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Ex-fiance's penis infection - NGU? Bad Test Results?
Hi. I hope you can shed some light on what might have caused my ex-fiance’s penis infection. A few months ago (when we were still together), I noticed he felt warm. When I mentioned it to him, he said he’d been having discharge from his penis and it felt itchy/tingly inside. He milked some of the discharge out and it was creamy and white. He is 35 years of age.
The next day, he told me he had squirted Bactine in his penis, and that (although extremely painful) it seemed to be helping his symptoms. He also said that based on pictures he’d seen on the Internet, it looked like gonorrhea. He went to urgent care, where he was tested for gonorrhea and chlamydia, and diagnosed with urethritis (pending the test results). I’m pretty sure he received two antibiotics, one of which was azythromycin. Whatever they were, they knocked out his symptoms in about 3 days.
Out of precaution, I was also tested for gonorrhea and chlamydia. I was also tested for trich, and given a full health screening. All of our test results came back negative, except my doctor found a bit of yeast. To this day, my fiance denies having been with anyone else, but I’m not so sure. The only sexual contact we had in the preceding month was about 4-5 days before his symptoms developed. I was getting over a cold/flu-type infection, so I guess it could have been caused by adenovirus, but wouldn’t the symptoms of NGU take longer to develop and wouldn’t the discharge be more clear? Could the Bactine have interfered with the test results? Finally, would the yeast have caused these types of symptoms in a man?
The next day, he told me he had squirted Bactine in his penis, and that (although extremely painful) it seemed to be helping his symptoms. He also said that based on pictures he’d seen on the Internet, it looked like gonorrhea. He went to urgent care, where he was tested for gonorrhea and chlamydia, and diagnosed with urethritis (pending the test results). I’m pretty sure he received two antibiotics, one of which was azythromycin. Whatever they were, they knocked out his symptoms in about 3 days.
Out of precaution, I was also tested for gonorrhea and chlamydia. I was also tested for trich, and given a full health screening. All of our test results came back negative, except my doctor found a bit of yeast. To this day, my fiance denies having been with anyone else, but I’m not so sure. The only sexual contact we had in the preceding month was about 4-5 days before his symptoms developed. I was getting over a cold/flu-type infection, so I guess it could have been caused by adenovirus, but wouldn’t the symptoms of NGU take longer to develop and wouldn’t the discharge be more clear? Could the Bactine have interfered with the test results? Finally, would the yeast have caused these types of symptoms in a man?
MEDICAL PROFESSIONAL
Welcome to the STD forum.
Your partner clearly had urethritis. Most urethritis is due to STD and from your description, I agree that gonorreha was a good bet, although chlamydia or nongonococcal urethritis (NGU) also are possible. It was a mistake for him to try to treat himself with Bactine or anything else (man, that must have hurt!). But it probably didn't make much difference in the long run and I doubt it affected the test results. The tests for gonorrhea and chlamydia are highly accurate, and with those results negative for both of you, most likely there is another explanation.
Your partner was treated appropriately, especially if the other antibiotic was ceftriaxone (an injection) or cefixime (2-4 pills at once). However, you do not say whether you were treated. This is essential, regardless of your test result. The tests aren't perfect and you should not resume sex with your partner until a week or so after both of you have completed treatment with drugs that target, gonorrhea, chlamydia, and the nonchlamydial causes of NGU.
Most NGU is a traditional STD, even when the exact cause cannot be found -- so you are right to question whether your partner had sex with other people recently. However, there are exceptions, and NGU isn't all that rare in monogamous couples. You could be carrying a nonchlamydial STD from some past sex partner; and sometimes entirely normal bacteria in the mouth may cause NGU (if oral sex is among your usual practices). Your speculation about adenovirus also is plausible, given your recent upper respiratory symptoms. Yeast is a rare cause of NGU, if it happens at all -- and would not respond to the antibiotics that were used.
Most likely clear answers will never emerge; sometimes these things just can't be sorted out with currently available diagnostic methods. If your partner seems honest about not having other partners, most likely he is being truthful. The important thing now is that you also be treated, if that hasn't been done.
I hope this helps. Best wishes-- HHH, MD
Your partner clearly had urethritis. Most urethritis is due to STD and from your description, I agree that gonorreha was a good bet, although chlamydia or nongonococcal urethritis (NGU) also are possible. It was a mistake for him to try to treat himself with Bactine or anything else (man, that must have hurt!). But it probably didn't make much difference in the long run and I doubt it affected the test results. The tests for gonorrhea and chlamydia are highly accurate, and with those results negative for both of you, most likely there is another explanation.
