Question after tests - Still slightly worried

[Tom725]

Good afternoon! I wrote your forum before and your expert advice really helped me. Approximately two weeks ago I had a sexual encounter with a CSW in the red light district of Amsterdam. I used a condom but was just not feeling right when I returned. I think it was mostly guilt. I took you advice to help ease my mind and went to the doctor’s to be tested. I was tested six days after the possible exposure. I had no symptoms. It did not hurt to urinate and I nothing like leakage or such. Both tests blood and the penis swab came back negative. It was a weight lifted off me. I also went to the doctor because I had a bad cough and was feeling run down after my trip. I was diagnosed with an upper viral respiratory infection. I was given steroids and azithromycin (Z pack). I have read that azithromycin is used to treat stds was well. I took two tablets the first day and one the next four days (5 days total) for a total of six pills. (no sure on the dosage size) I completed the whole pack on Friday. Since I got the results, I have had some weird sensations down below. It still doesn’t hurt to pee. It just feels almost tingling. At first I thought it may have been left over feelings from having something inserted in my penis. It did appear that one side of my penis opening was slightly red. The first part of my question is if this could be just in my head since I am still thinking about it? Could my penis be irritated from the std test that was done? Or am I over reacting? The next question I have is if I did have an std that slipped by the test, could the azithromycin have killed it since I took the whole pack? i have not had sex with my significant other since I returned; mainly because we have both been ill. Do you think it is safe for me to have unprotected sex with her since taking the pills and the tests coming back negative? She is on vacation and it will be seven days since I finished the z pack and getting the negative results by the time we have sex again.

[H. Hunter Handsfield, M.D.]

Glad to have helped.

Your new symptoms are not suggestive of STD, especially in view of the no-risk exposure -- and they are generally consistent with the dehydration episode.  Of course, it's generally unwise to not be completely open with providers about past medical history and there would be no harm in telling your doctor(s) about the STD work-up.  But it probably isn't necessary, and if you do it they undoubtedly will agree with my perspective.

[Tom725]

Sorry

I meant to say that it DOES NOT HURT TO PEE

[Tom725]

Sirs,

I had a follow up question but first I want to say you were both right! Things worked out great and as soon as you put things behind you and stop over-thinking situations, you definitely feel better. My follow up question is a health one. I recently had to have two IV’s for dehydration. I had been training hard for a race and did a number on my kidneys. The urine test said I had some protein in my urine. Since Thursday, I have had pain in my lower abdomen; specificlly below my belt to the base of my penis. My testicles have hurt and it fell like “someone has kicked you in the balls” (pardon the phrase). My urethra has had a tingle and an ache but it does hurt to pee or any leakage. I am going to go for a follow up with my family doctor. Should I bring up my prior STD tests and go down the road? I got test approx 4-5 days post exposure with neg results across the board. Any chance I got tested too soon or things may have been lying dormant. Thanks again and trust me I am not worried or paranoid like before. Thanks ~!

[Tom725]

Thank you sir! Sorry about the new thread issue.

[H. Hunter Handsfield, M.D.]

I meant to also say that your test results were reliable and you do not need any additional testing.  Of course return to your provider if you remain concerned.  But there is nothing more to be done from an online forum.  Best wishes.

[H. Hunter Handsfield, M.D.]

You did not need to start a new thread; Dr. Hook would have replied to a brief follow-up question on the other one.  We prefer it that way; only a limited number of new questions can be accommodated each day, and superfluous ones block others with new questions.

As Dr. Hook told you, the exposure you described carried no signficant risk of any STD.  And yes, the azithromycin would have cured or prevented any of the likely infections of concern from taking hold.  Your symptoms are not those of any STD.  "In your head"?  Whenever a person suggests his or her own symptoms have a psychological origin, that the problem is "mostly guilt", or that s/he is "overreacting" -- those are all your words, not mine -- usually s/he is correct.

No distant online expert can guarantee someone is not infected.  But if I were in your situation, knowing what I know, I would continue unprotected sex with my wife without concern for her health.

Regards--  HHH, MD