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Bacteria, especially Streptococcus spp., by themselves are the second most common cause of infectious balanitis.

Less common are Haemophilus parainfluenzae, Klebsiella spp., Staphylococcus epidermidis, Enterococcus, Proteus spp., Morganella spp., and Gardnerella vaginalis is responsible for symptomatic anaerobic-related balanitis in men; presentation includes a subpreputial “fishy”-smelling discharge similar to the odor from bacterial vaginosis in women. Other causes of balanitis and balanoposthitis include viral STIs, such as high-risk human papillomavirus (HPV) types, and parasitic infections such as Trichomonas vaginalis and protozoa, all more common in uncircumcised men.

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Microbiology of balanitis Various bacterial species and yeasts under the foreskin have the potential to cause penile inflammatory conditions. albicans is the most frequent fungal isolate from the penis.

Fungi are normal flora, but overgrowth can occur in certain conditions, especially in diabetic patients with phimosis.

Ammonia, released from urine by bacterial hydrolysis of urea, can induce inflammation of the glans and foreskin.

Another common irritant responsible for contact dermatitis is frequent washing with soaps containing topical allergens or irritants.

Overgrowth of yeasts as well as other microorganisms that favor development of balanitis can follow antibiotic treatment.

Any factor that increases microorganisms substantially has the potential to contribute to balanitis in boys.Correspondence Address: Brian J Morris School of Medical Sciences and Bosch Institute, Building F13, University of Sydney, New South Wales 2006 Australia Source of Support: None, Conflict of Interest: None Penile inflammatory skin conditions such as balanitis and posthitis are common, especially in uncircumcised males, and feature prominently in medical consultations.We conducted a systematic review of the medical literature on Pub Med, EMBASE, and Cohrane databases using keywords “balanitis,” “posthitis,” “balanoposthitis,” “lichen sclerosus,” “penile inflammation,” and “inflammation penis,” along with “circumcision,” “circumcised,” and “uncircumcised.” Balanitis is the most common inflammatory disease of the penis.Genital yeast infection (termed “candidiasis” or “thrush”) is uncommon in healthy individuals, but in immunocompromised individuals, such as those with HIV infection, in diabetic and cancer patients C.albicans can also cause bloodstream infection with serious consequences.Int J Prev Med [serial online] 2017 [cited 2018 Apr 8];. 2017/8/1/32/205695 They are painful and can be associated with penile bleeding, lichen sclerosus (LS), and complications such as phimosis and paraphimosis.

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