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possible gonorrhea, chlamydia or UTI?
Dear Medhelp,
About 2-3 weeks ago I noticed an itchy feeling in my urethra. I was also urinating more frequently, and there was redness around the end of my penis. The itchy symptoms occurred for about a week before I decided to go to the doctor. I had been trying to see if there was any discharge, and just before heading to see him, I managed to squeeze a drop of what I think was discharge from my penis - it was a small portion and lightly cloudy.
The doctor said I most probably had chlamydia or gonorrhea, and as I am allergic to penicillin, he prescribed me 100mg of Minocycline, twice daily, for 10 days. Symptoms seemed to reduce, but after a week I still had a prolonged uncomfortable sensation in the urethra as well as redness around the end of the penis. I also now had conjunctivitis in both eyes! I should also mention that in the meantime I had read that Minocycline is not very effective for Gonorrhea (50%). The doctor then prescribed me a single 500mg dose of Ciprofloxacine, and advised me to keep taking the minocycline until the end of the 10 days. He also gave me Ciloxan for my eyes, 4 times a day. That was four days ago.
As my eyes were not getting any better (a little worse, in fact), nor the redness and discomort of my urethra, I went to an STD/Andrology specialist. He was annoyed that I came to him while still taking antibiotics, and wasn't able to do any testing. But he said that it was definitely not gonorrhea because the minocycline should have cleared it up and because I did not have any discharge, and that it could be another bacteria - I was doubtful. He then prescribed me 250mg of azithromycine once daily for 6 days, as well as rifamycine for my eyes (4 times daily for 7 days).
I am not happy with his diagnosis. A doctor friend advised me to take double the dose for 3 days for gonorrhea. Do I take this prescribed dose (not effective for possible gonorrhea) or do I wait and see another specialist? Very confused.
Thank you
About 2-3 weeks ago I noticed an itchy feeling in my urethra. I was also urinating more frequently, and there was redness around the end of my penis. The itchy symptoms occurred for about a week before I decided to go to the doctor. I had been trying to see if there was any discharge, and just before heading to see him, I managed to squeeze a drop of what I think was discharge from my penis - it was a small portion and lightly cloudy.
The doctor said I most probably had chlamydia or gonorrhea, and as I am allergic to penicillin, he prescribed me 100mg of Minocycline, twice daily, for 10 days. Symptoms seemed to reduce, but after a week I still had a prolonged uncomfortable sensation in the urethra as well as redness around the end of the penis. I also now had conjunctivitis in both eyes! I should also mention that in the meantime I had read that Minocycline is not very effective for Gonorrhea (50%). The doctor then prescribed me a single 500mg dose of Ciprofloxacine, and advised me to keep taking the minocycline until the end of the 10 days. He also gave me Ciloxan for my eyes, 4 times a day. That was four days ago.
As my eyes were not getting any better (a little worse, in fact), nor the redness and discomort of my urethra, I went to an STD/Andrology specialist. He was annoyed that I came to him while still taking antibiotics, and wasn't able to do any testing. But he said that it was definitely not gonorrhea because the minocycline should have cleared it up and because I did not have any discharge, and that it could be another bacteria - I was doubtful. He then prescribed me 250mg of azithromycine once daily for 6 days, as well as rifamycine for my eyes (4 times daily for 7 days).
I am not happy with his diagnosis. A doctor friend advised me to take double the dose for 3 days for gonorrhea. Do I take this prescribed dose (not effective for possible gonorrhea) or do I wait and see another specialist? Very confused.
Thank you
MEDICAL PROFESSIONAL
OK, let me know.
Thank you Doc for all your advice. I am a foreigner living in France, and am not used to the low level of sensitivity to patients' needs here compared to back home, which is why I turned to this forum. Your input was a great help!
The specialist I went to see works in the same STD clinic where I obtained free testing for HIV, syphilis and Hep C. He was recommended to me by the staff there.
