Version 1: Erosive balanitis caused by Staphylococcus haemolyticus in a circumcised adult male.

Introduction 

Balanitis is an inflammation of the glans penis. Balanoposthitis involves both the glans penis and prepuce and occurs only in uncircumcised males. Recurrent balanoposthitis represents a strong indication for circumcision. After candida infections, bacteria are the second etiological cause of infectious balanoposthitis, mainly streptococci, groups A and B, and staphylococci, usually S. aureus. Staphylococcus haemolyticus is a part of skin microflora and one of the main species of coagulase-negative staphylococci. S. haemolyticus causes various infections of the male urogenital tract such as urinary tract infections, chronic prostatitis and epididymo-orchitis, but it has not been associated with balanitis. 

Case presentation

 A 45-year-old man underwent circumcision due to several episodes of balanoposthitis with only partial responses to the established treatments. The patient consulted for an episode of painful, erosive, and exudative lesions on the glans penis and over the post-operative scars. He had no urinary discomfort or inguinal lymphadenopathy. Abundant growth of Staphylococcus haemolyticus was obtained in the culture in standard bacterial media of the sample taken from the genital lesion. The fungal culture was negative. Based on the antimicrobial susceptibility test, treatment was started with oral ciprofloxacin and topical mupirocin, and the genital infection was completely cured. 

Conclusion 

We present a non-diabetic, circumcised male patient with severe, erosive, and painful balanitis due to S. haemolyticus.