Irritation not going away

[johnb00]

Hi Doc,

During the first week of May 09, I had protected intercourse (condom was used for both vaginal and oral sex) with a flight attendant and I never talked to/saw her again). She also gave me a handjob and she definately touched herself before touching my genitals.  Two days later, I started having a mild burning sensation and a little irritation. 5 days later I went to see a GP. He dismissed symptomes of any STD, gave me Lotriderm to use for 10 days, and took a blood sample for Herpes and Syphilis (came up negative, however a week is too early to test anyway). After the Lotriderm treatment, there was no improvement, but on the contrary irritation/redness increased. At that point, the symptoms were as follows: whenever I urinate, the head of my penis turns red along with the mild burning sensation (similarly when I ejaculate, with a bit more burning and irritation).

- I went to see the GP again after a month, and he took a swab test for ghonorea and a urine sample for a bacteria (both came negative)

- I went to see a dermatlogist 45 days after my second GP appointment and again he dismissed symptoms of STD's. However he did clearly notice an irritation and prescribed an other cortison based cream.

- At this point I had used the cream for 2 days, but when I gave a call to my hometown doctor, she told me to stop the cream as it contains high amounts of cortison and instead prescribed travocort for 6 days. Symptoms persisted and I called her again. She prescribed diflucan 150 (2 tablets in total at a week interval); however in vain.

- Finally a few weeks later I gave her a call, told her that I was concerned that I could have clamydhia so she prescribed vibromycin (2 tablets a day for 7 days).

-Symptoms described above persist til date
I'm also concerned as to whether I should test for Herpes, Syphilis again and whether I should test for HIV (anxiety talking)

Advice?

Thx for bearingwithme.

Any idea on what might be causing the symptoms?

[Edward W Hook, MD]

Nothing you have described carries any meanignful risk for STD.  I see no benefit to further testing.  Let us know what the dermatologist says.  EWH

[johnb00]

Thanks Doctor, I'll reschedule an appointement with my dermatologist.

what has puzzled me over this whole situation is that I believed I was being very safe. In your opinion, was there any risk of getting a STD from the scenario mentioned above? (even my sexual history involved less risky women and the same level of protection)

The herpes/syphilis test was done only a week after exposure. I later understood it was inconclusive. Should I retest?

I'll update the post after seing the dermatologist.

[Edward W Hook, MD]

Welcome to the Forum. I am not sure that I can add too much to what has been done now that you have been seen and examined by two doctors.  I will summarize my impressions and make a suggestion.

There is no reason to think that this might be an STD of any sort, including HIV.  Your exposures were protected, you have had negative tests and  have received antibiotic treatment which would have been curative if this were a typical bacterial STD (which it doesn't sound at all like).  Similarly, it sounds as though you have had antifungal therapy without change as well, making a fungal infection less likely.

I hate to disagree with your family doctor but I have to say that I would have done what the dermatologist said,  Your regular doctor is correct that treatment with high potency steroid creams can damage the skin if it used for a prolonged period but a week or two would be most unlikely to do any harm and might very well help.  I would return to the dermatologist and see what he/she has to say.  Your problem is now beyond the realm of what we generalists can do.  If the dermatologist suggests the higher potency steriod cream again, I'd ask about side effects and tell him/her about your family doctor’s concerns.

Hope this helps.  Let us know what happens please.  EWH