Amoebiasis of the Penis: A Review and Update

Ulceration of the penis/foreskin which would tend to be painful, Swelling of the penis, Oedema of the penis, Discharge from ulcer or inflamed area of penis that could be purulent or may contain blood, Balanoposthitis, Exudation from a penile ulcer which could be mild, profuse, purulent or bloody, Sloughing off of part of the foreskin and other tissues with resulting hypospadias, indurated swelling of the penis which may initially involve one part of the penis but could quickly spread, A history of homosexual coital activity may be obtained, The spouse of a man who has Amoebiasis of the penis could also have Amoebiasis of vulva, cervix or endometrium, The prepuce may not be retractable, There may be ulceration or swelling of the glans penis that may be irregular. Clinical examination findings in cases of Amoebiasis of the penis could reveal some of the ensuing: The general and systematic examinations may be normal. Examination of the penis may show: Tight non-retractile foreskin, Ulceration of foreskin, Swelling of the foreskin, Swelling of the glans penis, Ulceration and swelling of glans penis., Swelling and inflammation of the shaft of the penis, Ulceration on the shaft of the penis, Development of an iatrogenic hypospadias which was not there before, The inguinal lymph nodes may not be palpable but sometimes they may be enlarged on one side or on both sides, The penile swelling may involve part of the penis but at times on rare occasions the entire penis may be swollen, the penile swelling could on rare occasions extend to the supra-pubic area, On rare occasions the swelling of the penis could extend to include the scrotum but this is extremely rare. Amoebiasis of the penis does mimic various common conditions that affect the penis including: squamous cell carcinoma of the penis, chancroid, primary syphilitic ulcer of the penis, granuloma inguinale, balanoposthitis, and many other lesions affecting the penis. A high-index of suspicion is required to diagnose Amoebiasis of the penis. Clinicians need to be aware that male homosexuals who practice penetrative penis-anal coital activity have a higher risk of developing amoebiasis of the penis especially in Amoebiasis endemic countries. If an individual is suspected to have balanoposthitis or non-specific infection of the penis and is treated with antibiotics but the lesion does not respond to treatment, amoebiasis of the penis should be suspected. Secretions and discharges from the penile ulcer as well as biopsies of the penile lesion should be submitted for pathology examination which would demonstrate trophozoites, entamoebae as well as inflammatory cells. Even if carcinoma of the penis is initially suspected biopsy of the penile lesion would show features of Amoebiasis in the absence of any features of malignancy but in the very rare situation of a combination of Amoebiasis of the penis and carcinoma of the penis microscopic pathology examination of a biopsy specimen of the penile lesion would show features of Amoebiasis and carcinoma of the penis. .Amoebiasis of the penis does quickly and effectively respond to anti-amoebic medicaments.