Your partner was treated appropriately, especially if the other antibiotic was ceftriaxone (an injection) or cefixime (2-4 pills at once). However, you do not say whether you were treated. This is essential, regardless of your test result. The tests aren't perfect and you should not resume sex with your partner until a week or so after both of you have completed treatment with drugs that target, gonorrhea, chlamydia, and the nonchlamydial causes of NGU.
Most NGU is a traditional STD, even when the exact cause cannot be found -- so you are right to question whether your partner had sex with other people recently. However, there are exceptions, and NGU isn't all that rare in monogamous couples. You could be carrying a nonchlamydial STD from some past sex partner; and sometimes entirely normal bacteria in the mouth may cause NGU (if oral sex is among your usual practices). Your speculation about adenovirus also is plausible, given your recent upper respiratory symptoms. Yeast is a rare cause of NGU, if it happens at all -- and would not respond to the antibiotics that were used.
Most likely clear answers will never emerge; sometimes these things just can't be sorted out with currently available diagnostic methods. If your partner seems honest about not having other partners, most likely he is being truthful. The important thing now is that you also be treated, if that hasn't been done.
I hope this helps. Best wishes-- HHH, MD
MEDICAL PROFESSIONAL
The urgent care doctor is mistaken. No STDs are transmitted with 100% efficiency. Couples often have sex many times without transmission taking place, only to the have it happen long into a relationship. Admittedly this is more and more unusual the longer a relationship goes on, but it's still possble. Don't get me wrong: this is probably an STD and I'm not saying there were no other partners. Only that it is often difficult to know for sure, and when there is uncertainty it is often wise to give a partner the benefit of the doubt. I'm not sure I agree that this "leaves normal mouth bacteria or adenovirus as the more likely culprits". It is true that NGU usually causes less think, more clear/cloudy discharge than gonorrhea. But there is a whole lot of overlap, with gonorrhea with clear discharge and NGU with overt pus. Appearance of the discharge is only a clue, nothing more.
You definitely should be treated. If your doctor won't treat you with a combination of drugs active against gonorrhea, chlamydia, and NGU (e.g., cefixime plus either doxycycline or azithromycin) find one who will.
I think that's as far as this thread can go. Sorry I can't give more definitive answers.
You definitely should be treated. If your doctor won't treat you with a combination of drugs active against gonorrhea, chlamydia, and NGU (e.g., cefixime plus either doxycycline or azithromycin) find one who will.
I think that's as far as this thread can go. Sorry I can't give more definitive answers.
Thanks for your help, Dr. Handsfield.
I wondered whether one of us could have been carrying this from a past relationship, but since we had had sex (including oral sex) many times before in the year and a half prior to this occurring, the urgent care doctor told him it wasn't possible and that he had contracted it in the past week. (It had also been years since I'd had any prior sexual encounters.)
So I guess that leaves normal mouth bacteria or adenovirus as the more likely culprits, if I am understanding you correctly. I guess these are possibilities, but I was under the impression that the discharge from these types of NGU would be more clear or cloudy and would take more than 4 or 5 days to develop. Also, would these types of NGU respond to antibiotics?
I realize I may never have the answers, but to the degree I am able, I'd like to educate myself on the possibilities. By the way, my doctor did not treat me (other than telling me to buy OTC medication for the yeast) since my other test results came back negative, but it sounds like I should go back in and ask him to treat me anyway. Thanks for the advice.
I wondered whether one of us could have been carrying this from a past relationship, but since we had had sex (including oral sex) many times before in the year and a half prior to this occurring, the urgent care doctor told him it wasn't possible and that he had contracted it in the past week. (It had also been years since I'd had any prior sexual encounters.)
So I guess that leaves normal mouth bacteria or adenovirus as the more likely culprits, if I am understanding you correctly. I guess these are possibilities, but I was under the impression that the discharge from these types of NGU would be more clear or cloudy and would take more than 4 or 5 days to develop. Also, would these types of NGU respond to antibiotics?
I realize I may never have the answers, but to the degree I am able, I'd like to educate myself on the possibilities. By the way, my doctor did not treat me (other than telling me to buy OTC medication for the yeast) since my other test results came back negative, but it sounds like I should go back in and ask him to treat me anyway. Thanks for the advice.
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