Patient: I have had clear discharge from my penis for about two months it started 3 days after i had oral/anal sex. Since 3 weeks I have been having some pain in my testicles. It does not hurt when I walk or anything but i feel a bit of discomfort when I shower for example. I was given 1 gram of zithromax and 250 mg of Ceftriaxone a week after the sympoms. Later i took doxycyclin 2 times per day for 2 weeks. And then levifloxacin for 2 weeks. No improvements. 1 month after it started i did the following STD test and it all came back negative:- Chlamydia trachomatis- Neisseria gonorrhoeae- Mycoplasma hominis- Mycoplasma genitalium- Trichomonas vaginilis- Ureaplasma parvum- Ureaplasma urealyticumA few days ago I took a urineanalysis (white/red blood cells /bactieria etc) and it all looked normal.Not sure if i ever had an STD or if the antibiotics killed it. What other STD / infection could it be and what else could (prostatis etc?) it be that the antibiotics did not kill since I still got symptoms?
Symptoms: Clear discharge.
Doctor: Hello,Thanks for the query to ATD for an opinion,The fact that you had a clear discharge and testicular pain indic ated that you contracted an infection indeed for which you were rightly given zithromax and ceftriaxone course. The std screen came back negative probably because you were already treated when you got the screen done. The most likely organisms have been screened already but if you still suffer from discomfort and testicular pain then there is a possibility that you may have just E.COLI or enterobacter , or streptococcus fecalis infection which can remain persistent even with these antibiotics, which may be resistant. So it is advisable to get a urethral culture and a urine culture done as well to rule out any epididymo-orchitis or accompanied prostatitis.I hope this would healp,Wishing you good health,Regards
Comments / Follow Ups
Patient: Hi. I did the urine culture and urine analysis. They came back negative. The doctor felt my prostate and said it seems normal. I could not really feel any discomfort when he touchede it. Since about a week ago i started having pain in my perineum as well and the clear discharge (Im thinking it might be sperm). The pain in the perineum MIGHT come from when i drove motorbike and drove down a hole, and it hurt my but a bit but the pain the the perineum came 2 days after, so not sure if it can be that or if its related to the discharge i experience from my penis. The doctor said we should wait with doing a test from massaging the prostate since he did not wannna irritate it. He gave me anti inflamatory and alpha blockers. What else could be the diagnosis?
Doctor: If there is no std or infection and prostrate not involved then this could be a seminal discharge itself due to stress or perineal weakness, but the symptoms do not corroborate with the findings. So one needs to depend on investigation reports . The cultures were negative due to antibiotic course anyhow now. So i would go with your physician’s advise at present.
Patient: Hi. Can you clarify please, I dont understand. And it was 2 weeks ago I ate antibiotics before I did the culture, so it should be OK. Is it possible that it is candida inside?
Doctor: candida is a possibility but an unlikely organism in the urethral tract. Candida has to be grown in Sabourard medium and not in any other culture medium. You may seek a urethral culture for candida again.
Patient: I still hurt my perineum it feels like it’s a ball I’m sitting on. It’s sensitive when in touch my perineum. But it does not hurt when I pee. Would you guess it’s prostatitis or tension in muscles?
Doctor: I would suggest please get a surgical examination done and rectal exam may be necessary by the surgeon.