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Mycoplasma??
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The STD Forum is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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Mycoplasma??

About a month ago I had sex with a stripper in her late 30's.  I started with a condom but when I finished, very short experience, I didn't have a condom on.  I am not sure if it slipped off during sex or when I pulled out.  Two days later I had a painful ejaculation and for the next few days I had a burning sensation in my penis, not during urination though.  I was tested for chlamydia, ghonorrea, syphillis (syphilis), and herpes on day 5.  All came back negative but there was bacteria in my urine.  My burning sensation had started to subside but my doctor put my on Cipro for a possible infection.  About 10 days after the sex my testicles started to hurt, a pain that was strong enough to be felt in my lower back/abdomen as well.  My doctor gave me a 1g dose of Azithromyacin and referred me to a urologist for the testicular pain.  By the time I saw him it was almost 3 weeks after the sex exposure and I finsished my 2 week course of Cipro.  He looked at my urine but he said there wasn't any bacteria in it.  He put me on a two week course of Erythromycin (500 mg, 2 daily) for a possible mycoplasma infection.  I have now been on the Erythro for 10 days and have seen no improvement of the testicluar pain but it is my only symptom left.  However, my pain was the worst a few days ago but it improved when I ejaculated (no pain with the ejaculation, first one since the sex).  I am now getting an scrotal ultrasound to look for swelling because my urologist said testing for mycoplasma is very difficult.  I have a few questions.  One, is there a reliable test for mycoplasma genitallium?  Does it sound like something that could be Mycoplasma?  I found one test at LabCorp that tested for mycoplasma hominis, ureaplasma, and mycplasma T-strain, is that the test?  I live in Chicago so I find it hard to believe that I can't find someone to test me for Mycoplasma genitallium.  Also, I know Herpes 2 can take a while to show up, how long should I wait to retest?  
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Welcome to the Forum.  I understand that the timing of your exposure, followed by these difficult to resolve symptoms is worrisome for STD.  Given your lack of response to the therapy you have received to date, your negative specific tests for STDs and your negative tests for WBCs in your uterine, my guess is that what is going on is coincidental to what may have been an unprotected exposure rather than due to it.  

The questions about testing for Mycoplasma genitalium are good ones.  M. genitalium is a hard to test for organism which has only been described in the past 10-15 years and, over that period, it's association with STDs remains debatable.  The Lab Corp test that you mention does not test for M. genitalium.  The only current tests available are research tests and they are not standardized.  Neither I  nor the CDC recommend at the present time for use in patient management.  

I realize that this is a difficult situation for you and understand that you are frustrated with the time it is taking to come to a conclusion and to make progress towards resolution of your symptoms. At this time I suspect that the complexity of your situation is best addressed by continuing to work with your urologist.  Unfortunately, at this time there are still a number of problems in medicine that must be addressed through trial and error.  For that reason, it is important to commit to finding a doctor you feel confident in and working with them to solve this, even if it take several tries.

EWH
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H. Hunter Handsfield, M.D.Blank
University of Washington
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