Acute genital edema in herbecide contact poisoning
The following case has been reported in the Urology Case Reports.

A 41-year-old febrile man presented with a 1-day history of acute genital swelling. He was an agricultural worker and lived in countryside area. His symptoms began 24 hours prior when he noticed that his penis and scrotum began to swell. During the next 24 hours, his private skin developed progressive enlarging.

Scrotal ultrasonography confirmed scrotal subcutaneous edema without hydrocele of tunica vaginalis. The patient was transferred to emergency department, and given intravenous fluids to correct electrolyte imbalance and acidosis and given some supportive therapy including hepatic protectants, antioxidants and diuretics. Empiric broad-spectrum antibiotics was also used to prevent potential infection. What caused these anomalies confused the clinicians.

In the second day subsequent to his hospitalization, the patient reported an episode that he urinated twice and drank 200ml alcohol after sprayed a kind of herbicides without gloves, which contains acetochlor, onto his courtyard. It did not catch his attention as he used this kind of herbicide every year. This detail made the authors realized that the patient was intoxicated by acetochlor via skin absorption.

After 2-weeks supportive treatment, the laboratory tests gradually returned to normal, and the penile and scrotal swelling and pain gradually improved. During one-month follow-up, scrotal swelling disappeared and no obvious abnormalities were found.

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