STDs Expert Forum
STD Question
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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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STD Question

I recently had oral sex with another man. In this situation he performed oral sex on me, and I on him (though only for a few seconds), and at one point he pressed his penis up against my anus, but did not enter.
A few days later I experienced some discharge from my penis and some pain while urinating, along with a fever and fatigue. However, the discharge has since decreased (it went from milky, to yellow and thick, to milky again) and any discomfort I had with my penis is nearly absent besides a constant warm/"full" feeling. I now have a "full" feeling in my lower abdomen and general discomfort there. I have already gone to the Department of Health in my town and gotten tested, but they did not give me antibiotics for gonorrhea and chlamydia because they did not think I was at high risk and would prefer to wait for the results of the test. They said they thought it could possibly be a UTI instead, but I've heard that those are nearly nonexistent in young men.
So my questions are "how high-risk do you think my situation was?" and "Do you think it probable that I do have gonorrhea? or is it more likely a UTI or some other infection?"
300980_tn?1194933000
Welcome to the Forum.  If you had come to my clinic we would have performed testing for signs of inflammation (increased numbers of white blood cells) at your penis using a swab specimen from your penis or through analysis of a urine specimen collected just as you began to void.  If these tests were not available, with your history I would have most likely have treated you with azithromycin as a single 1.0 gram dose or doxycycline 100mg by mouth twice daily for 7 days.  Both of these regimens are for a problem called non-gonococcal urethritis which is probably the most common STD occurring following receipt of oral sex.  In many cases of NGU following oral sex the tests for gonorrhea and chlamydia are negative.  

UTIs are VERY uncommon in men under the age of 40 and most "UTIs" are actually STDs.  

With a visible discharge after the exposure you report the most likely diagnosis is NGU, then gonorrhea (less common) and still far more unlikely is a UTI or chlamydia infection.

I hope this is helpful.  I think you need to be tested for NGU.  EWH
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I went to the doctor and had the test for gonorrhea and chlamydia, which came back negative. The doctor did give me a shot for gonorrhea and a 1 gram dose of azithromycin (four 250 mg tablets). He also prescribed a 150 mg dose of Fluconazole in case of a potential yeast infection. I took all the medication yesterday.
Would this work to clear up a case of NGU? And how soon should I see results?
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300980_tn?1194933000
Yes, if you had NGU this treatment would be curative.  NGU should improve over several days

EWH
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Avatar_m_tn
Ok, I was just wondering since I have not yet seen much improvement how long it would take.
Thank you.
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H. Hunter Handsfield, M.D.Blank
University of Washington
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Edward W Hook, MDBlank
University of Alabama at Birmingham
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