Differential Diagnosis for Penile Pain
The patient presents with penile pain, erythema, and edema of the foreskin, which suggests an inflammatory or infectious process. Considering the patient's symptoms and history, the following differential diagnoses are possible:
- Single Most Likely Diagnosis
- Phimosis with superimposed balanoposthitis: The patient's uncircumcised status, erythema, and edema of the foreskin, along with the darker color of the tip of the penis, suggest an inflammatory condition. Phimosis, a condition where the foreskin cannot be fully retracted over the glans penis, can lead to balanoposthitis, an inflammation of the glans and foreskin. The patient's history of crypto organism infection may also contribute to the development of this condition.
- Other Likely Diagnoses
- Cellulitis: The patient's symptoms of erythema, edema, and pain in the penis could be indicative of cellulitis, a bacterial skin infection. The patient's high BMI and smoking history may increase his risk for infections.
- Thrombosed dorsal vein: The patient's pain and darker color of the tip of the penis could be related to a thrombosed dorsal vein, which is a blood clot in the vein that runs along the top of the penis.
- Do Not Miss Diagnoses
- Penile cancer: Although rare, penile cancer can present with pain, erythema, and edema. The patient's history of smoking and high BMI may increase his risk for this condition.
- Necrotizing fasciitis: This is a rare but life-threatening condition that can present with severe pain, erythema, and edema. The patient's symptoms and history of crypto organism infection make this a possibility that should not be missed.
- Rare Diagnoses
- Peyronie's disease: This condition is characterized by a curved penis and pain during erection. Although the patient's symptoms do not fully align with this condition, it is a possible rare diagnosis to consider.
- Sickle cell disease: This genetic disorder can cause episodes of pain, including penile pain, due to sickling of red blood cells. Although the patient's history does not suggest this condition, it is a rare possibility to consider.