I have decided not to take another round of antibiotics as suggested by the specialist, and instead will go to see the general practitioner in order to get tested for gonorrhea, chlamydia and mycoplasma. Then, with test results in hand, I will return to the specialist. I would prefer to take this approach rather than taking more antibiotics for possible bacterial infections which I still haven't been tested for.
Thank you once again, and I will endeavour to inform you of the final outcome!
The specialist I went to see works in the same STD clinic where I obtained free testing for HIV, syphilis and Hep C. He was recommended to me by the staff there.
I have decided not to take another round of antibiotics as suggested by the specialist, and instead will go to see the general practitioner in order to get tested for gonorrhea, chlamydia and mycoplasma. Then, with test results in hand, I will return to the specialist. I would prefer to take this approach rather than taking more antibiotics for possible bacterial infections which I still haven't been tested for.
Thank you once again, and I will endeavour to inform you of the final outcome!
MEDICAL PROFESSIONAL
This makes it less likely to be adenovirus, which once improvement starts would usually continue to complete resolution.
An online forum cannot prescribe or recommend specific treatments in particular situations. You need to return to a qualified health care provider. I would recommend against relying on informal advice from a doctor friend in this situation; either return to the original doctor or consider visiting your local health department STD clinic for guaranteed expert care in this situation. Standard treatment for NGU that persists or recurs after doxycycline (or minocycline) is single dose azithromycin 1.0 g (plus metronidazole or tinidazole if trichomonas is suspected, but you can't get trich from oral sex).
Gonorrhea remains very unlikely, but it would still be a good idea to be tested for it to be maximally safe -- which is one reason you need to be professionally evaluated in person.
An online forum cannot prescribe or recommend specific treatments in particular situations. You need to return to a qualified health care provider. I would recommend against relying on informal advice from a doctor friend in this situation; either return to the original doctor or consider visiting your local health department STD clinic for guaranteed expert care in this situation. Standard treatment for NGU that persists or recurs after doxycycline (or minocycline) is single dose azithromycin 1.0 g (plus metronidazole or tinidazole if trichomonas is suspected, but you can't get trich from oral sex).
Gonorrhea remains very unlikely, but it would still be a good idea to be tested for it to be maximally safe -- which is one reason you need to be professionally evaluated in person.
Update:
It's been 2.5 days since having stopped antibiotic treatment, and unfortunately, symptoms are returning. Redness is increasing at urethra opening, itchiness and general mild stinging of urethra has also returned, and my eyes are slowly beginning to get worse. I don't have burning while urinating, and never really did before treatment.
Not sure what to do next.
Do I hold off for a week in total so I can get some clinical tests done?
Do I commence the antibiotic treatment that the specialist suggested, i.e. 250mg azithromycine daily for 6 days, and rifomycin drops for the eyes, over 7 days? And a week after stopping them, then get tested as he suggested?
Or do I take 500mg of azithromycine over three days, as a doctor friend of mine suggested?
Quite confused about what to do. I don't want to make the wrong decision and possibly cause complications for future treatment.
BTW... is gonorrhea always associated with large amounts of a thick discharge? I have no discharge, and only ever had one small drop before antibiotics.
Thank you!
PS... tested negative for HIV, Syphilis and Hep C.
It's been 2.5 days since having stopped antibiotic treatment, and unfortunately, symptoms are returning. Redness is increasing at urethra opening, itchiness and general mild stinging of urethra has also returned, and my eyes are slowly beginning to get worse. I don't have burning while urinating, and never really did before treatment.
Not sure what to do next.
Do I hold off for a week in total so I can get some clinical tests done?
Do I commence the antibiotic treatment that the specialist suggested, i.e. 250mg azithromycine daily for 6 days, and rifomycin drops for the eyes, over 7 days? And a week after stopping them, then get tested as he suggested?
Or do I take 500mg of azithromycine over three days, as a doctor friend of mine suggested?
