs in boys, they are normally born with a short, wide penis that is curved abnormally. Rather than the urethra opening at the tip of the penis, it may open on the top of side of the penis, or it may be open all along the length of the penis. Signs and symptoms of epispadias in males include an abnormal opening in the urethra, a widened pubic bone, an abnormally shaped penis or abnormally curved penis (chordee), reflux nephropathy (backward flow of urine into the kidney), urinary incontinence and urinary tract infections. Cases range from mild to severe. Mild cases may not require surgery, but most cases of epispadias will need to be surgically corrected. The goals of treatment are to maximize the function and length of the penis and to create a more normal appearance of the penis. In cases where the bladder is involved, surgery will also need to create a pathway for urine to pass normally and to help preserve fertility. There are two common surgical techniques to correct epispadias: the modified Cantwell technique and the Mitchell technique.
Hypospadias
Hypospadias is a birth defect in which the opening of the urethra develops on the underside of the penis instead of on the tip. The condition ranges in severity, depending on where the opening forms. Many times, the urethral opening is near the head of the penis. Some boys are born with the opening in the middle of the shaft or the base of the penis, and rarely, boys can be born with the urethral opening below the scrotum. Signs and symptoms of hypospadias include an abnormal urethral opening, chordee (a downward curve of the penis), abnormal spraying during urination and foreskin abnormalities that make the penis appear hooded. Hypospadias is a relatively common problem that has a straightforward diagnosis and treatment. Most men who were born with hypospadias experience normal sexual function as adults if they received treatment. Treatment involves surgical correction to reposition the urethral opening and, in some cases, to straighten the shaft of the penis. Surgery is most often done between the ages of three and 18 months.
Penile cancer
Cancer of the penis, also called penile cancer, almost always begins in the skin cells of the penis. There are five basic types of penile cancer: squamous cell carcinoma, melanoma, basal cell cancer, adenocarcinoma and sarcoma. About 95 percent of all cancers of the penis develop from squamous cells, which are flat skin cells. Cancer that develops from squamous cells is called squamous cell carcinoma. Squamous cell cancers tend to grow slowly, and they can usually be cured if they are found early. Carcinoma in situ, or CIS, is the earliest stage of squamous cell penile cancer. With CIS, cancer is only found in the top layers of the skin on the penis. Melanoma and basal cell cancer each make up less than 2 percent of all penile cancers, and sarcoma and adenocarcinoma, otherwise known as Paget disease of the penis, are even rarer. Penile cancer must be treated. If the cancer is found early, chances are good that the penis can be saved. However, if cancer has spread to deep tissues of the penis, a surgeon may have to perform a penectomy (removal of part or the entire penis) to remove the cancer. Learn more about penile cancer symptoms, causes, diagnosis and treatment.
Peyronie's disease
Peyronie's disease is a penile condition that develops when scar tissue, called plaque, forms inside the penis and causes erections to be curved and painful. Many men have a slight curve to their erect penis, and it doesn't cause any problems. But when it is painful or the bend is significant, it can lead to erectile dysfunction and may even make sexual intercourse impossible. Signs and symptoms of Peyronie's disease include scar tissue that can be felt under the skin of the penis, a significant bend or curve of the penis, difficulty getting or keeping an erection, pain in the penis, and shortening of the penis. Sometimes Peyronie's disease is mild and doesn't cause significant problems. In that case, treatment may not be necessary. There is also a chance it will improve or even go away on its own without treatment. However, if you have penile pain or the curve of your penis causes problems with sexual intercourse, callBalanitis
Balanitis is inflammation of the glans (head) of the penis. If the foreskin is also inflamed, the condition is called balanoposthitis. Symptoms of balanitis can include penile pain, swelling and itching, a rash on the penis, and a strong-smelling discharge from the penis. The most common cause of balanitis is poor hygiene in uncircumcised males. If the penis isn't properly cleaned underneath the foreskin, bacteria, sweat, dead skin cells, and debris can build up around the glans and lead to inflammation. If an uncircumcised male has phimosis (foreskin that is difficult to retract) and cannot clean under the foreskin, risk of inflammation increases. Other causes of balanitis include dermatitis and infection (yeast infection or sexually transmitted infection). If infection is the cause, treatment will include antibiotic or antifungal medication. If balanitis is severe or recurrent, circumcision may be the best treatment option.
