I am an expat living in Thailand. On the night of the 2nd of December 2006, I met up with an ex-girlfriend also a foreigner. We ended up sleeping together without protection, after having showed our respective Hiv tests which were negative. This was just a one night incident. Four days after the incident, I developed urethral itch, irritation after urination and ejaculation and a very slight clear discharge. I went to see a doctor for a gram stain test and a urinalysis. The results were negative for gonnorhea and chlamydia. The Urinalysis was normal...no elevated wbc or blood in urine. But the Urethral swab test came back with gram positive coccobacilli. I was treated with an injection of Ceftriaxone 500mg, one week of Roxithromycin 150mg twice a day. I also took a single dose of Zithro 2 grams and a single dose of Flagyl 2 grams (just in case). After a couple days off the antibiotics, I still felt slight irritation and discomfort, but not as severe and no discharge I waited one week to be off the antibiotics to go back for a follow up exam. The results were positive for gram positive coccobacilli and a slight increase in wbc count 3-5. The doctor this time administered me with Klacid MR 500mg (Clarithromycin) one tablet a day for a week. He also frightened me and said I should go to see a urologist and that it might be NSU. He also stated that the roxithromycin was inappropriate, this was done by his colleague. He was also worried about prostatitis, which I am sure it is not, as I had a bout of it 10 yrs ago. My questions are;
a. What is the proper treatment for gram positive coccobacilli?
b. How can it be NSU if the pathogen was identified?
c. Does gram positive coccobacilli come as a result of a partner with bacterial vaginitis?
d. What should be my next approach for treatment?
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