Chinese Journal of Dermatology ›› 2022, Vol. 55 ›› Issue (6): 528-531.doi: 10.35541/cjd.20210278

• Research Reports • Previous Articles     Next Articles

Gonococcal infections of the penile skin and accessory glands in men: high?frequency ultrasound features and their clinical significance

Fan Wenge1, Zhang Qingsong2, Ye Xun3, Wei Mei1, Fan Zhijiang4, Zhang Jing1, Wang Ling1, Xue Qiao1, Tao Xiaoyu1, Ding Hao1, Zhao Jun1   

  1. 1Department of Dermatology, Changshu No.1 People′s Hospital, Changshu Hospital Affiliated to Soochow University, Changshu 215500, Jiangsu, China; 2Department of Dermatology, Changshu Hospital of Traditional Chinese Medicine, Changshu 215500, Jiangsu, China; 3Department of Radiology, Changshu No.1 People′s Hospital, Changshu Hospital Affiliated to Soochow University, Changshu 215500, Jiangsu, China; 4Department of Urological Surgery, Changshu No.1 People′s Hospital, Changshu Hospital Affiliated to Soochow University, Changshu 215500, Jiangsu, China
  • Received:2021-04-06 Revised:2021-08-06 Online:2022-06-15 Published:2022-06-02
  • Contact: Fan Wenge E-mail:fwgqh@sina.com

Abstract: 【Abstract】 Objective To investigate ultrasonographic manifestations of gonococcal infections of the penile skin and accessory glands in men, and to assess their clinical significance. Methods From January 2014 to January 2021, male patients with gonococcal infections of the penile skin and accessory glands were collected from Department of Dermatology, Changshu No.1 People′s Hospital. The diagnosis had been confirmed by laboratory examinations, and these patients had not received relevant treatment. The real-time ultrasound imaging system SIEMENS ACUSON X300 was used to examine the penile skin and accessory gland lesions infected with Neisseria gonorrhoeae, with the probe frequency ranging from 7.5 to 15 MHz. Patients with tubular anechoic fluid-filled areas on the high-frequency ultrasound images received a single dose of intramuscular ceftriaxone (1 g); those with oval-shaped anechoic fluid-filled areas on the high-frequency ultrasound images received incision and drainage followed by intramuscular injection of ceftriaxone at a dose of 1 g once a day for 5 consecutive days; those with hypoechoic or mixed echoic areas on the high-frequency ultrasound images received intramuscular injection of ceftriaxone at a dose of 1 g once a day for 5 consecutive days, and if the nodules did not regress after 1-month treatment, local resection would be performed. After 1-month treatment, the patients were followed up, and the efficacy was evaluated. Results A total of 32 male patients with gonococcal infections of the penile skin and accessory glands were collected. They were aged 28.54 ± 3.27 years, all had a history of non-marital sexual contact, and the duration from non-marital sexual contact to the onset of symptoms was 4.45 ± 1.03 days. The disease course was 8.64 ± 1.87 days. Lesions were all solitary, and located at the external urethral meatus in 16 cases (50.00%), at the glans of penis in 7 cases (21.88%), beside the foreskin frenulum in 5 cases (15.62%), as well as at the penile raphe in 4 cases (12.50%). Sixteen patients (50.00%) presented with sinus-like lesions, 9 (28.13%) with abscesses, 7 (21.87%) with nodules, and all had tenderness on palpation. High-frequency ultrasound examination showed tubular anechoic fluid-filled areas in 16 cases (50.00%), oval-shaped anechoic fluid-filled areas in 7 cases (21.88%), hypoechoic areas in 5 cases (15.62%), and mixed echoic areas in 4 cases (12.50%). Gonococcal infections involved the cavernous body of urethra in 16 cases (50.00%), cavernous body of penis in 5 cases (15.62%), and subcutaneous penis in 11 cases (34.38%). After treatment, all patients were cured. Conclusion High-frequency ultrasound can be used in the assessment of skin lesions and selection of treatment regimens for male patients with gonococcal infections of the penile skin and accessory glands.

Key words: Gonorrhea, Neisseria gonorrhoeae, Accessory gland, High-frequency ultrasound