Epispadias
Epispadias is a rare birth defect characterized by a urethra that doesn't fully develop, which results in the inability to pass urine from the body properly. Both boys and girls can be born with epispadias. When it occurs in boys, they are normally born with a short, wide penis that is curved abnormally. Rather than the urethra opening at the tip of the penis, it may open on the top of side of the penis, or it may be open all along the length of the penis. Signs and symptoms of epispadias in males include an abnormal opening in the urethra, a widened pubic bone, an abnormally shaped penis or abnormally curved penis (chordee), reflux nephropathy (backward flow of urine into the kidney), urinary incontinence and urinary tract infections. Cases range from mild to severe. Mild cases may not require surgery, but most cases of epispadias will need to be surgically corrected. The goals of treatment are to maximize the function and length of the penis and to create a more normal appearance of the penis. In cases where the bladder is involved, surgery will also need to create a pathway for urine to pass normally and to help preserve fertility. There are two common surgical techniques to correct epispadias: the modified Cantwell technique and the Mitchell technique.
Hypospadias
Hypospadias is a birth defect in which the opening of the urethra develops on the underside of the penis instead of on the tip. The condition ranges in severity, depending on where the opening forms. Many times, the urethral opening is near the head of the penis. Some boys are born with the opening in the middle of the shaft or the base of the penis, and rarely, boys can be born with the urethral opening below the scrotum. Signs and symptoms of hypospadias include an abnormal urethral opening, chordee (a downward curve of the penis), abnormal spraying during urination and foreskin abnormalities that make the penis appear hooded. Hypospadias is a relatively common problem that has a straightforward diagnosis and treatment. Most men who were born with hypospadias experience normal sexual function as adults if they received treatment. Treatment involves surgical correction to reposition the urethral opening and, in some cases, to straighten the shaft of the penis. Surgery is most often done between the ages of three and 18 months.
Penile cancer
Cancer of the penis, also called penile cancer, almost always begins in the skin cells of the penis. There are five basic types of penile cancer: squamous cell carcinoma, melanoma, basal cell cancer, adenocarcinoma and sarcoma. About 95 percent of all cancers of the penis develop from squamous cells, which are flat skin cells. Cancer that develops from squamous cells is called squamous cell carcinoma. Squamous cell cancers tend to grow slowly, and they can usually be cured if they are found early. Carcinoma in situ, or CIS, is the earliest stage of squamous cell penile cancer. With CIS, cancer is only found in the top layers of the skin on the penis. Melanoma and basal cell cancer each make up less than 2 percent of all penile cancers, and sarcoma and adenocarcinoma, otherwise known as Paget disease of the penis, are even rarer. Penile cancer must be treated. If the cancer is found early, chances are good that the penis can be saved. However, if cancer has spread to deep tissues of the penis, a surgeon may have to perform a penectomy (removal of part or the entire penis) to remove the cancer. Learn more about penile cancer symptoms, causes, diagnosis and treatment.
Peyronie's disease
Peyronie's disease is a penile condition that develops when scar tissue, called plaque, forms inside the penis and causes erections to be curved and painful. Many men have a slight curve to their erect penis, and it doesn't cause any problems. But when it is painful or the bend is significant, it can lead to erectile dysfunction and may even make sexual intercourse impossible. Signs and symptoms of Peyronie's disease include scar tissue that can be felt under the skin of the penis, a significant bend or curve of the penis, difficulty getting or keeping an erection, pain in the penis, and shortening of the penis. Sometimes Peyronie's disease is mild and doesn't cause significant problems. In that case, treatment may not be necessary. There is also a chance it will improve or even go away on its own without treatment. However, if you have penile pain or the curve of your penis causes problems with sexual intercourse, call your doctor. You may need to take medication, have the scar injected with a medication or have surgery to correct the Peyronie's.. Your doctor may prescribe other medications as well. If your disease is severe and isn't improving on its own or with treatment, surgery may be an option.
Phimosis and paraphimosis
Phimosis is a condition that makes it difficult to retract the foreskin of the penis. Paraphimosis is a condition that makes repositioning the foreskin difficult. Both conditions can occur in boys and men who are uncircumcised (have not had their foreskin removed).
Otitis media is inflammation located in the middle ear. Otitis media can occur as a result of a cold, sore throat, or respiratory infection.
Facts about otitis media
More than 80 percent of children have at least one episode of otitis media by the time they are 3 years of age.
