Mucus Threads In Urine

Hey doc
just got the results of a full STD panel 10.2 weeks after a very low risk experience with a dancer. I know you would have said the testing wasn't even necessary but my anxiety got the best of me as I began experiencing some strange pains a couple of weeks ago. Mostly some minor tightness/tenderness just above and to the left of the shaft of my penis. I've also experienced the same type of feeling under my right armpit for about the same amount of time. Originally, the whole HIV node thing kind if freaked me out and I may have mashed and probed a little more than I should have but I can't imagine I would still be feeling it two weeks later if it was self induced. Anyway here are the results. Cbc was completely normal. Chlam/gonn/HIV/hep all negative. Hsv1 negative hsv2 positive. I already knew this even though I can't ever recall having an outbreak. My question revolves around the urinalysis. Based on the overall results everything was "within range" and normal. Rbc not detected. WBC shown as 0-5 and within range. Epithelial cells 0-10 and within normal range. No bacteria detected. But they did see mucus threads. They didn't list them as abnormal so I'm not sure what to make if them. Are they normal?  Given al of the reults is is it possible I still have some type of infection that's causing the irritation I'm feeling?  I've never experienced any burning or discharge. No real testicular pain to speak of so I'm just a little stumped as to what cod be causing my symptoms. Any ideas??  Anxious to hear what you have to say.
Thanks  

[H. Hunter Handsfield, M.D.]

Welcome to the STD forum.  You also had a question about the HIV risks on the HIV Prevention and Safe Sex forum.  As you were told, this was a low risk exposure that was unlikely to result in either HIV or any other STD.  That remains true.

Threads of mucus are common in the urine -- which is why the urinalysis report did not report them as abnormal.  If there were an infection, the white blood cells would have been elevated.  Nothing is wrong.

My guess is that you read a website or other information somewhere about mucus threads as a sign of urethritis.  Indeed, sometimes persons with urethritis (NGU, gonorrhea, chlamydia) have visible threads that may be more prominent than in the absence of urethritis.  Some STD specialists hold their patients' urine up to the light to look for threads, for an early clue about possible urethritis.  But they never rely on presence of threads for actual diagnosis -- it's only a rough clue.  In the absence of penile discharge and WBC in the urine, and with negative gonorrhea and chlamydia tests, you should just forget the threads.

As for your symptoms, the vague sort of discomfort you describe is quite common in situations when men have anxieties or fears about sexual exposures.  My term for it is "genitally focused anxiety".  If the symptoms persist and you are convinced they are abnormal, continue to work with your primary provider to figure out whether something is wrong.  But I am quite certain you have no STD or anything else that threatens your health or that of your current or future sex partner(s).

Regards--  HHH, MD

[Nervousxxxxx]

Clarification on the hsv2 diagnosis. I did not know I had it prior to this contact but when the very first IGG teat was run six days post contact I was told that this could not have been from the recent contat as I would not have developed igg antibodies six days after contact. A subsequent negative igm test confirmed that I must have had this for some time prior to this contact.  This being the case, I can't imagine my current symptoms would have anything to do with this.

[H. Hunter Handsfield, M.D.]

I agree your positive HSV-2 test has nothing to do with the urine "threads" or the symptoms you describe.

[Nervousxxxxx]

Thanks for taking the time to provide such a thorough and detailed reply. I just have one follw-up question about the WBC count. This most recent urinalysis done through Labcorp shows a value of 0-5. I also had one done back on 8/11(24 days post contact) through Quest that came back as none seen. Not sure if the 0-5 is the standard response for Labcorp when they don't see anything or if they actually did see something. Assuming they did see somewhere between 0 and 5 WBC would this still be considered normal. How high would the value have to be for you to assume that there might actually be an infection of some kind?

[Nervousxxxxx]

Stated differently. If there were an infection of some kind, which I agree with you, there probably isn't what would you expect the WBC count to be at 10 weeks?

[Nervousxxxxx]

And one more question and I'm done for good. I promise. I've tested for hsv three times now with very different results. The first was an igg test with Labcorp six days after contact with a value of 3.2. The next was an igg test with Quest six weeks after contact with a value of 1.12. And finally, another igg with Labcorp that's back up to a 3.02. Do you have any thoughts on what could be driving the extreme difference between the values  getting from the two labs?  Labcorp has consistently had me in the 3 range while Quest has me barely registering as positive. All igg tests. Would the type of test make a difference or is there only one type of test? The 1.12 Quest test says herpeselect. Not sure about the Labcorp test.          

[H. Hunter Handsfield, M.D.]

The number of WBC in urine between 0 and 5 makes no difference of any kind.  Any number of WBCs in that range is normal.

I'm not sure how to interpret the discrepancy in your HSV-2 test results.  LabCorp does the HSV-2 Captia test (manufactured by Trinity Biotech).  The HerpeSelect test, done by Quest, has been more intensively studied than Captia, and that result of 1.12 suggests that most likely you don't have HSV-2.  On the other hand, the strongly positive Captia result suggests you are infected after all.

If you have symptoms that suggest genital herpes (recurrent sores etc), then almost certainly you are infected.  But if not, the best way to sort this out is to ask your health care provider to request an HSV-2 Western blot test from the University of Washington clinical laboratory.  The lab request should report the discrepant outcomes of all your previous tests.  The WB result will tell for sure whether or not you are infected with HSV-2.

This is an interesting and peculiar situation, and I and other forum users will be interested in learning the outcome.  Please return to tell us your WB results.  Until then, however, I won't have any other comments.