Quite confused about what to do. I don't want to make the wrong decision and possibly cause complications for future treatment.
BTW... is gonorrhea always associated with large amounts of a thick discharge? I have no discharge, and only ever had one small drop before antibiotics.
Thank you!
PS... tested negative for HIV, Syphilis and Hep C.
Thanks once again for your help.
I've taken your comments on board, and have decided to hold off launching into a new regime of antibiotics prescribed by the specialist, at least for a few days, so I can better assess the situation.
So far, the symptoms haven't seemed to worsen, and it even appears that my eyes are getting better. Only time will tell. I will endeavour to keep you informed of the outcome!
I've taken your comments on board, and have decided to hold off launching into a new regime of antibiotics prescribed by the specialist, at least for a few days, so I can better assess the situation.
So far, the symptoms haven't seemed to worsen, and it even appears that my eyes are getting better. Only time will tell. I will endeavour to keep you informed of the outcome!
MEDICAL PROFESSIONAL
Thanks for filling in the details. Adenovirus NGU often results from oral sex; I continue to suspect that's what you have had. It sounds like your symptoms are improving gradually, which is the normal outcome. From your description, I cannot judge whether they are improving as a result of antibiotic treatment or because they are just clearing up on their own. If they eventually go away, you can stop worrying about it. Infections like this are rarely if ever harmful in any serious way.
Your doctor doesn't understand how gonorrhea and chlamydia testing works; or maybe he was using an excuse to avoid the bother of testing you. It doesn't matter whether or not the lab is open when the specimen is collected. The specimen can be be saved in the refrigerator for several days before testing is done.
Your doctor doesn't understand how gonorrhea and chlamydia testing works; or maybe he was using an excuse to avoid the bother of testing you. It doesn't matter whether or not the lab is open when the specimen is collected. The specimen can be be saved in the refrigerator for several days before testing is done.
I'm sorry, I forgot to mention that no tests for chlamydia or gonorrhea were done beforehand. I first went to the doctor on a Saturday afternoon, and he said the labs were shut, and that I could take the antibiotics without getting tested if I wanted. Regrettably, I chose to do so as I wanted the problem to be solved as soon as possible.
Thanks!
Thanks!
Dear Dr,
Thank you so much for your prompt reply!
A little about my background. In the three weeks leading up to my first symptoms, I'd had four homosexual encounters. I received and performed oral sex in all of these encounters, and in one, the man I was with inserted my penis into his anus, which lasted all but one second after I refused to have unprotected sex with him. Subsequently, I had a blood test taken last week for HIV etc. The results will be ready in a couple of days.
With the antibiotics I've been taking, there seemed to be an initial reduction in symptoms and they kind of plateaued. The symptoms "down there" are not as pronounced as they were before the antibiotics, but nonetheless, I still feel a sensation... like a very dull pain in the urethra, and there is still a little redness.
Not sure if this doctor will appreciate my informing him of anything. He was pretty aggressive and dismissive, to be honest, which is why I was thinking about seeing another physician.
Hope this info helps.
Thanks again!
Thank you so much for your prompt reply!
A little about my background. In the three weeks leading up to my first symptoms, I'd had four homosexual encounters. I received and performed oral sex in all of these encounters, and in one, the man I was with inserted my penis into his anus, which lasted all but one second after I refused to have unprotected sex with him. Subsequently, I had a blood test taken last week for HIV etc. The results will be ready in a couple of days.
With the antibiotics I've been taking, there seemed to be an initial reduction in symptoms and they kind of plateaued. The symptoms "down there" are not as pronounced as they were before the antibiotics, but nonetheless, I still feel a sensation... like a very dull pain in the urethra, and there is still a little redness.
Not sure if this doctor will appreciate my informing him of anything. He was pretty aggressive and dismissive, to be honest, which is why I was thinking about seeing another physician.
