persistent uritheritis

[bert15]

Hello,
Starting about 5 months ago I tested positive for chlamydia.  I was given the single dose azithromycin.  A week later the symptoms persisted however I tested negative to chlamydia and gonnorhea on swab and urine tests four times.  I was told I had an internal yeast infection and givin diflucan.  Symptoms lessened for a while but after a week returned fully.  Since then I have had extensive treatment including: a months worth of doxycycline, a months worth of cipro, a z pack, a months worth of erythromycin and other relaxants including: cardura and urimax (each taken for a month along with antibiotic regiment).  
After the month of doxycyclin I had protected vaginal sex but unprotected oral sex.  My partner spent some time around the testicles and I didn't think anything of it.  However three days after that I started having rectal inflammation and discharge.  This tells me that there is more than just a urethera inflammation, since something obviously is alive to spread to the rectum.
Anyways right now my symptoms include a very clear, mucus discharge  , painful urination, and a sense of itchy discomfort in the pubic region as well as rectal inflammation and rectal discharge.  I have no sores or bumps or anything indicating a virus and I have tested negative for HIV and hepatitis.  Basically I have been on antibiotics for about 5 months straight with little to show for it.  I don't know what else to do and I am worried about whether this will ever go away or not.  Please help!
Thank you so much

[H. Hunter Handsfield, M.D.]

Persistent urethritis is an inconvenient conundrum for patients and health care providers alike.  But the important thing is that it is not at all serious, i.e. has no known long-term health consequences for either you or your current or future sex partners.  Repeated antibiotics probably won't help.  The best guess is that the initial inflammation caused by chlamydia (or other causes of NGU) starts a vicious cycle of inflammation that is due to an aberrant immune response, not to continuing infection.

As to the rectal problem, I'm not sure it's the same problem.  It sounds like you have proctitis, the medical term for inflammation of the lining of the rectum.  I doubt an infectious agent is causing either that problem or the urethritis, and I doubt something was actually transmitted from your urethra to your rectum.

Herpes is a remote possibility for the proctitis, and even more remotely for the urethritis.  Consider a blood test for HSV-2 infection.  (See many previous messages on this board about the proper kind of herpes blood test.)

If a gastroenterologist isn't involved in your care, that might be a good next step to assess the rectal problem.  I suggest you stop worrying about your mild urethral symptoms, which probably will eventually fade away.  And stop taking antibiotics.  One (remote) possibility is that either or both problems might be related to the effects of long-term antibiotic therapy.

Good luck--  HHH, MD

[Joosh]

My doctor told me i had contracted chlamydia. He gave me 3 days worth of ciprofloxacin at 2 pills a day. it still hurts to urinate it acually worse now then before. before it was just painfull urination and penis dischare. Also if my penic gets bunched up it feels like there is something in there and it kinda hurts. now my testicals are tender mabey bigger(not shure), and little discharge. i was also wondering if it is only sex that transmits it or if there is more then one way. my doctor i should be feeling better within a couple of days but it is not at all better. i have had the pain for 2-2.5 weeks now.
Thanks