Otitis media can also affect adults, although it is primarily a condition that occurs in children.
Who is at risk for getting ear infections?
While any child may develop an ear infection, the following are some of the factors that may increase your child's risk of developing ear infections:
Being around someone who smokes
Family history of ear infections
A poor immune system
Spends time in a daycare setting
Absence of breastfeeding
Having a cold
Bottle-fed while laying on his or her back
What causes otitis media?
Middle ear infections are usually a result of a malfunction of the eustachian tube, a canal that links the middle ear with the throat area. The eustachian tube helps to equalize the pressure between the outer ear and the middle ear. When this tube is not working properly, it prevents normal drainage of fluid from the middle ear, causing a build up of fluid behind the eardrum. When this fluid cannot drain, it allows for the growth of bacteria and viruses in the ear that can lead to acute otitis media. The following are some of the reasons that the eustachian tube may not work properly:
A cold or allergy which can lead to swelling and congestion of the lining of the nose, throat, and eustachian tube (this swelling prevents the normal flow of fluids)
A malformation of the eustachian tube
What are the different types of otitis media?
Different types of otitis media include the following:
Acute otitis media (AOM). The middle ear infection occurs abruptly causing swelling and redness. Fluid and mucus become trapped inside the ear, causing the child to have a fever, ear pain, and hearing loss.
Otitis media with effusion (OME.) Fluid (effusion) and mucus continue to accumulate in the middle ear after an initial infection subsides. The child may experience a feeling of fullness in the ear and hearing loss.
Chronic otitis media with effusion (COME). Fluid remains in the middle ear for a prolonged period or returns again and again, even though there is no infection. May result in difficulty fighting new infection and hearing loss.
What are the symptoms of otitis media?
The following are the most common symptoms of otitis media. However, each child may experience symptoms differently. Symptoms may include:
Unusual irritability
Difficulty sleeping or staying asleep
Tugging or pulling at one or both ears
Fever
Fluid draining from ear(s)
Loss of balance
Hearing difficulties
Ear pain
The symptoms of otitis media may resemble other conditions or medical problems. Always consult your child's physician for a diagnosis.
How is otitis media diagnosed?
In addition to a complete medical history and physical examination, your child's physician will inspect the outer ear(s) and eardrum(s) using an otoscope. The otoscope is a lighted instrument that allows the physician to see inside the ear. A pneumatic otoscope blows a puff of air into the ear to test eardrum movement.
Tympanometry, is a test that can be performed in most physicians' offices to help determine how the middle ear is functioning. It does not tell if the child is hearing or not, but helps to detect any changes in pressure in the middle ear. This is a difficult test to perform in younger children because the child needs to remain still and not cry, talk, or move.
A hearing test may be performed for children who have frequent ear infections.
Neuritis
Neuritis, inflammation of one or more nerves. Neuritis can be caused by injury, infection,
or autoimmune disease. The characteristic symptoms include pain and tenderness,
impaired sensation, often with numbness or hypersensitivity, impaired strength and
reflexes, and abnormal circulation and decreased the ability to sweat in the distribution of the
named nerve or nerves. Although the term neuritis is sometimes used interchangeably
with neuropathy, the latter is an often painful condition that is associated generally with
nerve damage, dysfunction, or degeneration rather than with inflammation alone. In
some instances neuritis can progress to neuropathy. One of the more common forms of
the condition is optic neuritis.
Neuritis can affect one nerve (mononeuritis) or a plexus of nerves (plexitis). When several
single nerves are affected simultaneously, the condition may be referred to as
mononeuritis multiplex. When widely separated nerves are affected, it is known as
polyneuritis. The symptoms of neuritis are usually conned to a specic portion of the
body served by the inamed nerve or nerves.
Inammations of sensory neurons in a nerve bre cause sensations of tingling, burning, or
stabbing pains that usually are worse at night and are aggravated by touch or
temperature change. The inammation of motor neurons causes symptoms ranging from
muscle weakness to complete paralysis. Muscles in the area served by the affected nerve
lose tone, become tender, and may atrophy. Bell palsy, which causes a characteristic
distortion of the muscles on one side of the face, is a form of mononeuritis and is caused
by the inflammation of a facial nerve (the condition is sometimes also described as a form
of mononeuropathy).
