Differential Diagnosis for 8yo Male with Focal Penile Shaft Swelling and Fever
- Single Most Likely Diagnosis
- Balanitis: This is an inflammation of the glans penis and is a common condition in uncircumcised males. The presence of fever and focal penile shaft swelling could be indicative of an infectious cause, with balanitis being a plausible diagnosis given the age and symptoms.
- Other Likely Diagnoses
- Phimosis: This condition, where the foreskin cannot be fully retracted over the glans, can lead to swelling and infection, especially if there is an underlying condition such as balanoposthitis (inflammation of both the glans and the foreskin).
- Urethral stricture or meatal stenosis: These conditions can cause urinary retention or difficulty urinating, potentially leading to infection and swelling.
- Penile trauma: Direct injury to the penis can cause swelling and may become infected, leading to fever.
- Do Not Miss Diagnoses
- Testicular torsion: Although testicular torsion typically presents with acute testicular pain and swelling, it's a surgical emergency that must be considered in any case of genital swelling and pain, even if the primary complaint is penile.
- Fournier's gangrene: A severe and potentially life-threatening condition characterized by necrotizing fasciitis of the genitalia. Early recognition is crucial for effective treatment.
- Epispadias or hypospadias complications: Though these are congenital conditions, complications such as urinary tract infections or obstruction could present with swelling and fever.
- Rare Diagnoses
- Penile cellulitis or abscess: While not uncommon, these conditions can be considered rare in the context of the specific presentation and age group, but they should still be considered, especially if there's a history of trauma or infection.
- Malignancy: Extremely rare in children, but conditions like sarcomas can present with swelling and systemic symptoms such as fever.
- Genital manifestations of systemic diseases: Certain systemic diseases (e.g., Henoch-Schönlein purpura) can have genital manifestations, including swelling and fever, though these would be uncommon presentations.