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Help in identification on meatus redness

Need help identifying condition.
Day 0: Noticed marble sized lump in groin lymph node
Day 1:  I received fleeting (15 seconds) unprotected oral sex, followed by protected intercourse with a one night stand.  Immediately following, I washed my penis vigorously with soap for several minutes.  Obviously overkill.  I went to bed, then 6 hours later I woke with discoloration on the meatus with raised bumps in that area.  Within 24 hours the discoloration turned red, and then with 48 hours in noticed the lips of the meatus has a raised lesion.  The tip of the meatus has a sore/throb sensation and still red to this day along with general feelings of malaise and red throat but not sore throat like strep would feel (now 5 weeks).  No burning while urinating nor notice any discharge.
Day 3: started 7 days of Amox.
Day 5: Chlamydia, Trich, and gonorrhea came back negative from walk-in-clinic
Day 12: 1G Azithromycin and started using gold bond powder and coconut oil, which really helped the sensitivity issue when rubbing on shorts and generally soothed the skin.  Meanwhile the groin where the legs meat the scrotum are slightly itchy, but satiated with the powder.
Day 14: Visited urologist, gonorrhea and chlamydia came back negative.  Urologist states does not look like herpes or warts.   Also, prostate exam shows prostate does not seem inflamed. Advised to use nothing and then if symptoms persist then call a dermatologist.  
Day 29: Visited a dermatologist.  The meatus was not red when visiting, had used gold bond the night before.  So at the visit the primary symptom was the still raised lesion on meatus lip/wall.  Dr stated doesn’t look like fungus or typical STI.  Given Doxycycline for a 21 day regime and 2.5% hydrocortisone cream for twice daily administration.   The advice was checking the lymph node after 4 weeks for biopsy if still there.  Dr also stated the scrubbing could cause the meatus issue even this far out.  Also advised after the following 4 weeks maybe some more STI testing could be done.  
Day 35:  Symptoms still persisting, general malaise and red/slight throb in penis tip.  If anything, I must say the hydrocortisone has made the irritation slightly worse and more sensitive than any better.  Worse than the coconut oil for sure.  The lymph node (remember was there prior to the sexual event) might be marginally smaller but still there.   Using gold bond on the crevice itching, I may have picked this up from outdoor activity (similar to jock itch) from the summer heat or perhaps the condition is fungal on the meatus.
Since neither doctor actually saw the meatus when red at time of visit, looks like a irritant rash to me, but this is not my field and to last so long is strange to me.
Could the symptoms be STI related from the sexual encounter, or the scrubbing, strange for the meatus to show symptoms less than 7 hours after the event??   Perhaps a general virus I picked up from her??
Possibly related to the lymph node??  Love to hear thoughts from folks in similar scenario.  The penile meatus soreness/burn/throb sensation and malaise is super annoying now persisting at the 5th week.  The penis meatus looks the same at day 2 as it does 5 weeks later, any second opinions on this?
1 Responses
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207091 tn?1337709493
Okay, so first, your first STD testing was too soon. Your results came back on day 5, and gonorrhea and chlamydia shouldn't be tested for until at least day 5. Also, I don't know if you were already on the Amox when you tested, but if you were, that could give you false negatives.

Also, from what I can gather, you've been on Amox for 7 days, took 1G Azithromycin on day 12, Doxy for 21 days, which you are still on. This is a crap ton of antibiotics, and you haven't tested positive for any bacteria. Why are you taking these? What do they think you have?

You've also used gold bond, hydrocortisone 2.5%, coconut oil.

So, as you've likely suspected, you wouldn't see STD symptoms within hours. It would be a minimum of 2 days, likely longer. You had the swollen node before the encounter, if I'm understanding correctly.

Some of it, I suspect comes from the vigorous washing, which, by the way, does nothing to prevent infection. Once you're infected, you're infected. Some of it I wonder if you'd have gotten anyway, and the node was just a first symptom.

I don't know why you're on the doxy, and I wouldn't ever tell you to stop it if you're taking it under a doctor's orders. If you don't know why you're taking it, call your doctor and ask. 21 days is a long course of that.

I'd also suspect that some of this is a fungal infection in response to all the antibiotics. Perhaps it started as irritation or a reaction to the soap, and then developed into a fungal infection since you washed off the good bacteria that keeps everything in check - I don't know. Has anyone done any skin cultures or swabs? Has anyone cultured your urine to see if there's any bacteria or white blood cells?

If you don't know why you're on the doxy, find out and let me know that, too.

Helpful - 0
Thank you for replying.  I've asked doc to call.

You are correct about no testing for bacteria nor swabbing, which is why I'm reaching out here.  Both visits to the docs involved 10 sec of looking and then prescribing.  
Derm says doxy is broad, so the node issues is bacterial in nature that would address, if not then need biopsy.   The hydrocortisone, should address the meatus area per derm.
So here we are 7 days later of doxy and hydrocoritzone and no changes.  The irritation still persists.  

So now I wonder, should I being seeing reprieve by this point from either the doxy or cortizone?
Would the test at day 14 for gonorrhea and chlamydia be accurate at that point?  Maybe I should insist a cultural test, I've never had anything last thing long period.  Just wondering if sounds at all related to an STI.  Prior relationship was monogamous.  
So now I wonder, should I being seeing reprieve by this point from either the doxy or cortizone?  -

This depends on what it is. Doxy is broad, but it doesn't cover everything. It doesn't cover gonorrhea, for example.

Would the test at day 14 for gonorrhea and chlamydia be accurate at that point?

No. You were on amox prior to that. You need to be off all antibiotics for at least 3 weeks before testing or you could get a false negative.

If this is fungal, you won't get much relief while you are still on antibiotics. It's hard to say if this sounds like an STD. Your symptoms developed too soon for an STD, you've been on a ton of antibiotics which could slow the progress of an STD - the azithromycin would cure chlamydia and NGU, as would 7 days of doxy, if you're taking 100 mg twice a day, but neither would cure gonorrhea. If it's slowing the progress of gonorrhea, it's hard to say what kind of symptoms you'd be having. The original symptoms could be from the soap, and are now continuing from a fungal infection and/or an STD.

Again, thank you for response.  

Last question before I see doc again.  Can the doxy provide a false negative if I go for a gonorrhea test?
Yes. You need to be off all antibiotics for 3 weeks before testing for any bacterial STD. Gonorrhea is one of those.

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