Treatment is directed toward the cause of the neuritis; analgesics may be prescribed for
pain relief. Recovery is usually rapid in less-severe cases.
Lupus Nephritis
Lupus nephritis is inflammation of the kidney that is caused by systemic lupus erythematous (SLE). Also called lupus, SLE is an autoimmune disease. With lupus, the body's immune system targets its own body tissues. Lupus nephritis happens when lupus involves the kidneys.
Up to 60% of lupus patients will develop lupus nephritis. When the kidneys are inflamed, they can't function normally and can leak protein. If not controlled, lupus nephritis can lead to kidney failure.
Symptoms of Lupus Nephritis
Lupus nephritis is a serious problem. Its symptoms, though, are not always dramatic. For many, the first noticeable symptom is swelling of the legs, ankles and feet. Less often, there can be swelling in the face or hands.
Other symptoms can vary from person to person and from day to day. They may include:
Weight gain
High blood pressure
Dark urine
Foamy, frothy urine
The need to urinate during the night
Not all urinary or kidney problems in people with lupus are due to lupus nephritis. People with lupus may also be prone to urinary tract infections. These cause burning on urination and require treatment with antibiotics. Certain lupus medications can also affect the kidneys and cause swelling and other symptoms similar to those of lupus nephritis. Problems related to these drugs usually go away when the drugs are no longer used.
Lupus Nephritis Diagnosis and Treatment
The diagnosis of lupus nephritis begins with a medical history, physical exam, and evaluation of symptoms. You doctor will likely order tests to make or confirm a diagnosis. Tests used in diagnosing kidney problems include urine tests, blood tests, imaging tests such as ultrasound, and kidney biopsy.
There are five different types of lupus nephritis. Treatment is based on the type of lupus nephritis, which is determined by the biopsy. Since symptoms and severity vary from person to person, treatments are individually tailored to meet a person's particular circumstances.
Medications used in treatment can include:
Corticosteroids. These strong anti-inflammatory drugs can decrease inflammation. Doctors may prescribe these until the lupus nephritis improves. Because these drugs can cause a variety of potentially serious side effects, they must be monitored carefully. Doctors generally taper down the dosage once the symptoms start to improve.
Immunosuppressive drugs. These drugs, which are related to the ones used to treat cancer or prevent the rejection of transplanted organs, work by suppressing immune system activity that damages the kidneys. They include cyclophosphamide (Cytoxan), azathioprine (Imuran) and mycophenolate (Cellcept).
Medications to prevent blood clots or lower blood pressure if needed
Even with treatment, loss of kidney function sometimes progresses. If both kidneys fail, people with lupus nephritis may need dialysis. Dialysis involves filtering the blood through a machine to remove waste products from the body.
Ultimately, it may be necessary to have a kidney transplant. In those cases, people will need additional drugs to keep their immune system from rejecting the transplanted kidney.
Lifestyle Changes for Lupus Nephritis
Certain lifestyle habits can help protect the kidneys. People with lupus nephritis should do the following:
Drink enough fluids to stay well hydrated.
Eat a low-sodium diet, especially if hypertension is an issue.
Avoid smoking and drinking alcohol.
Exercise regularly.
Maintain a healthy blood pressure.
Limit cholesterol.
Avoid medications that can affect the kidneys, such as nonsteroidal anti-inflammatory drugs (NSAIDs).
Your doctor may also recommend that you eat a diet low in potassium, phosphorus, and protein if there is already loss of kidney function.
Although lupus nephritis is a serious problem, most people who receive treatment do not go on to have kidney failure.
What is encephalitis?
Encephalitis is an inflammation of the brain tissue. The most common cause is viral infections. In rare cases it can be caused by bacteria or even fungi.
There are two main types of encephalitis: primary and secondary. Primary encephalitis occurs when a virus directly infects the brain and spinal cord. Secondary encephalitis occurs when an infection starts elsewhere in the body and then travels to your brain.
Encephalitis is a rare yet serious disease that can be life-threatening. You should call your doctor immediately if you have symptoms of encephalitis.
What are the symptoms of encephalitis?
The symptoms of encephalitis can range from mild to severe.
Mild symptoms include:
fever
headache
vomiting
stiff neck
lethargy (exhaustion)
Severe symptoms include:
fever of 103°F (39.4°C) or higher
confusion
drowsiness
hallucinations
slower movements
coma
seizures
irritability
sensitivity to light
unconsciousness
Infants and young children show different symptoms. Call a doctor immediately if your child is experiencing any of the following:
vomiting
bulging fontanel (soft spot in the scalp)
constant crying
body stiffness
poor appetite
What causes encephalitis?
