Re-Occurring Penis AND Scrotal Swelling, with feaver

[swellingproblem]

About every two months for the past 3 years my penis and scrotum swell to almost double in size.  Penis hurts while swollen, scrotum is very tender/large.  I also get fever, shivering and it is so bad I have to lay in bed for the first day when it “hits.”  Penis turn very red, but no lesion or skin breaks.  Second day I can get out of bed, feel normal, but swelling is very bad.  3rd day swelling subsides, and 4th day is starts to go down.  Then both penis and scrotum itch a little, and top layer of skin sheds/peels (due to the excessive stretching?).  been to doctor, urologist several times.  Not STD, not angio edema.  I caught herpes 25 years ago, but have not had that out break for 15 years.  (doc said this couldn’t be related, as I get NO herpes pimples)  The worst swelling “episode” also turned my butt bright red, seemed to connect via the medial line from my puffed up scrotum, and my head hurt so bad I was crying,.  It feels like the worst flu you have ever had at onset.  The “seam” up my scrotum always swells, feel tender.  It always hits VERY fast, sometimes feeling like pliers pulling on the bottom of my scrotum, then bad fever and chills with-in 1 hour, very frustrating.  I have to get to bed immediately!  after a week, back to normal.  Doc did CAT scan too – nothing wrong.  You can’t imagine how frustrating this is.

[Alan Rockoff, MD]

Your case is obviously very unusual, so you will forgive me for not being able to give you a straightforward answer.  The only thing which comes to mind is that you may be getting recurrent herpes that is subclinical (meaning that there are no external signs.)  It might be worthwhile taking an anti-herpes antibiotic (Valtrex, Famvir) on a daily basis to suppress recurrence.  This is quite safe--we use this method all the time for people who get frequent recurrences of herpes.  If you then go several months without another episode like the ones you describe, that may be an answer.

Beyond that, I suggest that you get another opinion, perhaps from someone at an academic medical center who can consult with many colleagues.  Sometimes it helps to have a  fresh pair of eyes (or several) when a case is as perplexing and uncomfortable as yours.

Good luck.

Dr. Rockoff

[lizziecee]

Hi - I don't know if this will help, but I had a similar attack but on my face, it is called erysipelas, an infectious skin disease caused by stapp infection. I first had it 8 yrs ago when it was wrongly diagnosed (by a photo, after the attack had finished) by my previous gastro as Sweet's Disease. Sweet's is assoicated with Crohn's Disease which I have had for 34 yrs.
This recent attack (none inbetween) was 2 months ago and I was taken to hospital by ambulance as I was so ill. My gastro came to see me in hospital, took one look at my face, which was grossly swollen and red and immediately said "You've got erysipelas!" Duh? He had previously worked in a leper colony and with Aids patients and knew a lot about infectious skin problems.
The only treatment is antibiotics. I had erythromycin and the redness and swelling subsided in about a week and I am just left with what looks like sunburn. The attack starts like yours - as if it is the worst flu imaginable - every bone in my body hurt and I had a fever. Although my episodes have always affected my face, I believe it can occur on other parts of the body. There is quite a bit about it on the internet, just google erysipelas.
I hope you get a diagnosis soon, so that you can have appropriate treatment. If it is erysipelas, it can be life threatening if the infection gets to major organs.
Liz.

[Alan Rockoff, MD]

Erysipelas is a strep infection that involves the face--different location and circumstance from this one.

Dr. Rockoff