had two negative tests and still have symptoms

[james dean 1996]

I had sex 2x with an escort.  we used condoms that seemed to work.  I had taken some viagra.  She also gave me oral sex without a condom.  within 30 hours I was having some burning and stinging in my penis and on one occassion only I had a small amount of milky fluid in the tip of my penis.  It did not hurt to urinate.  I went to urgent care 3 days after the sex.  they gave me a shot of rocephin and put me on doxicycline.  I was culture tested for G&C which came back negative.   I went to an urgent care in my town one week later b/c I was still having symptoms including some swollen and sore testes. I also had some real mild flu symptoms.  They switched me to sulpha and did a urine test which was negative for any bacteria.  I started getting better but then the symptoms came back.  I went to my urologist who tested me again for G&C and ureaplasma with an invasive swab way inside my penis.  All were negative.   He left me on the sulpha but switched me back to 10 more days of doxicycline when the sulpha did not work.  I did miss one set of pills.  The symptoms went away again but now are back.   They are more mild but my penis still stings regularly.  My doc thinks its prostatitis but I am still afraid.  I had prostatitis before but it seemed different.  I also got blood tested for HIV and Syphillis and urine tested again for any bacteria.  All negative.  
My question is whether I could have had clamidia and it could still be around despite the negative tests.  Is there something else I should get checked for.  How can you really tell prostatitis from an STD?   I have a regular partner and am scared to death she will get this.  Is prostatitis contaigious?  I will be leaving on vacation and probably cannot see my doc b/4 I go.  Please advise.   Two negative tests make an STD seem unlikely but what are the what if's?

[Edward W Hook, MD]

Your risk for STD from the exposure you describe was very, very low to start with and now, with the testing and treatment you have had, you can be sure that your continuing problems are not due to an STD.  Your genital sex was condom protected, pretty much guaranteeing that you did not get an STD from this exposure.  Receipt of oral sex can lead to STD transmission, primarily non-gonococcal urethritis (NGU) and gonorrhea but the treatment you have had, ceftriaxone (the injection) and doxycycline is highly effective therapy for NGU and gonorrhea (chlamydia too for that matter).

If you had unprotected genital sex, I would worry that you might have trichomonas but this is not transmitted by oral sex.  (the treatment of trich is metronidazole, 2.0 grams as a single dose.

At this juncture, prostatitis is a possibility.  Prostatitis is not an STD and having it does not place your partner at risk.  Diagnosis often involves a rectal examination to feel the prostate.  It is treated with different medications (fluroquinolone antibiotics, like levofloxacin) which must be taken for longer periods of time (3-4 weeks).

Bottom line, believe the tests.  You do not have chlamydia.  Work with your doctor to address non-STD causes of your symptoms.  Good luck.  EWH

[james dean 1996]

Thank you-  I believe I had a urine test for trich which was negative.  is is possible to have a false negative for that?   what are the symptoms of trich?   can it come and go?

[Edward W Hook, MD]

Trich can cause urethral (penile symptoms) although most men do not have them.  As I said before, trich is not transmitted by oral sex.   In addition, you have now been tested and the tests were negative. This is not trich.  EWH