[Question #11161] Mycoplasma Genitalium?

16 months ago

Hey Drs,

This is a follow on from my previous post which Dr Hook responded to. Regarding unprotected oral sex. The dr now wants to test me for mycoplasma genitalium after the negative gonarrhoea and chlamydia results, given that im still exhibiting some symptoms 11 days post exposure. To be sure there is no STI. Im abit upset why my previous dr didnt test for MG, and now i have to put myself through another weekend of anxiety.

What is the likelihood that this is MG given my symptoms and that i was the one receiving oral?

What is the recommended treatment for MG, ive read arythromycin is the first line of defence but ive seen in your previous posts u recommend myloxifan?

Is 2 weeks post exposure not too late for treatment?

If it is MG wouldnt there have been changes in my urine ie WBCs or culture test?

My next question is if this isnt MG? Can we confidentally conclude i do not have an STI which i can pass onto a sexual partner?

I just want to be 100% certain i dont have anything else i can pass on.

I will keep you posted on the result.

H. Hunter Handsfield, MD

16 months ago

Welcome back, but it really wasn't necessary.

I reviewed your discussion with Dr. Hook and agree with all he said. The problem here is that the doctor you are seeing may misunderstand Mycoplasma genitalium. It rarely infects the oral cavity, therefore not a risk from oral sex. In addition, as Dr. Hook advised you, your symptoms are not typical for any STD -- and M. genitalium is not known to cause epididymitis, prostatitis, etc; and also its symptoms generally do not appear sooner than 7-10 days after exposure. Finally, expert recommendations (e.g. from CDC) advise against testing for M. genitalium in circumstances like yours -- the main reason for testing is when NGU is treated but not cured.

If you go ahead with testing, you can expect a negative result. (If positive, it will not be from the sexual event described to Dr. Hook.) There is little point in addressing M gen treatment until and unless you test positive. Feel free to return at that time. In the meantime, you can confidently conclude right now that you have no STI from the exposure described and nothing that you can pass on to a sex partner.

HHH, MD

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16 months ago

Hey Drs, its been exactly 3 weeks since unprotected oral event, okay theres been a few updates since my last post. I tested negative to Mycoplasma and did Testes US which was unremarkable as well as negative for genital herpes. Despite all this and negative STI tests i was still experiencing some residual symptoms which no has been able to explain why. One of them being foreskin irritation (uncircumcised) i believe this was due to my increased urination causing my foreskin to be damp, one Dr recommended me to use Hydrozole on the area, which i proceeded to do so for 3 days, after which i ceased. 1 day after stopping the hydrozole i experienced a worst pain than the original one i experienced 3 weeks ago. I would describe it as a combination of soreness, and cold heat. I believe it this may have been caused by the hydrozole which came into contact with the head of my penis when my foreskin would roll down. Went to a different dr and after looking at my penis noticed it to be quite inflamed and red. He has diagnosed me with Fungal balanitis and has me on Canestan antifungal cream which ive been using for the past 2 days. My question is was my original diagnosis from the beginning fungal balanitis? does that explain all the negative STI testing? I dont think so because orginally what i was feeling was more a generalised pain my my scrotum. However I do remember when all this started i did notice some cheese like substance from my penis, but dismissed it. And also could what im experiencing now be be bacterial balanitis? My dr did swab my penis for Candida and am awaiting the result. I really hope the Canestan can finally resolve my symptoms.

H. Hunter Handsfield, MD

16 months ago

Thanks for the follow-up information. Of course I'm not surprised at your negative test results. But I'm afraid we can't be of further help. First, you're in the care of your own doctors who, based on your description, seem to be on top of the problem. I agree with everything they have advised and recommended. Second, the forum is not a venue to address all genital infections or genital symptoms. Of course we often have views on non-STD symptoms before the diagnosis is secure, but once STDs are out of the picture, our advice ends. I'll also add that the average urologist has a lot more experience with problem like you have described than STD experts do.

So my closing advice is that you 1) stop worrying about STDs; you don't have any. 2) Continue to work with your doctor as needed for continuing symptoms, treatment advice and so on.

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