• Received unprotected oral sex from a sexual female worker on 3/12/24; Feel itchy on the tip of my urethra/penis and burning during pee the 1~2 days after the exposure. Burning pee relief after three days of OFLODAL, and then I took another four days of DOXYCYCLINE, still feel discomfort irritation & pain within the urethra & scrotal. 
• The urine test 2 weeks after exposure showed WBC normal, NIT positive, no bacteria could be isolated, likely due to the previous 7 days of antibiotic; The follow up urine test were all normal. Had STD panel test ( syphilis, gonorrhea, chlamydia trachomatis, 4th gen HIV & Herpes I & II igm/igg) at 1, 2, 4 & 6 weeks after the exposure, all came back negative; 
• Meet a urology doctor 6 weeks after exposure and he checked my prostate and stated that it is good. He suspected my discomfort in the urethral was due to a virus infection and prescribed me Valacyclovir 2 x 500 mg/day for 14 days.  I also feel discomfort & pain around the enter of my anal & lower back after the finger exam.
  
• The discomfort in the urethra seems to be relieved for a week after treatment but the irritation/pain came back after, it get worse every time for ~ 24-48 hrs after masturbating and then it recovers to the baseline level of discomfort.
• Questions:

1. Does my symptoms sound like Herpes or prostatitis? Any other test I can be screened, such as mycoplasma genitalium/ Mycoplasma hominis/ Ureaplasma anaerobic bacteria?
2. I plan to do another STD screen test at 12 weeks after the exposure. If 12 weeks still show HSV IGG negative,  may miss up to 30% of HSV1 infection. Should I do western blot test at 16 weeks for a definite answer?

• 3/14-3/15: Burning pee relief after three days of OFLODAL but still feels mild discomfort irritation & pain
• 3/20-3/23: Took DOXYCYCLINE (HCL) for 4 days, still feels discomfort irritation & pain within the urethra & scrotal 
• 3/24 (12 days): Emergency room, a urinalysis test showed that white blood cell normal, NIT positive, bacteria negative, no aerobic bacteria can be isolated; The doctor claimed that the NIT positive indicated that i may got bacteria infection but the antibiotics treatment in the past few days had killed the bacteria, so nothing can be cultivated. On the same day of the doctor's visit, I also got 1000 mg of Azithromycin and cephalosporin injection as a pre-treatment for potential Gonorrhea.
• 3/30 (18 days): The follow-up urinalysis test showed that white blood cells were normal, NIT negative and trace bacteria;  However, no aerobic bacteria can be isolated;
• I had another two urinalyses after 29 days (4/10) & 43 days (4/24)of exposure, all came back normal ( white blood cell normal, NIT negative, no bacteria). 
• Had STD panel test ( syphilis, gonorrhea, chlamydia trachomatis, 4th gen HIV & Herpes I & II igm/igg) at 1, 2, 4 & 6 weeks after the exposure, all came back negative; The test at 6 weeks were HeperSelect test from LabCorp.

4/24: Meet a urology doctor 6 weeks after exposure and he checked my prostate and stated that it is in good condition. He suspected my discomfort in the urethral was due to a virus infection (likely herpes) and prescribed me Valacyclovir 2 x 500 mg/day for 30 days. The finger exam was painful and my anal & lower back felt pain & discomfort for a whole two weeks!!! The discomfort in the urethra seems to be relieved for a week after treatment but the irritation/pain came back after.

5/10 (60 days): Completed two weeks of Valacyclovir but still feel mild discomfort irritation & pain (level 2 out of 10) within the urethral over the past few weeks;  It get worse every time for ~ 24-48 hrs after masturbating and then it recover to the baseline level of discomfort. I also feel discomfort & pain around the enter of my anal & lower back after the finger exam