treatments not working

[neworder]

I had sex with a sex worker in Rio 6 weeks ago. I was using a condom but it split, once I realised, (a couple of seconds) I withdrew.

I definately contracted some kind of sexual disease that I thought was chlamydia a few days later with what felt like by balls were burning and I so was my penis. I think there was a slight clear discharge aswell.
Initially I didn't go to the doctors and prescribed myself Doxycyline for 10 days. On the treatment my penis skin started to go red then flake off which cleared up. The other effects reduced but didn't go away. I also notice that my ball or scrotum have protruding red veins that I have never seen before. No itchness at all. I waited a few days then I went back on the doxycyline for a day or two. I was obviously getting worried then and so I went to the docs who prescribed Ciprofloxacin for 5 days together with oceral for my balls (stings like hell stuff). I did not get tested for anything. After this treatment there was no real difference like I felt with the doxycyline.

Then last Thursday (5 weeks after risk) I started to feel a little unwell with a sore throat and fatigue and I think my lymph glands have swollen in my neck. I also have very furry tongue especially at the back of the throat. obviously panic has been the result. And when you panic you turn to the internet to get more info to fuel the panic. I am going back to the doctor but the english is a problem so I thought I would ask you first. I will ask for a hiv test as that is top of my list but you gave me hope by saying that ARS happens within 20 days and in my case it was 35 days which is a little longer. Also I thought that with so little contact I would not be high risk for HIV but I did catch an std so that probably means I could be HIV. Did the drugs supress the effects?

The red veins in the balls also causing me concern to a lesser degree and I cannot find any symptoms for any diseases on your site or any other. As I said they don't itch they are just veiny red as if they are infected not a skin rash.

I hope you can help cos like most of the people who get in touch with you I am desperate, bordering on insanity!

many thanks,

[youngin]

Well here goes...My girlfriend of many many year has tested positive for chlamydia recently. I have suspected I had chlamydia for 7 years or so, but never bothed to get tested because my girlfriend had several negative tests over the years we have been together. I just figured it was a track infection, and left it at that. I recieved a script of 200mg of Doxi for 7 days. I finished up my script this week, but I still have the symtoms. My question is since I have unknowingly had chlamydia for so long is it possible it is untreatable or uncureable? I have read other posts about men who also have symtoms that have not gone away after treatment, but  my situation is slightly different due to the length in which iv'e had it. Thanks for listening it is much appreciated.

[H. Hunter Handsfield, M.D.]

And I can pretty much assure you it was NOT an STD, even if it was somehow related to the sexual exposure you describe (e.g., chemical irritation).  No STD causes the scrotum symptoms you describe--none, period.  And none causes sweatiness.  And unequivocally you do not have LGV. Medically untrained people generally are incapable of accurately assessing their own lymph node enlargements, but monkeyflower is right (and as I said before):  if you can't tell for sure, then almost certainly they are not enlarged.

Bottom line:  See a health care provider.  It is just plain dumb to try to figure it out online and certainly to keep trying to treat yourself.  I will have no further replies.

HHH, MD

[MrWorried]

I had irritation issues myself.  The doctor I went to told me it was most likely chemical irritation and that I should use a very mild soap as well as use hypercortisone to help relieve the redness.  After using this for 5 days, I noticed the irritation went down and after a full week, the problems were all gone.

As a word of advice, beware of using harsh soaps while irritated.  It may end up irritating it more.  In my case, I used anti-bacterial soap, and that ended up making it look worse.

[neworder]

Thanks for getting back to me, I will not really be able to relax until after the test ofcourse but thanks for your words.

No it was an std I can assure you of that. Also I am getting sweaty like I have got the flu but it comes and goes. Basically I have all the symptoms for ARS apart from the rash. Although it hasn't knocked me for six or anything like that. I thought after research that it could be lymphogranuloma venereum (I am in Brazil) other than HIV. I have also got what look like blisters or red spots on my tonsils and surrounding area. The back of my tongue resembles something thrush like. I did perform a bit of oral sex on her, why I will never know, but I did. It didn't last very long and it was just around the clit with no tongue penetration.

To be honest I don't know how to check if I have got swollen glands, would I physically be able to notice. When I feel them (cant really tell if its them or not) they don't appear tender. The other issue is the scrotum. You didn't answer that one. Why would it be so veiny and red (the veins are red not the skin) It like spider veins. I don't think my balls have swollen but its not pretty down there. Its not a rash and its not itchy. Infact they don't do anything other than look veiny. I can't find anything on it as far a symptoms to any std or other illnesses.

thanks,

[monkeyflower]

What looks like varicose veins probably is. Google varicocele.

Also, re: lymph nodes, I have a feeling you would definitely know if they were really enlarged. I had a client who came to see me once with a sore neck, thinking he'd just slept wrong, but the lymph nodes in his neck were unmistakeably palpable. I've never felt anything like that before or since. I sent him to the doctor, and it turned out he had mono. Also, I think inguinal (groin) lymph nodes have to be pretty darn big to be considered enlarged. I'm fairly thin, and my inguinal lymph nodes are visible and easily palpable... but they're still not enlarged.

But why are you trying to diagnose yourself online? Why are you prescribing meds for yourself, for conditions you don't even know you have? Why are you so sure you even HAVE a STD? Jeez. See a doctor and get tested.

[nyc_worried]

Hello Dr. H,

Thanks in advance for taking a look at this.  I have similar symptoms to the poster: red, irritated tip of penis and scrotum, but no discharge.  For a similar amount of time as well, over a month.

If it is some kind of chemical irritation (it might be in my case, as I recieved protected oral from a stripper), could it go on for this long?  And if so, how can it be cleared up?  I'm trying hydrocortisone which seems to lessen the discomfort a bit, but not permanently.

Thanks again sir.

[H. Hunter Handsfield, M.D.]

The symptoms you describe do not sound like chlamydia or any other STD.  The "slight discharge" might count, but you seem doubtful about it; but burning red skin of the penis or scrotum suggests some sort of chemical irritation (e.g., from condom lubricant? latex allergy?), not chlamydia or any STD.  The skin flaking afterward also suggests it was some sort of skin irritation.  However, if you had chlamydia or gonorrhea to explain the discharge component, the combination of doxycycline plus ciprofloxacin would have taken care of it.  In any case, at this point you'll never know.

It is unlikely your more recent symptoms are due to HIV.  ARS usually includes fever (usually pretty high fever, skin rash, and widepsread lymph node enlargement--not subtle ("I think my nodes are swollen") enlargement.  Anyway, the risk is low very after any single episode of vaginal intercourse, even if your parter was infected, which she probably wasn't.  And your risk was particularly low since you were exposed so briefly after the condom failed.  If you turn out to have HIV, most likely you caught it some other time.

Testing for HIV is not affected by the antibiotics you took (or by any other drug or medicine).  You will be able to rely with almost 100% certainty on a negative test result at 35 days.  In the meantime, relax.

Good luck--  HHH, MD