title: The summer penile syndrome: seasonal acute hypersensitivity reaction caused by chigger bites on the penis.
abstract: OBJECTIVE
  To describe the seasonal acute hypersensitivity reaction of the penis due to chigger bites, known as the summer penile syndrome.
  
  
  METHODS
  A consecutive series of patients.
  
  
  METHODS
  The emergency department of an urban academic children's hospital in the midwestern United States.
  
  
  METHODS
  Male pediatric patients with an acute hypersensitivity reaction of the penis.
  
  
  RESULTS
  Ninety-four patients were treated for summer penile syndrome during the four-month period from June through September. Patients ranged in age from seven months to 11 years (mean = 5.1, SD = 2.5). Twenty-one percent of patients had also experienced a similar prior episode of penile swelling. Symptoms included pruritus in 84% of cases, dysuria in 33%, and decreased strength of urine stream in 8% of patients. Eighty-four percent of patients had recent exposure to the woods, park, lawn, or poison ivy. In addition to edema, findings on physical examination included a papule or bite puncture mark in 50% of patients, erythema in 32%, and excoriation in 6% of patients. Fifty-six percent of patients had bites on other areas of the body. The emergency physician attributed the penile edema to an insect or chigger bite in 98% of cases. Treatment consisted of an oral antihistamine and cold compresses in most cases. The reported duration of penile swelling ranged from one to 18 days with a mean of 4.1 days (SD = 3.5), and the reported duration of pruritus ranged from 0 to 14 days with a mean of 3.0 days (SD = 2.6).
  
  
  CONCLUSIONS
  This study provides an understanding of the summer penile syndrome for pediatric care providers. To our knowledge, this study is the first to describe this seasonal syndrome in the medical literature.
authors.affiliation: Division of Emergency Medicine, Children's Hospital, Columbus OH 43205, USA.
authors.forename: G A
authors.initials: GA
authors.lastname: Smith
authors.forename: V
authors.initials: V
authors.lastname: Sharma
authors.forename: J F
authors.initials: JF
authors.lastname: Knapp
authors.forename: B J
authors.initials: BJ
authors.lastname: Shields
mesh_terms: D000208:Acute Disease; D000818:Animals; D002648:Child; D002675:Child, Preschool; D004487:Edema / Q000209:etiology; D006801:Humans; D006967:Hypersensitivity / Q000209:etiology*; D007223:Infant; D007299:Insect Bites and Stings / Q000150:complications* / Q000276:immunology; D008297:Male; D008923:Missouri; D010409:Penile Diseases / Q000209:etiology* / Q000276:immunology / Q000628:therapy; D011537:Pruritus / Q000209:etiology; D012621:Seasons; D013577:Syndrome; D014324:Trombiculidae / Q000276:immunology