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Table of Contents   
LETTER TO THE EDITOR  
Year : 2014  |  Volume : 7  |  Issue : 2  |  Page : 148
Not a typical urinary tract infection: A case of urethritis due to an exogenous oil instillation in penile urethra of an infant


1 Department of Pediatrics, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
2 Department of Patholog, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
3 Department of Surgery, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India

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Date of Web Publication8-Dec-2014
 

How to cite this article:
Bhatt GC, Sharma T, Agrawal PK, Dhingra B. Not a typical urinary tract infection: A case of urethritis due to an exogenous oil instillation in penile urethra of an infant. Ann Trop Med Public Health 2014;7:148

How to cite this URL:
Bhatt GC, Sharma T, Agrawal PK, Dhingra B. Not a typical urinary tract infection: A case of urethritis due to an exogenous oil instillation in penile urethra of an infant. Ann Trop Med Public Health [serial online] 2014 [cited 2020 Mar 30];7:148. Available from: http://www.atmph.org/text.asp?2014/7/2/148/146450
Dear Sir,

A few case reports on the self-penile injections of foreign body into the subcutaneous tissue have been reported in adults mainly from the Asian and Eastern European countries to make the sexual organ appear bigger. [1],[2],[3] Self-injection of oil in penile urethral is extremely rare, and only one such case is reported in a 19-year-old adult male. [4] However, there are no reports of the exogenous oil instillation in penile urethra in infants or children. We report the first case of sterile urethritis caused as a result of cultural practicing of blowing oil into urethra of an infant.

An 11-month-old male child was taken to the outpatient department of a tertiary care center of Central India with the complaints of increased frequency and excessive crying during micturition. There was no history of passing of loose stools, fever, and previous history of urinary tract infection or edema. There was no external gross deformity of the penis. Investigations revealed total leucocyte count of 5600/cumm (polymorphs 38%, lymphocytes 54%, monocytes 6%, and eosinophils 2%). Serum urea, creatinine, and electrolytes were within the normal limits. Urinalysis was also within normal limits except for the 40-50 white blood cells/high power field. Ultrasonogarphy of the abdomen was within normal limits. On detailed history taking from the parents it was admitted that mustard oil was instilled in the urethra of the infant. It was further admitted by the mother that this a common practice in their tribe to instill oil in urethra and blow it with mouth to relieve physiological phimosis in children. A diagnosis of sterile urethritis was made, and the parents were counseled to avoid such harmful customs. Patient was given a short course of paracetamol and prednisolone (1 mg/kg/day) for 5 days. A repeat urinalysis was done after a week which revealed no abnormality.

Thus, in the present case, the urethritis was caused by the exogenous instillation of mustard oil and presented as sterile pyuria that is a common sign of intraurethral foreign body induced disorder. [5] Presence of sterile pyuria in our case supports the urethral inflammation. [6],[7] The management is conservative with few reports showing good outcome with prednisolone. [4] There is no role of antibiotics. Wiwanitkit [4] reported a case of sterile urethritis in a 19-year-old male patient caused as a result of self-intraurethral injection of baby oil, presented with sterile pyuria and managed with a short course of steroids and paracetamol. However, in our case, the oil was blown into urethra by the mother leading to urethritis. Therefore, although rare, this entity should be considered in the differential diagnosis in the patients presenting with atypical urinary symptoms, especially in developing countries where such harmful cultural practices are still present due to illiteracy and insufficiency in public health information.

 
   References Top

1.
Wiwanitkit V. Penile injection of foreign bodies in eight Thai patients. Sex Transm Infect 2004;80:546.  Back to cited text no. 1
[PUBMED]    
2.
Pastor Navarro H, Donáte Moreno MJ, Carrión López P, Segura Martín P, Lorenzo Romero J, Pastor Guzmán JM, et al. Penile foreign bodies. Arch Esp Urol 2009;62:501-7.  Back to cited text no. 2
    
3.
Christ JE, Askew JB Jr. Silicone granuloma of the penis. Plast Reconstr Surg 1982;69:337-9.  Back to cited text no. 3
[PUBMED]    
4.
Wiwanitkit V. Self intraurethral injection of baby oil: A case report. Asian Pac J Trop Biomed 2012;1:139-40.  Back to cited text no. 4
    
5.
Calahorra Fernández FJ, Tamayo JC, González Romojaro V, Aguirre F, de la Rosa F, Leiva O. Purulent urethritis secondary to intraurethral foreign body. Actas Urol Esp 1991;15:69-71.  Back to cited text no. 5
    
6.
Ochoa Sangrador C, Conde Redondo F, Grupo Investigador del Proyecto. Utility of distinct urinalysis parameters in the diagnosis of urinary tract infections. An Pediatr (Barc) 2007;67:450-60.  Back to cited text no. 6
    
7.
Dieter RS. Sterile pyuria: A differential diagnosis. Compr Ther 2000;26:150-2.  Back to cited text no. 7
[PUBMED]    

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Correspondence Address:
Girish C Bhatt
Department of Pediatrics, All India Institute of Medical Sciences, Saket Nagar, Bhopal, Madhya Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1755-6783.146450

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