Many different viruses can cause encephalitis. It’s helpful to categorize the potential causes into three groups: common viruses, childhood viruses, and arboviruses.
Common viruses
The most common virus that causes encephalitis in developed countries is herpes simplex. The herpes virus typically travels through a nerve to the skin, where it causes a cold sore. In rare cases, however, the virus travels to the brain.
This form of encephalitis usually affects the temporal lobe, the part of the brain that controls memory and speech. It can also affect the frontal lobe, the part that controls emotions and behavior. Encephalitis caused by herpes is dangerous and can lead to severe brain damage and death.
Other common viruses that can cause encephalitis include:
mumps
Epstein-Barr virus
HIV
cytomegalovirus
Childhood viruses
Vaccines can prevent the childhood viruses that used to cause encephalitis. Therefore, these types of encephalitis are rare today. Some childhood viruses that can cause encephalitis include:
chicken pox (very rare)
measles
rubella
Arboviruses
Arboviruses are viruses carried by insects. The type of arbovirus that’s transmitted depends on the insect. Below are different types of arboviruses:
California encephalitis (also called La Crosse encephalitis) is transmitted through mosquito bites and mainly affects children. It causes few to no symptoms.
St. Louis encephalitis occurs in the rural Midwest and southern states. It’s generally a mild virus and causes few symptoms.
West Nile virus is most often found in Africa and the Middle East. However, it can occur in the United States. It’s usually relatively mild, causing flu-like symptoms. However, it can be fatal among older adults and people with weak immune systems.
Colorado encephalitis (also called Colorado tick fever) is transmitted by the female wood tick. It’s typically a mild disease, and most people will recover quickly.
Eastern equine encephalitis is spread by mosquitoes. It affects both humans and horses. Although rare, it has a 33 percent mortality rate.
Kyasanur forest disease is transmitted through tick bites. People can also get it by drinking raw milk from goats, sheep, or cows. Hunters, campers, and farmers are most at risk for getting this disease.
What are the risk factors for encephalitis?
The groups most at risk of encephalitis are:
older adults
children under the age of 1
people with weak immune systems
You may also have a higher risk of getting encephalitis if you live in an area where mosquitos or ticks are common. Mosquitos and ticks can carry viruses that cause encephalitis. You’re more likely to get encephalitis in the summer or fall when these insects are most active.
Although the MMR (measles, mumps, rubella) vaccine has a long history of being safe and effective, in rare cases it has caused encephalitis. Approximately 1 in 3 million children who receive the vaccine develop encephalitis. However, the statistics are much more striking for children who don't receive the vaccine. Rates of encephalitis in the days before routine vaccination reached as high as 1 in 1,000. In other words, encephalitis was roughly 3,000 times more common before vaccination was available.
How is encephalitis diagnosed?
Your doctor will first ask you about your symptoms. They may perform the following tests if encephalitis is suspected.
Spinal tap or lumbar puncture
In this procedure, your doctor will insert a needle into your lower back to collect a sample of spinal fluid. They will test the sample for signs of infection.
Brain imaging with CT scan or MRI
CT scans and MRI detect changes in brain structure. They can rule out other possible explanations for symptoms, such as a tumor or stroke. Certain viruses have a tendency to affect certain areas of the brain. Seeing what parts of your brain are affected can help determine what type of virus you have.
Electroencephalograph (EEG)
An EEG uses electrodes (small metal discs with wires) attached to the scalp to record brain activity. An EEG does not detect the virus that causes encephalitis, but certain patterns on the EEG may alert your neurologist to an infectious source of your symptoms. Encephalitis can lead to seizures and coma in later stages. That's why the EEG is important in determining the areas of the brain that are affected and the types of brain waves that occur in each area.
Blood tests
A blood test can reveal signs of a viral infection. Blood tests are rarely performed alone. They usually help diagnose encephalitis along with other tests.
Brain biopsy
In a brain biopsy, your doctor will remove small samples of brain tissue to test for infection. This procedure is rarely performed because there’s a high risk of complications. It’s usually only done if doctors can’t determine the cause the brain swelling or if treatment isn’t working.