Systemic paradoxical response to antituberculous drugs: resolution with corticosteroid therapy.

the condition was self-limited. Cultures for streptococci were not performed for the partners, who were not described as having systemic complaints, in this study. Carlino and Calzavara [2] described a case of "chronic urethritis" with recurrent attacks of cellulitis. Chlamydiae were isolated at the onset, and group G streptococci were isolated each time the cellulitis recurred. No cultures were performed for the female partner. We believe that the two cases of penile cellulitis described herein were due to each female partner's vaginal streptococcus. In both cases, the women were asymptomatic. Both men were symptomatic, with penile swelling and erythema and marked tender inguinal adenitis. Both were febrile and responded to treatment with amoxicillin. The patient in case 1 had a recurrence of his infection, and he and his partner were retreated. Both patients claimed to be monogamous. How these men became infected is unclear. The patient in case 1 described engaging in vigorous sexual activity before the two episodes. The patient in case 2 noted a few small cuts on the penile skin before he had intercourse and developed the infection. We believe that this report represents the first description of streptococcal penile cellulitis that occurred following vaginal intercourse. The recurrent nature of the first case underlines the need to counsel such patients when the diagnosis is first made. Perhaps some cases previously described as idiopathic penile edema represent a mild form of streptococcal cellulitis. In situations where penile edema associated with inguinal adenitis and a systemic illness are encountered, cultures of the female partner's vaginal secretions may help elucidate the etiology of the condition, and appropriate therapy may be instituted for both individuals.