Coag Neg Staph Infection

[Lostinasia]

Hi Doc,
Great service. I found lots of support here and info. Here's my situation. I have been treated for a staph infection I caught from unprotected Oral Sex 7 weeks ago in Thailand. (Coag Neg Staph). It had infected my penis, testicles, bladder, ureathera and probably prostate. The doc first treated me emperically for the regular STDs. Nothing worked and it spread. Eventually I got a swab and was given Ceftraxone 1 shot 500mg the same day. 5 days later the lab reported staph and gave a sensitivity analysis. The urologist gave me over 2 weeks of Cravit 3 days x 500mg plus 2 weeks x 250. As well as Anti Inflamitories, and meds for my prostate (Hardingle??)

The doc has been treating me for chonic prostitits. I also took cipro, flagyl, doxy and zithromax prior to the shot but none were useful against staph. Durring that the doc also thought an opprotunistic yeast infection got involved. I took 5 days of diflucan and it seemed to have helped. I did comply with the meds.

I had two types of discharge  the largest was about 3x3 cm white and crusty and happend a couple times after the shot. The second type and more regular is described below.

I have had
2 swabs for Chlamydia both neg (on meds)
1 swab for ghon which in turn diagnosed staph (on meds)
3 urine tests all neg (on meds)
2 HIV test both neg
1 VDLR after 5 days exposure neg. (before meds)
2 Ultrasounds to diagonse (Epydymitis and Orchitis) Spll?

Chlamydia, Ghonnera, Trich, syphallis can be ruled out as I took all the meds to cure those.

[Lostinasia]

Thanks Doc.

[H. Hunter Handsfield, M.D.]

You apparently have an atypical situation, especially with a second species of staph now the dominant bacteria present. Almost certainly this is not an STD, and not related to the oral sex event.  You'll need to follow through with your own providers; or if things remain unclear, ask about referral to an infectious diseases specialist.

[Lostinasia]

Three weeks on...still have a discharge...not an STD as you said earlier, but nontheless recived from sex therefore perhapes an case of NGU. A new swab of the discharge showed a heavy population of Staph Aureus. This is consitent with the first swab which showed coage neg staph, which is the case in some strains of Staph Aureus. For 1 month I was off all meds. The infection never went away and the discharge appeared most mornings after not urinating for more than 5-6 hours while sleeping. Some days big, some days not so big.

Went straight to the doc when I returned from overseas. The doctor perscribed bactrim. In two days there has been no discharge. Still have a sensitive glans penis.

Anyways, here are my last questions then I will close this

Is it possible to have an infection without having a high WBC? All my urine tests were negative, but I still have a discharge. If so, what does this mean?

Finally, it smells! Kind of yeasty. I have taken meds for fungal infections. No help. What does this indicate.

Thanks in advance if you have time to answer this.

[H. Hunter Handsfield, M.D.]

It is unlikely that meds for "regular STDs" would fail to cover gonorrhea.  Ggenital gonorrhea symptoms generally clear up entirely in a few days of appropriate treatment, regardless of severity.  It is unlikely that gonorrhea was ever the problem, but there are no tests for past gonorrhea, so there is no way to know for sure.

[Lostinasia]

Thanks Doc,
I'll be following up with my doctors. I am seeing a GP and a Uroligist.
A three follow up questions and I'm done with this.

Many posts say that meds may mask gohnerra tests. I only got better after the shot of Ceftraxone.
1) Is it possible my problems come from Ghonnera?
2) Is there anyway to test to see if I had it?
3) For a severe case, what's the recovery time expected?

Thanks

[Lostinasia]

Cont

Fast forward to today. The staph infection seems to be gone. I'm not in any major discomfort and off the meds as of Sunday but I seem to be paying alot of attention to each twitch or feeling in my groin. The plumbing works fine. Nothing visable in my ejaculate, no discomfort during orgasims, or urination.

I still do have a pain in the tip of the penis. The inside the top half  of ureathera is red in comparasion to the lower half which is normal in color. It seems to be getting better day by day.  In the morning, I still have a discharge but this is after I urinate and go back to bed. I think it may be dried mucous. It's a clear  discharge that dries clear, white and can be peeled off, about the size of the tip of a pencil in 2 or 3 spots, which I have had regularly for 6 weeks. I realize most of this may be in my head, but the discharge is not. It's litterlaly in my shorts :-)

Normally when I urinate, I can capture some clear mucous in a tissue. It's not a large amount but non the less worrysome. No discharge during the day but urinate 8-12 times perday due to increased fluid intake.

I assume that it is a result of the infection and hope it will dissapear in a few more days. I'm going back in a couple days to have a follow up. I don't have many symptoms left from the infection. ie. pain, swelling,  crusty discharge.
I have gone back and forth from diarhea to constipation with lots of gas. But I attribute that to the meds I have been on. Three days now with no meds and its begining to pass out of my system. So its hard to say my bladder is uncomfortable its my whole lower stomach. Deficating and passing gas helps. Each day seems better.

Questions?
1) Is the mucous likely an after effect of the infection and meds? I'm drinking Cranberry, OJ and lots of water to flush my system as well as an additional 1-2 cups of coffee for my fix. Could the acidity be a contributing factor in causing mucous?
2) Is the discharge possibly mucous? Or what else can cause such a unique discharge?
3) Could Herpes be involved? (I was infected through oral sex but have none of the external symptoms. Is it perhaps in my ureathea. Its highly unlikely)
4) Can you provide any other insights into staph infections and treatement times? In your experience how long does it take to make a full recovery on average?
5) What's the next step?
6) Finally, can I have unprotected sex with my partner? Is staph an issue?  We have not had sex since I was infected.

[H. Hunter Handsfield, M.D.]

The purpose of the limit on number of characters is so that the entire question will be asked in the initial field, without spilling over.  Also, although you might have acquired your staph infection soon after the oral sex event, that is not where you caught it.  We all are bathed in coagulase negative (and coag positive) staph infections all the time; they are normal bacteria on our skins and in our body cavities.  It is not a sexually acquired or transmitted infection, thus not appropriate for this forum.

That said, perhaps the staph is simply a contaminant that has nothing to do with any of your symptoms.  If you were to test the urine or urethral discharge from 100 men, you might detect staph in 80 of them.  Finally, you have been under the care of at least one (or is it two?) health care providers.  Your situation is much too complex for someone not directly involved in your care to speculate.

As to the questions below:

1,2) Continuing "mucus" (urethral discharge) might mean either continuing infection or just an inflammatory reaction even though the initial infection is gone.  This is a question for the docs providing your care for the problem.

3) There is nothing in your story to suggest herpes.

4) See above.  I'm not sure the staph has anything to do with the symptoms you have described.  But I doubt any STD is involed either.

5) Ask your own doctors about the next step.

6) Probably it is safe to have sex with your partner now. Oral sex rarely results in any infection that is likely to be harmful to a partner.  But again, this is a question for the docs involved in your care.

Regards---  HHH, MD