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Urethritis after unprotected oral sex
I received unprotected oral sex from a completely asymptomatic female. 3 days later I noticed a slight irritation of the penile tip with mild redness and swelling. There is an irregular stream, probably due to distal urethral swelling. There is no discharge. There are no blisters. I've taken Cipro 500 mg bid with no relief.
I guess the question is whether an asymptomatic person can be a healthy "carrier" of adenovirus or even HSV. Or rather, can this be associated with anaerobic oral bacterial flora. Assuming the latter, would metronidazol be effective?
Thank you.
I guess the question is whether an asymptomatic person can be a healthy "carrier" of adenovirus or even HSV. Or rather, can this be associated with anaerobic oral bacterial flora. Assuming the latter, would metronidazol be effective?
Thank you.
MEDICAL PROFESSIONAL
Welcome back to the forum.
Certainly it is possible to acquire urethritis by oral sex. But I'm not sure whether you really have it or not. The main symptom usually is discharge, although it is possible to have it only with the apparent inflammation you describe at the tip of the penis and perhaps irregular stream. The short incubation period suggests gonorrhea rather than nongonococcal urethritis (NGU). I'm sorry you took ciprofloxacin before getting properly evaluated; that makes thing more difficult to sort out. A small percentage of NGU cases indeed are due to viruses, especially HSV or adenovirus -- but as you imply, oral-to-genital HSV-1 transmission seems to be rare in the absence of an overt herpes outbreak in the oral partner, and I would think (but don't know for sure) that most adenovirus infections cause overt cold symptoms.
Normal oral bacteria indeed are hypothesized as possible causes of orally acquried NGU, but there are no particular reasons to implicate anaerobic organisms. The standard NGU treatment, i.e. doxycycline or azithromycin, usually are effective, which argues against anaerobes. But I'm skeptical about this explanation anyway, since most non-viral NGU cases have incubation periods of 1-2 weeks, not 3 days.
Going back to your thread last summer, there was evidence you acquired HSV-2 around that time. So a strong consideration here is that genital herpes indeed explains your current symptoms, but not as a new infection -- rather as an episode of recurrent genital herpes. If more than a couple days have passed, it might be too late for a viral culture, but that still might be tried if the irritation and redness are persisting. For sure consider doing that, and not self-treating with cipro or anything else, if and when you have a similar recurrence in the future. Also, to be safe you should tell your oral partner that you might have exposed her to HSV-2; you might well have been incubating an outbreak and shedding virus at the time of the exposure.
Given the possible prostate problem you described in another thread last summer, you also have to consider the possibility that the present event is a recurrence of that problem and only coincidental with the oral sex event.
Your terminology and overall context suggest you have some medical training. Perhaps you have heard the aphorism that the physician who treats himself has a fool for a doctor. I suggest you see an appropriate provider, with experience in STD management, and follow that person's guidance about what tests or treatments might be warranted at this time.
Regards-- HHH, MD
Certainly it is possible to acquire urethritis by oral sex. But I'm not sure whether you really have it or not. The main symptom usually is discharge, although it is possible to have it only with the apparent inflammation you describe at the tip of the penis and perhaps irregular stream. The short incubation period suggests gonorrhea rather than nongonococcal urethritis (NGU). I'm sorry you took ciprofloxacin before getting properly evaluated; that makes thing more difficult to sort out. A small percentage of NGU cases indeed are due to viruses, especially HSV or adenovirus -- but as you imply, oral-to-genital HSV-1 transmission seems to be rare in the absence of an overt herpes outbreak in the oral partner, and I would think (but don't know for sure) that most adenovirus infections cause overt cold symptoms.
Normal oral bacteria indeed are hypothesized as possible causes of orally acquried NGU, but there are no particular reasons to implicate anaerobic organisms. The standard NGU treatment, i.e. doxycycline or azithromycin, usually are effective, which argues against anaerobes. But I'm skeptical about this explanation anyway, since most non-viral NGU cases have incubation periods of 1-2 weeks, not 3 days.
Going back to your thread last summer, there was evidence you acquired HSV-2 around that time. So a strong consideration here is that genital herpes indeed explains your current symptoms, but not as a new infection -- rather as an episode of recurrent genital herpes. If more than a couple days have passed, it might be too late for a viral culture, but that still might be tried if the irritation and redness are persisting. For sure consider doing that, and not self-treating with cipro or anything else, if and when you have a similar recurrence in the future. Also, to be safe you should tell your oral partner that you might have exposed her to HSV-2; you might well have been incubating an outbreak and shedding virus at the time of the exposure.
Given the possible prostate problem you described in another thread last summer, you also have to consider the possibility that the present event is a recurrence of that problem and only coincidental with the oral sex event.
Your terminology and overall context suggest you have some medical training. Perhaps you have heard the aphorism that the physician who treats himself has a fool for a doctor. I suggest you see an appropriate provider, with experience in STD management, and follow that person's guidance about what tests or treatments might be warranted at this time.
Regards-- HHH, MD
MEDICAL PROFESSIONAL
I still think herpes is the best bet.
Otherwise, things still don't hang together. Gardnerella vaginalis is a normal component of the vaginal flora, so presence of that organism is meaningless. Some (outdated) clinicians use the term "gardnerella" as synonymous with bacterial vaginosis, and high numbers of G. vaginalis indirectly indicate BV as a high likelihood. But BV's symptoms are pretty much limited to vaginal odor and modestly increased vaginal discharge; pruritus and urinary frequency suggest something esle. In any case, neither G. vaginalis nor BV have ever been found to be linked with male NGU, despite many studies attempting to do so.
Otherwise, things still don't hang together. Gardnerella vaginalis is a normal component of the vaginal flora, so presence of that organism is meaningless. Some (outdated) clinicians use the term "gardnerella" as synonymous with bacterial vaginosis, and high numbers of G. vaginalis indirectly indicate BV as a high likelihood. But BV's symptoms are pretty much limited to vaginal odor and modestly increased vaginal discharge; pruritus and urinary frequency suggest something esle. In any case, neither G. vaginalis nor BV have ever been found to be linked with male NGU, despite many studies attempting to do so.
As always, your answers are enlightening. Thank you! I thought of the possibility of a herpetic recurrence, coinciding with the exposure to unprotected oral sex. However, this is the second time that this has happened (in a period of approximately 2 months). Although possible, it seems unlikely or improbable. I considered bacterial flora as a causative agent and was curious as to whether you may have had prior experience or knowledge.
Interestingly, following up on one of my previous posts, which I thought may have been prostate-related, my sex partner was found to have Gardnerella and was treated,
with complete resolution of her symptoms (occasional pruritus, post coital urinary frequency, etc.)
I will take your advice!
Thanks again,
Interestingly, following up on one of my previous posts, which I thought may have been prostate-related, my sex partner was found to have Gardnerella and was treated,
with complete resolution of her symptoms (occasional pruritus, post coital urinary frequency, etc.)
I will take your advice!
Thanks again,
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
