Question about STD Symptoms

[Ciemny]

Hello,

29  year old male, uncircumcised.
On Aug 12 Received oral, no condom from SW 5 minutes, e/j outside mouth.
Aug 18 Saw discharge – greenish/yellowish at head of penis (not much), burning inside 1cm of urethra, itching at tip of penis. Only after urination.
Aug 19 STD clinic did urethral swab, took urine sample. Told its NGU gave me Zithromax 1G. Urine tests not back for 3 weeks. Told not Gonorrhea.
Aug 22 Burning in urethra, NOT when I urinate but after, like urnine irritating and wants to drip out 1cm inside, itchy tip too on and off, something is still in my bladder but nothing, little comes out, bladder feels tight, crampy. Had hot flashes, panic attacks at night, cold sweats. Used a urethral swap q-tip with warm H2O to itch urethra inside….felt sooo much better for rest of day.
Aug 23 – Went to general clinic, Doc stated that it does not sound like herpes (I think otherwise). Gave me another 1G Zithromax, 400mg Suprax.

Aug 25 – . Had feeling of very hot scrotum, not burning but HOT, around anus too for 3-4 hours. 2 hours after masturbation. Have very loose bowel movement everyday.
I think its HSV-1 I know it can be urethral in nature and asymptomatic otherwise. The urethral burning is sometimes non existent in the morning and starts later in the day, some days only for couple of hours after 2 weeks post exposure. Had Polysporin in my urethra with q-tip a couple of times for the night, before the tip of penis felt hot or burning sensation.

After Zithromax, 2 days later had insomnia, anxiety attacks at night, loss of appetite, chills, cold sweats, feverish, burning lips, sore throat (4 days) and light cough. Second pill dose didn’t have as bad effects.

Aug – 27th On/off and on burning on and off tip of penis/urethra, no visible signs of rash or bumps yet, no drippage yet. How long it takes for the symptoms of an infection (if it is bacterial) to wear off? I ve heard 2 weeks from the presentation of symptoms is that correct? Or is this viral? Yeast?

[H. Hunter Handsfield, M.D.]

Welcome to the STD forum.

NGU is the most common STD acquired through oral sex and that is undoubtedly what you had.  You were treated appropriately, but symptoms often persist for a couple of weeks.  Give it more time and probably they will go away.  NGU from oral sex is never serious, with no known long term complications.  Some cases are caused by garden variety respiratory viruses, especially one called adenovirus -- which is not affected by antibiotic treatment but goes away on its own over a couple of week.

Herpes?  Theoretically possible, but your statement "I think otherwise" is not likely.  If your urethritis were due to herpes, you likely would have had much more pain than you describe; there would have been herptic blisters/sores on the penis; and the symptoms would have cleared up by now.  Herpes doesn't cause persistent mild symptoms like you describe.

"I think its HSV-1 I know it can be urethral in nature and asymptomatic otherwise."  You have learned some inaccurate information in your online searching.  Herpes doesn't behave this way.

"...had insomnia, anxiety attacks at night, loss of appetite, chills, cold sweats, feverish, burning lips, sore throat (4 days) and light cough."  Also not possibly due to any STD.  Sounds most like the physical manifesations of anxiety.

"On/off and on burning on and off tip of penis/urethra, no visible signs of rash or bumps yet, no drippage."  Ditto.

"2 weeks from the presentation of symptoms is that correct?"  That's about righty.  "Or is this viral?"  Possibly; see above.  "Yeast?"  No.  Yeast infections are rare in the male genital tract and this is quite unlikely.

If your symptoms continue, return to your health care provider of choice for further assessment.  But don't lose a lot of sleep over this.  You have been adequately treated from any possible STD that could have caused significant harm; and most of your symptoms do not suggest you still have any STD.

Good luck--  HHH, MD

[Ciemny]

Thank you doctor for your anwser, I really apreciate it. The internet can be a scary place when trying to look up symptoms. After an infection has manifested itself how long does it usually take for the urethra to heal after medication? Or would the accidity in the urine aggrivate the sore urethra? I was informed by the nurse at my STD clinic that the symptoms should be gone in a week, not to have sex for 7 days, seems a tad short to me since you stated that symptoms can take a couple of weeks to resolve. I still get periodic burning at the tip of the penis after urination, slight full bladder feeling when i know there is not much there, woke up at 7am, didn't feel anything until 4pm this was after coffee and food, just feels irritated.

Could my infection have been caused by the Adenovirus..even with the drippage? I had a really bad cough, chest pain, very sore throat, congestion couple of days after the symptom apperance.  Looking and examining my penis 20 times a day proably does not hep matters either.

Also would q-tip insertion into the urethra to relieve the burning with Polisporin agrivate the situation for a longer period of time? The day I did it it really helped.

Thank you.

[Ciemny]

Sorry to ask so many questions, but I was told my urethral swab had a high white blood cell count..what STD's does that refer to? Also what does the clinic look for in the first stream urine sample?

[H. Hunter Handsfield, M.D.]

It is true symptoms usually clear up in a week, but as I already said, 2 weeks or even more isn't rare --- especially if you in fact had a viral infection like adenovirus.  Urine concentration, acidity, and irritants from food could cause urinary discomfort to vary from time to time.  And for goodness sake, stop putting polysporin in your urethra, with or without a swab!  Absolutely yes that could cause ongoing irritation.

Any and all causes of urethrits have increased WBCs in the urethra.  That's part of the definition of urethritis and there is no difference from one cause to another.  The first stream urine is typically used to test for gonorrhea and chlamydia, and sometimes to look for WBC.

If your symptoms continue another week return to your provider.  In the meantime, just leave it alone, stop examining yourself, and stop searching the web for bad news.  As I said to start, you have nothing that will ever harm you or a sex partner.

That's all for this thread.  Take care.

[Ciemny]

Dr.

Out of curiosity. I still feel a slight, and I mean slight burning or irritation in one section of my urethra. I went a day or 2 without any symptoms..even after urination, and only after voiding at night and masturbation does the same spot in my urethra feel irritated (as if something is there, urine agrivates it ). Wondering IF semen and/or masturbation can cause the irritation. OR is my urethra healing from an infection and gets irritated at certain times. It has been 12 to 13 days since onset of symptoms of supposed NGU. May take a while to heal?? OR could be something super resistant or viral?

Thank You.

[H. Hunter Handsfield, M.D.]

"That's all for this thread" means what it says.  Please direct any additional questions about this episode to the provider you are seeing about it.