Urethritis (Follow-up)

[BenG]

Hi, I posted a few weeks ago. I am writing with new (surprising) information and a couple of questions.

I am 29, Male. Oral sex with a woman 3 months ago (received and gave). Stinging when urinating started at 8 days post encounter.
Tested at 3 GUM clinics - all STDs clear. No antibiotics given despite ongoing symptoms.
At 8 weeks, urologist gave me doxycycline 100mg 1-a-day for 4.5 weeks. Didn't help and at around this time, I started getting joint pains (ankle mostly, which has persisted to this day. Also around pelvis).
ESR was 7 (not 70 as previously posted - receptionist made a mistake!). HLA-B27 negative.
Saw a rheumatologist who ruled out Reiter's (he said there was no arthritis on examination).

The latest is I saw a GUM Consultant/Specialist. He swabbed me himself and spotted lots of puss cells under microscope! Diagnosed NGU.
Although he put the rod further up the urethra (boy it hurt), it is really weird how it escaped 3 previous screenings. I have had no sex at all since the original encounter.
He has put me on Doxycycline (again), this time 100mg TWICE a day for 2 weeks. He said the previous dose was inadequate.
He also said I don't have Reiter's.
Been taking doxy for 5 days but no change in symptoms (stinging).

1. I found it odd that he gave me doxy again. Are there any other antibioitics that could cure it?
2. This joint pain is very weird (never had it before). Despite no frank arthritis, could it be a mild form of Reiter's?

Thanks SO much for steering me in the right direction (you said go and see a GUM Consultant).

Ben

[H. Hunter Handsfield, M.D.]

I'm glad you got on the right track, and that your ESR wasn't so high.  But I don't think I can help further.  You're seeing a specialist who probablly is as knowledgeable as I am.  NGU has a lot of mysteries to it, and intermittent evidence of inflammation, is pretty common.  Repeating the original antibiotic for a  more prolonged treatment period is a common strategy.  If it doesn't work, the GUM doc might give a still longer course of doxy or might try a different antibiotic.  You should inform him your symptoms are persisting and take his advice.  Also I would trust his advice if he says you don't have Reiter's syndrome.

Good luck--  HHH, MD

[cbonner]

Hi Ben

I too have had tests at GUM (Leic) clinics, i have aching balls that seems to not have a cause!! i have had 5 seperate tests and all were negative, As no cause can be found it does make you wonder about test accuracy!! ( its got to the stage where i am tempted to get some antibiotics of the net to try as i dont seem to be getting anywhere ) did they not look for NGU with the urine sample? i take it you waited the 2 hours beforehand and then did 2 samples, i thought that was to check for chlamydia and NGU. hope you get sorted soon!!

Cheers

Carl

[BenG]

Hi Carl,
They did all the tests (urine/swab under microscope, cultures, etc) and I held my urine for about 4-5 hours each time and still nothing. Dr HHH gave me some great advice to see a GUM Consultant and I can recommend the Dr I saw if you are willing to travel to St Albans (near london). You can imagine how shocked i was when he spotted an infection under the microscope! On the consultant's advice, I held my urine for the whole night and saw him first thing in the morning. I have had the infection for 3 months. But the antibiotics are not resolving the stinging. Good luck, Ben.

[H. Hunter Handsfield, M.D.]

Many people with continuing symptoms of urethritis have no actual continuing infection.  Some cases probably are due to a residual inlammation, perhaps an immunologic reaction of some kind that doesn't respond to antibiotics.  Others have only symptoms that don't respond to treatment.  In all cases, nothing dangerous is going on, nothing to cause permanent harm, nothing to harm a future sex partner.  You all may just have to live with your symptoms and don't worry about it.  Over time they will fade.

HHH, MD