Aa
Gonorrhea with no discharge?
Hi again Dr. I've been treated with Zithro and then a week later with doxy, but that didn't seem to affect the symptoms. That and the fact that I’ve had 3 neg Cham IgGs from different labs has led me to conclude that it’s not Chlamydia. My doc has diagnosed me with prostate infection and is adamant that it is not from an STD (due to lack of discharge). At present (after 20 days on doxy), the frequency/urgency have gone down but I still urinate about every hour and get burning pain in my right groin if I sit in an awkward position or don’t urinate for a while. There’s also lower-left back pain. Until recently I wasn’t concerned with gonorrhea due to lack of discharge and the fact that my frequency only appeared 10 wks after the act. But I’ve read here that gonorrhea can infect the prostate and that it is common for gonorrhea to be asymptomatic or for symptoms to appear late. There is no DNA test available here and doctors will not do a swab in the absence of discharge, so the best I could do was a urine culture, which showed no growth and no WBC, RBC, puss, nitrites, protein, etc. I did have some very fleeting (i.e. a few seconds, or minutes) of shooting pains in my legs, toes, forearms and fingers a couple of weeks ago but these have disappeared (there was also pain in my ankle once for a few hours). On this basis, do you think it is safe to rule out gonorrhea? If not, what can I do to rule it out short of a PCR or swab? Would a blood test work? Do the pains I described sound like “transient arthritis”? Thanks again.
MEDICAL PROFESSIONAL
Based on your symptoms, I would be skeptical about the diagnosis of reactive arthritis. But if two rheumatologists concur in it, I will go along.
It is likely that any inflammation of certain mucous membranes, especially of the genital or gastrointestinal tract, can trigger ReA; i.e. it doesn't necessarily have to be an infection. Accordingly, I suspect your antibiotic related diarrhea is responsible. But that's little more than an educated guess.
That will end this thread. I won't have any other comments. Good luck.
It is likely that any inflammation of certain mucous membranes, especially of the genital or gastrointestinal tract, can trigger ReA; i.e. it doesn't necessarily have to be an infection. Accordingly, I suspect your antibiotic related diarrhea is responsible. But that's little more than an educated guess.
That will end this thread. I won't have any other comments. Good luck.
Hi Doctor. I thought I'd provide an update for the sake of completeness and the education of future visitors. I used a recent trip abroad as an opportunity to get some proper testing done, including a NAAT on urine for chlam/gc (both negative) and an EPS culture (also negative). Was told that prostate was inflamed but not infected. The only prostate-related symptoms I have are frequent urination/weak stream and a noticeable change in the volume and consistency of the semen (i.e. very little pelvic pain if any). However, the aches and pains in my joints have not gone away. Several times a day I have pain in my fingers, toes, soles, elbows, wrists, forearms and around the knees and occasionally lower back. Sometimes the pain is in the joints or bones and other times it feels more like the tendons or muscles. It migrates from one place to another lasting only a few minutes each time. This started around 7 or 8 weeks ago. For the past three weeks, I've also had longer, more concentrated pain in my right ankle and occasionally my left and in the achilles, which only subsides with NSAIDs, otherwise it impairs my walking and driving (the tendon on the front of the foot especially). Two rheumatologists have diagnosed me with reactive arthritis and put me on NSAIDs for the foreseeable future. So, there must have been some infection in the past few months. The question is what that infection may have been. I do understand that the timing of the symptoms (10-12 weeks from exposure) make an STD an unlikely cause. The only other possibility is the endoscopy followed by 14 days of amoxicillin/clarthromycin which may have caused some kind of GI infection that precipitated all of my symptoms (including the urinary/prostate symptoms). I know I've tested your patience on this thread and completely understand if you decline to answer, but given your expertise in ReA I would greatly appreciate your view on the relative likelihood of these two possibilities. Thanks.
Thank you, Doctor.
MEDICAL PROFESSIONAL
I don't know anxiety explains your symptoms. With the additional information that your doctor has diagnosed infectious prostatitis, perhaps that's the only issue. All I can say for sure is that it's neither gonorrhea nor any other STD is the cause.
