What kind of infection is this?

[Sarah72600]

In October I noticed a fishy smelling discharge.  While waiting to see doctor had sex with husband. Experienced severe cutting/burning pain upon entry.  5-7 days later my husband starts having pain/burning when urinating.  He went to doctor.  No bacteria found in his urine.  Symptoms persisted for several days. Called dr. back. He called in a prescription for doxycycline for my husband and he started taking it.  Never had any relief of symptoms. I started having redness, swelling, burning pain in my vagina and vulva. DR. did a vaginal swab culture.  It came back with heavy growth of Gardnerella.  STD tests negative for gonorrhea, chlamydia, trich, herpes,and HPV.  Took one dose of metrogel.  Started feeling better within 12 hours but I had a reaction to the medicine. Did 5 days of peroxide douches for the BV. burning, redness and swelling continued. Went to dr. She did another vaginal culture.  Neg for all STDs again and gardnerella gone. She gave me Estrace cream. Didn't help. I still have the burning all the time.  after any sort of stimulation I get VERY red all around the vestibule and sex is painful for days afterwards. My husband took the doxycycline for 3 weeks. Then Cipro. It spread to his bladder and then prostate.  He went to see a urologist, diagnosed chronic prostatitis.  He had std tests after the doxycycline didn't help.  They were negative. We asked the urologist if he should test his semen for infection or do another urine test.  He said it wasn't necessary. One day the prostatitis would go away.  We have told all of the doctors we've seen that our symptoms started around the same time. They dont seem to know what to do or test for. Could this be caused by a bacteria like ureaplasma or mycoplasma? My HIV , herpes and HPV tests were negative.  My husband did get a couple of tiny (1-3mm) blisters that opened one day and were gone the next.  The dr. said it was probably a reaction to doxycycline.  What should we test for next? DNA probe or PCR test?

[Sarah72600]

Thank you

[Edward W Hook, MD]

1.  Could my husband have contracted the Gardnerella infection I had and caused his symptoms?  

Gardnerella is "normal flora" and not a pathogen.  thus is it normal to have Gardnerella.  For that reason, most experts do not culture for it since if present it does not need treatment.  In women with bacterial vaginosis, the concentrations of Gardnerella increase dramatically and go back to more normal levels following treatment with metronidazole.  There is no evidence that BV is an STD or that partners of women with BV need treatment.

2.  Could mycoplasma or ureaplasma cause the symptoms we both have?  Will mycoplasma and Ureaplasma show up in the vaginal culture and STD testing that were done?  

Mycoplasma and ureaplasma are also normal parts of the genital microbiology and do not need treatment if detected.  Testing for these organisims is not recommended either.

3.  Would the doxycycline and Cipro my husband took treat/cure Mycoplasma, Ureaplasma and Gardnerella?

Efforts to treat these infections with any antibiotic are typically unsuccessful.  As I said above they are normally present, thus when "treated" they may decline in concentration but they then come back.

4.   If a couple like us came to your office for treatment are there any other tests you would do?
It is not clear to me that your symptoms and your husbands are due to the same process. Bacterial vaginosis in woman is not clearly and STD and does have a tendency to recur.  Similarly, prostatitis in men can be challenging to treat, typically requires prolonged and sometimes multiple courses of antibiotics and is almost never an STD.  The these two problems occur in a couple may be coincidence and nothing more.  

EWH

[Sarah72600]

I'm sorry for being unclear.  This has been a very frustrating experience. It seems like there is some sort of infection that caused these symptoms my husband and I are experiencing.  They started within days of each other.  If you can answer these questions please.  Could my husband have contracted the Gardnerella infection I had and caused his symptoms?  Could mycoplasma or ureaplasma cause the symptoms we both have?  Will mycoplasma and Ureaplasma show up in the vaginal culture and STD testing that were done?  Would the doxycycline and Cipro my husband took treat/cure Mycoplasma, Ureaplasma and Gardnerella?  If a couple like us came to your office for treatment are there any other tests you would do?  Thank you for your expert opinion.

[Edward W Hook, MD]

I'm sorry, your question is not clear.   From what you say, you and your husband have each been extensively tested an found not to have an STD.  EWH