Summer Penile Syndrome from Hypersensitivity to Chigger Bites

Source: chiggers (Trombiculidae)

This tends to occur in late spring or summer in pediatric patients who spend time outside.

Risk factors:

(1) lack of insect repellant

(2) time spent in an area with large number of insects

Clinical features:

(1) rapid onset of penile edema

(2) penile pruritis

(3) small papules or bite marks on skin

(4) presence of chigger bites elsewhere

(5) normal vital signs without signs of serious infection

(6) variable dysuria or altered urine stream

(7) variable penile skin erythema

Exclusions:

(1) poison ivy or poison oak

(2) exposure to other causes of a hypersensitivity reaction