It is certainly a "realistic possibility" that you could acquire an E. coli prostate infection. It's rare at your age, but rare things sometimes happen. Still the lack of response to antibiotics suggests E. coli might not be the main cause of your symptoms. The reasons prostatitis is more common in older men are pretty complex, and beyond the scope of this forum, which is limited to STDs. All these are issues for you to discuss with your doctor.
That will end this thread. You can dismiss STDs entirely, and you should disregard any past sexual exposures. You have no infection from such an event.
It is certainly a "realistic possibility" that you could acquire an E. coli prostate infection. It's rare at your age, but rare things sometimes happen. Still the lack of response to antibiotics suggests E. coli might not be the main cause of your symptoms. The reasons prostatitis is more common in older men are pretty complex, and beyond the scope of this forum, which is limited to STDs. All these are issues for you to discuss with your doctor.
That will end this thread. You can dismiss STDs entirely, and you should disregard any past sexual exposures. You have no infection from such an event.
Thanks, Dr. I respect your opinion even though I find it odd that anxiety-generated symptoms would take 10 weeks to show up and do so so abruptly. I know you don't want a long discussion or a re-tread over ground we've already covered, but if you can answer the following question that would be greatly appreciated:
My doctor's diagnosis is not CPPS (though he did mention it) but bacterial prostate infection due to e choli, strep or some other bacteria. Is it a realistic possibility for a 31 year old to get that kind of infection? How does it come about and why does its occurrence vary by age?
My doctor's diagnosis is not CPPS (though he did mention it) but bacterial prostate infection due to e choli, strep or some other bacteria. Is it a realistic possibility for a 31 year old to get that kind of infection? How does it come about and why does its occurrence vary by age?
MEDICAL PROFESSIONAL
I meant to also say that failure of your symptoms to improve with antibiotics is evidence NOT of an infection that is resistant, but rather evidence that no infection of any kind is going on. Most prostate problems are non-infectious (antibiotics are often tried but usually don't work). This is additional evidence that the real problem is genitally focused anxiety or CPPS (which itself often is just the result of anxiety, as you will see in reading about it).
And by the way, CPPS or genitally focused anxiety are often triggered by sexual exposures that cause regret, guilt, or shame. Your username suggests this is likely in your case.
Let's not get into a prolonged discussion as in your previous thread. There is no information you can provide that would be likely to change my opinion or advice, so I won't have any further comments. If your symptoms or other concerns continue, keep working with your primary care doctor about it.
And by the way, CPPS or genitally focused anxiety are often triggered by sexual exposures that cause regret, guilt, or shame. Your username suggests this is likely in your case.
Let's not get into a prolonged discussion as in your previous thread. There is no information you can provide that would be likely to change my opinion or advice, so I won't have any further comments. If your symptoms or other concerns continue, keep working with your primary care doctor about it.
MEDICAL PROFESSIONAL
I'm sorry to learn your symptoms and anxieties are continuing following our previous discussion on this forum.
I agree with your doctor. Your symptoms are not possibly due to gonorrhea or any other STD. Gonorrhea doesn't cause the sorts of symptoms you describe, but they are typical for a prostate problem or the related condition called the chronic pelvic pain syndrome. (Look it up on Google and start your reading with the excellent Wikipedia article.) And if you had had gonorrhea, the treatments you have had would have cleared it up.
You need to stop any further STD testing. If you have a regular partner, you should continue or resume unprotected sex. You have nothing that will ever cause serious harm either to you or to her; in fact, regular sexual release sometimes is helpful in symptoms like yours, whether due to a prostate problem or CPPS.
Best wishes-- HHH, MD
I agree with your doctor. Your symptoms are not possibly due to gonorrhea or any other STD. Gonorrhea doesn't cause the sorts of symptoms you describe, but they are typical for a prostate problem or the related condition called the chronic pelvic pain syndrome. (Look it up on Google and start your reading with the excellent Wikipedia article.) And if you had had gonorrhea, the treatments you have had would have cleared it up.
You need to stop any further STD testing. If you have a regular partner, you should continue or resume unprotected sex. You have nothing that will ever cause serious harm either to you or to her; in fact, regular sexual release sometimes is helpful in symptoms like yours, whether due to a prostate problem or CPPS.
Best wishes-- HHH, MD
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
