The patient's penis and testicles are swollen. In some places the skin flakes off. The 41-year-old reports that the symptoms started the day before. His genitals are always swollen. The doctors measure 38.6 degrees Celsius body temperature, so the man is feverish.
There are no other problems for the patient working in agriculture. On demand, he denies suffering from cough, nausea, abdominal pain, diarrhea or difficulty breathing. His heart beats normally, his blood pressure is not elevated, his breathing is regular.
The doctors in the first hospital of Jilin University in Changchun inquire about past illnesses. The only conspicuous thing the man mentions is that he has been drinking alcohol regularly for ten years.
Does the 41-year-old perhaps suffer from a so-called hydrocele, in which fluid collects in the testes? By an ultrasound, the doctors follow this suspicion, but he does not confirm. The fluid accumulations are located in the lower part of the skin, not in deeper tissue layers like a hydrocele.
Conspicuous blood values
Among other things, a blood test shows elevated levels of a liver enzyme, and some important electrolytes such as calcium are not in the normal range. In his blood swim too few clotting platelets important. The number of red blood cells is also slightly reduced. In addition, the blood is acidified.
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An enigmatic patientDark itching
The doctors administer to the man intravenously different substances to normalize the values. In addition, he receives active ingredients that support his liver. Because they worry that the man might get an infection, they give him precautionary antibiotics.
But what is behind the complaints? In the case report in the journal "Urology Case Reports" the physicians around Kaimin Guo frankly admit: They have no idea.
What the patient did not mention at first
The puzzle solution brings no further ultrasound, no CT, no lab test. But a conversation with the patient. The patient says that he sprayed the so-called herbicide acetochlor without wearing gloves. After this mission he drank alcohol and urinated twice. He had not mentioned this on the first day, because he uses the weed killer every year and therefore does not attach importance to the event.
But the doctors recognize the cause of his problems: He has obviously taken the remedy through the skin. When urinating, he reached his penis from his unprotected hands, penetrated the skin and through small vessels into the bloodstream, where it then damaged red blood cells and platelets and impaired liver function.
In the next two weeks, the man continues to be cared for, he gradually recovers, the swelling slowly fades and his blood levels return to normal. After one month, doctors do not notice any abnormalities at a follow-up appointment.