Differential Diagnosis for Swollen Glans Penis in an 11-month-old Uncircumcised Baby

Single Most Likely Diagnosis

• Balanitis: This is an inflammation of the glans penis and is common in uncircumcised males due to the warm, moist environment under the foreskin, which can lead to irritation and infection. The age and uncircumcised status of the baby make this a highly plausible diagnosis.

Other Likely Diagnoses

• Phimosis: This condition, where the foreskin cannot be fully retracted over the glans, can lead to swelling and irritation, especially if there is an underlying infection or if the foreskin is forcibly retracted.
• Urine Retention: Inability to fully empty the bladder can cause swelling and discomfort in the genital area, including the glans penis.
• Allergic Reaction or Contact Dermatitis: Exposure to irritants or allergens (e.g., soaps, lotions, or diapers) can cause an allergic reaction leading to swelling and redness of the glans.

Do Not Miss Diagnoses

• Testicular Torsion: Although less common in this age group and not directly related to the glans, any acute scrotal or genital swelling in a child warrants consideration of testicular torsion, a surgical emergency.
• Epispadias or Hypospadias: Congenital conditions that may not have been diagnosed yet and could potentially cause swelling or abnormalities in the appearance of the glans penis.
• Sexually Transmitted Infections (STIs): While unlikely in an 11-month-old, STIs should be considered in the differential diagnosis of genital swelling, especially if there's a suspicion of abuse.

Rare Diagnoses

• Cellulitis or Abscess: Bacterial infections that can cause swelling, redness, and warmth of the skin. These are less common but can occur, especially if there's a break in the skin.
• Genital Trauma: Accidental or non-accidental injury to the genital area could result in swelling of the glans penis.
• Congenital Anomalies: Other rare congenital conditions affecting the genital area could potentially cause swelling or abnormalities of the glans penis.

Each of these diagnoses requires careful consideration of the clinical presentation, history, and potentially, further diagnostic testing to determine the appropriate treatment.