Confusing symptoms

[littleworried]

Here is quick run down of my history.
Engaged in intercourse with a prostitue 8 weeks ago.  After 1 week had irritation in penis and genereal tingling in anus.  Saw doctor and was tested for gonohrea and chlamiydia.  Got a shot of something and 10 days of doxcyline (100mg 2 times a day).  Symptoms went away after taking doxcyline but both tests returned negative.  After 2 weeks had general dull pain in testicles and a pain (a little like a pulled muscle) in my Thigh and down the back of my right leg.  Symptoms continued with an occational irritation in the urethra and down by the prostate.  Doctor thought I had epiditmutus and gave me a weeks worth of Cipro and scheduled me for an ultra sound.  Also had a urine sample done which turned up clean for bacteria.  Ultra sound was normal.  Also had about 2 weeks of hemeroid type symptoms.  At the six week point I took a Home Access HIV test which came out negative.  I am still having mild irritation in the urethra(especially by the prostate and the tip), a "tightness" felling in the left testicle and just inside the left thigh, also continue to have pains in the right leg at various times and places.  Also have developed a cold sore in the mouth this past week.

Question.
Have not been tested for syphillus but I have had no visible canchre or other symptoms.

Could it be Herpes, the symptoms have generally been continuos since week 1 which seems unusual.  Also, have no visible lesions.

Could it be trichamiaosis

I plan on getting tested for syphillus and Herpes but not sure if they would be effective at this point.

[H. Hunter Handsfield, M.D.]

Your symptoms don't suggest herpes at all.  They really don't suggest any STD, and most possible STDs would have responded to the antibiotics you received.  Don't worry about syphilis; both ceftriaxone (which probably was what the injection was) and doxycycline would have cured incubating syphilis before it got started, so there is no point in being tested for syphilis.  Your HIV test result has already disproved that possibility.  You could get tested for herpes if you like, but even if positive, I will be 100% convinced it has nothing to do with your symptoms.  (A quarter of the US population have positive blood tests for HSV-2.  Think carefully whether you really want to be tested for it.)

For what it's worth, I also doubt you had epididymitis, which does not cause the mild, vague symptoms you describe.  Epididymitis causes excrutiating pain of a single testicle, usually with dramatic tenderness to the lightest touch.  (Epididymitis sometimes is suspect in men as arrive at the door to an STD clinic, because of the way they walk!)

AS to trichomonas, it almost always is asymptomatic in men, and it's hard to diagnose in men.  On the other hand, a trial of treatment is easy, just a single dose of the antibiotic tinidazole (Tindamax).  (Tinidazole is new in the US, but appears to be much more reliable as single dose treatment for men than the older treatment, metronidazole [Flagyl].)  So you could discuss this with your doctor.  But it won't resolve your symptoms.

My main advice is to just sit tight and do nothing.  Your symptoms probably will fade with time.  Whatever is causing them, you can be certain it is nothing that will ever cause you any kind of serious health problem, and nothing you can ever transmit to a future sex partner.  Anxiety alone is a very good bet.

Good luck-- HHH, MD

[littleworried]

Forgot to add.  Started with condum but it broke at some point.

[littleworried]

Is there any other "non" STD that I caught in this instance that is causing the tightness felling in the leg.  I though for a while it could be NGU but I figured the meds would still clear it up and the urine sample had no other bacteria.

[H. Hunter Handsfield, M.D.]

NGU doesn't cause the symptoms you describe.  They probably are not related at all to the sexual encounter you describe, except for the possibility of anxiety about it.

HHH, MD

[littleworried]

Just a few more questions and I'll leave you alone.  I have a new health care provider and he wanted to run the series of bacterial (Gon, Chlam) test and found nothing.  He doesn't think it is trichomonas.  I have not received a herpes test as I was waiting unit about the 12 week mark.  I have had contiuous discomfort in my urethra and the "tightness" felling in my left testicle, thigh almost contious, I have also notices a tingling in my right leg and foot at times.  I also have had reoccuring anal itching, not continous but near continous.  When I wipe there is some evidence of blood but only a few small spots.  Concern is this may be a lesion and I just can't see it.  In you experience do these seem like herpes symptoms.  Also, are herpes tests accurate at less than 12 weeks.