Very Worried

[AnxietyAboutSymptoms]

I hope you can help.  I'm a 38 year old male.  In early April I got drunk and had unprotected sex with a stripper.  2 Hours after the encounter I noticed a slight burning in my urethra.  The mild pain was intermittent, but persistent.  2 days later I visited the public health clinic to receive STD testing.  Testing came back normal.  I revisited the clinic the following week because the burning persisted and in addition I started developing a persistent low back pain and intermittent lower abdominal discomfort.  I also consistently get mild burning that persists for severals hours in my anus after defecation.  The NP at the clinic gave me a 1 or 2 gram dose of azithromycin and a 1 time dose of Flagyl, just in case it was too early to detect Chlamydia.  Unfortunately all the symptoms persisted.  I went to my FP and he suspected prostatitis or some other rare protozoa and gave me a 30 course of Cipro and a 10 day course of Metronidazole.  I am 10 days into the treatment and it seems as if the symptoms are getting worse.  Penis burns consistently, backs aches feel like they are encompassing a larger area and now my scrotum feels as if it's burning sometimes as well.  I have had no physical manifestations of any STD.  What would you recommend is my next step?

[Edward W Hook, MD]

It would be most unusal for this to be an STD.  In case herpes is on your mind, initial episodes of herpes typically occur within two weeks of exposure and thus this would be quite late for the apearance of newly acquired herpes.

Obviously however, it the redness persists and worries you, it may be to your benefit to have it looked at by a knowledgable clinician.  I REALLY doubt that this is an STD acquired at the encounter you have described.  EWH

[AnxietyAboutSymptoms]

So, to clarify this redness and irritation manifested almost one month after the sexual exposure.

[AnxietyAboutSymptoms]

Shortly after your response to me, I noticed that the area around the opening of the urethra is beginning to swell and is red and irritated.  The red irritation continues medially and caudally to the bottom of the glans and continues underneath the bottom of the glans.  This has now been present for 5 to 6 days.  Any recommendations?

[AnxietyAboutSymptoms]

Thank you for your time and insight.  You have definitely helped me put my mind at ease.

[Edward W Hook, MD]

Welcome to our Forum.  I'll try to help.  There are two likely explanations for your situation, neither of which is related to an STD acquired in the encounter you describe.   The first (and less likely) possibility is that you have coincidentally developed some illness which is causing these symptoms at about the time you had sex with the partner you describe.   The second possibility is that since the encounter you have been more attuned to sensations and possible symptoms than normal and are noticing symptoms that you might not notice in other situations.  I note that there is no discharge sores or rash reported by either you or the clinicians who saw you and that your lab tests are normal.  In addition, I note that the penile burning began within hours of the encounter and there are NO STDs which cause the onset of symptoms sooner than a few days after sex.  It is not at all unusual for persons to become hypersensitive to sensations they might otherwise overlook following an encounter that, in retrospect, they wish they did not have.  I would urge you to try to put this behind you.  There is nothing here to suggest an STD.

My assessment is that these symptoms are most unlikely to be due to STD.  Perhaps my comments will be helpful to you.  EWH