Hope this info helps.
Thanks again!
MEDICAL PROFESSIONAL
Welcome to the forum. I'll try to help. But in judging this, it would be helpful to know about your risk of STD exposure. Can you say something about your sexual lifestyle and relationships, recent new partners, sex or partners, and so on? Also, were tests for gonorrhea and chlamydia not done before you started treatment?
Based on the information provided so far, I doubt you have gonorrhea, which usually causes more prominent urethral discharge than you have described. Instead of squeezing out a very small amount, gonorrhea usually causes profuse yellow pus dripping from the penis. There are exceptions, but they aren't common.
The combination of urethritis with conjunctivitis conceivably could indicate chlamydia, but minocycline is always effective against chlamydia -- so persistent urethral symptoms and onset of eye symptoms while on that treatment rules out chlamydia as a cause.
I think there's a good chance you are infected with adenovirus, which causes around 3-5% of nongonococcal urethritis (NGU) cases. Adeno is mostly a cause of respiratory infections (colds, bronchitis, and sometimes pneumonia), with or without conjunctivitis, but some strains can cause urethritis. Adeno might be even more likely if you had received oral sex in the week or so before your symptoms began. Lack of response to treatment fits with adeno, since no viruses respond to any antibiotics.
Here are three threads that go into adenovirus and NGU. You can find others by using the search link.
http://www.medhelp.org/posts/STDs/Possible-Adenovirus-Urethritis-Conjunctivitis/show/705605
http://www.medhelp.org/posts/STDs/Urethritis-Herpes-or-Other-Virus/show/1113305
http://www.medhelp.org/posts/STDs/Painful-Urination--Antibiotics-havent-worked/show/1041584
Many (most?) doctors are unaware of the adenovirus/NGU connection, and yours might be among them. He might appreciate being brought up to speed. If that's what you have, you can expect your symptoms -- both eye and urethral -- to clear up on their own after week or two. No long term harm will come.
Let me know the missing information about testing and your sexual exposures and perhaps I'll have more to advise. In the meantime, I wouldn't be very worried. This isn't likely anything serious.
Regards-- HHH, MD
Based on the information provided so far, I doubt you have gonorrhea, which usually causes more prominent urethral discharge than you have described. Instead of squeezing out a very small amount, gonorrhea usually causes profuse yellow pus dripping from the penis. There are exceptions, but they aren't common.
The combination of urethritis with conjunctivitis conceivably could indicate chlamydia, but minocycline is always effective against chlamydia -- so persistent urethral symptoms and onset of eye symptoms while on that treatment rules out chlamydia as a cause.
I think there's a good chance you are infected with adenovirus, which causes around 3-5% of nongonococcal urethritis (NGU) cases. Adeno is mostly a cause of respiratory infections (colds, bronchitis, and sometimes pneumonia), with or without conjunctivitis, but some strains can cause urethritis. Adeno might be even more likely if you had received oral sex in the week or so before your symptoms began. Lack of response to treatment fits with adeno, since no viruses respond to any antibiotics.
Here are three threads that go into adenovirus and NGU. You can find others by using the search link.
http://www.medhelp.org/posts/STDs/Possible-Adenovirus-Urethritis-Conjunctivitis/show/705605
http://www.medhelp.org/posts/STDs/Urethritis-Herpes-or-Other-Virus/show/1113305
http://www.medhelp.org/posts/STDs/Painful-Urination--Antibiotics-havent-worked/show/1041584
Many (most?) doctors are unaware of the adenovirus/NGU connection, and yours might be among them. He might appreciate being brought up to speed. If that's what you have, you can expect your symptoms -- both eye and urethral -- to clear up on their own after week or two. No long term harm will come.
Let me know the missing information about testing and your sexual exposures and perhaps I'll have more to advise. In the meantime, I wouldn't be very worried. This isn't likely anything serious.
Regards-- HHH, MD
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Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
