Treatment of Lymphedema of the Scrotum and Penis Using Scrotal Flaps

PURPOSE: Lymphedema of the scrotum and penis is a functionally and emotionally incapacitating problem for patients. Patients suffer pain from swelling, chronic irritation, repeated infections, drainage, and sexual dysfunction. Although there are various methods for the treatment of scrotal and penial lymphedema, achieving a satisfactory reconstruction in severe cases still remains a challenge due to the lack of locally available tissue. METHODS: A 33-year-old man sustained severe lymphedema of the scrotum and penis. He reported a history of swelling since 25 years, which had been intensified during the past few months. There was no history of irritation, surgery, trauma, infection or travel to endemic countries. The authors reconstructed the scrotum and penis using 4 scrotal flaps made by incising the enlarged scrotum crucially. RESULTS: The postoperative course was uneventful. Histopathologic examination showed nonspecific chronic inflammation. The patient was followed up for 18 months and a good reconstructive result was obtained with no recurrence. CONCLUSION: The authors' method is safe and easy to perform. This method may be a convenient and reliable alternative for the treatment of severe lymphedema of the scrotum and penis.

Streptococcus pneumoniae Isolates with Decreased Susceptibility to Optochin / 대한임상미생물학회지

Streptococcus pneumoniae is the most common cause of community-acquired pneumonia in adults and an important agent in other infections, including meningitis, otitis media, and conjunctivitis, etc. The optochin susceptibility test is the most widely used method to discriminate S. pneumoniae from other streptococci. However, 0.8-1.5% of S. pneumoniae contain optochin resistant population. Recently, we experienced three cases of variants of S. pneumoniae with decreased susceptibility to optochin. Equivocal optochin disk test should be confirmed by bile solubility, agglutination test, or DNA probe test.