title: Unique infective complication after routine vasectomy: a case report.
abstract: BACKGROUND
  We present a case of a 51-year-old gentleman who, after undergoing routine vasectomy, presented with an infected wound 7 days after the procedure--one day after receiving oral sex from his wife.
  
  
  OBJECTIVE
  We hope to present a unique case of an infected wound after oral sex. Group A Streptococcus (GAS) was cultured from the patient's wound and the asymptomatic wife's pharyngeal mucosa.
  
  
  METHODS
  To educate and expose a rare but potentially devastating postvasectomy complication that, without prompt and aggressive treatment, can lead to significant morbidity.
  
  
  METHODS
  The patient was promptly treated and after hydration, broad spectrum antibiotics, and supportive care, patient showed excellent recovery. The wife was also treated with oral antibiotics.
  
  
  RESULTS
  Infective complicated are relatively uncommon after routine vasectomy. When present, the vast majority of the infections are treated with a simple course of oral antibiotics. There is strong evidence that establishes oral contact as a vector for transmission of virulent pathogens. Some have linked orogenital transmission of GAS since the 1970s.
  
  
  CONCLUSIONS
  To our knowledge, this is the first reported case of oropharyngeal transmission of GAS that led to rapidly progressive infection of the scrotum following vasectomy. Care should be taken to minimize exposure during postoperative healing.
authors.affiliation: Department of Urology, New York University, New York, NY 10010, USA. krishna.rama@gmail.com
authors.forename: Krishna
authors.initials: K
authors.lastname: Ramaswamy
authors.forename: Jed
authors.initials: J
authors.lastname: Kaminetsky
mesh_terms: D006801:Humans; D008297:Male; D008875:Middle Aged; D012725:Sexual Behavior; D013290:Streptococcal Infections / Q000188:drug therapy / Q000209:etiology*; D013297:Streptococcus pyogenes; D013530:Surgical Wound Infection / Q000188:drug therapy / Q000209:etiology*; D014659:Vasectomy / Q000009:adverse effects*