Hi again Doctors, I just had a doubt and wanted to clear it. I had sex with an Indian girl on the 23rd of April 2024. I did use a condom. I am not really sure if it broke or not. I did not really notice a tear. Regardless, around the 2nd week of July, I started having terrible pelvic pain. Started with a perenium pain, burning while urination, leg pain etc. I was given levofloxacin for 8 days. Since it did not work, I took doxycycline + cefixime for 10 days. The pain just persisted. The pain started getting worse. The pain started radiating to my lower back and lower abdomen and my perenium was swollen. I'm also very fatigued. My ultrasound and MRI were normal. However, from the rectal exam, the doctor found out that my prostate was tender. I didnt take any STI tests. My urine analysis was normal. But my semen analysis found a bacteria called enterococcus faecalis. My doctor however said there was a strong chance of sample contamination. He still kept me on ciprofloxacin for 15 days along with Amikacin IV for 5 days. I've also been taking alpha blockers. Almost two months now, I'm still in terrible pain. I'm on linospan along with pregabalin and alpha blockers now. My question is, can this be an STI infection? Can prostatitis be caused by chlamydia or gonorrhea or any other STIs? Can this also be caused by herpes? I also read that HIV can cause prostatitis. I already had an unprotected exposure around February which I had mentioned in my previous question months back. But am I at risk for HIV or herpes or any other STDs? The girl I slept with had 2 partners back in India and has had unprotected sex with them which is why I am kind of in a dilemma. Should I test for all the STDs? Am I at risk here? Again, I'm still not sure if the condom broke or not. My PSA and CRP tests are also normal. Should I be worried about any of the STDs? 

I apologise for writing again. I had forgotten to mention few details. With respect to the exposure in April, I had noticed a yeast type of infection on my fingers after fingering her. I did not eat her out or have sex without a condom. However since Im not sure if the condom broke or not, there is a confusion. If she had some infection like trichomonas vaginalis or any other bacterial or fungal infections, wouldn't I be at risk? Should I get tested for all these? I'm not sure what tests to do however. Also, the exposure in February, I had unprotected sex with her right before her periods started. Infact she got it the same day. However, we had sex before it started. Would these cause any infections?

Welcome back to the forum. I’ll be glad to come out and hope that the information I provide will help you do not worry that your current problems are related to any STI.  From their onset your symptoms have not be particularly suggestive of an STI and are consistent with prostatitis.    Prostatitis is virtually never caused by STI pathogens such as gonorrhea, chlamydia or herpes.  I would discuss with your doctor about the possibility of treating the enterococcus found in your semen culture.---

Hello Dr. Hook, hope you are doing well. Would any of the STIs cause perenium swelling as such and also pain after ejaculation? I also read that HIV can cause prostatitis. Is this true? I'm not sure if I'm at risk for HIV though. Am I? I asked about STIs since I've had an unprotected exposure around February. After that exposure, I had some sort of pain related to the urinary tract similar to what I have now but less intesity. I had mentioned about this earlier in the previous questions. It was resolved when I had IV Ceftriaxone. But it was actually given to me as I had a lung infection parallely. But it had actually cleared out my urinary issues as well. Would there be a chance for it to reappear if it wasnt fully cleared up? Would you recommend urine tests for pathogens like chlamydia, gonorrhea,  trichomonas,  candida etc? I'm on linezolid currently. Nothing seems to help to cure my issue sadly. With respect to the enterococcus faecalis bacteria that was found. Wouldn't it be a sample contamination? Because when they did an antibiotic susceptibility test, they found ciprofloxacin and levofloxacin to be working against the bacteria. But I had both of them and they didn't help. The semen culture test showed that the gram positive cocci were few and that the leukocytes were moderate. The grading of bacteria growth was shown as moderate growth. Couldn't this be a simple contamination? Do I need to get tested for any of the pathogens? If so, how long after the antibiotics do I need to get tested to get accurate results? 

I’m afraid you’ve been misinformed.  I hope you are not searching the internet regarding your problems- much of what is there is incorrect.  For instance, STIs do not cause perineal swelling and HIV does not cause prostatitis.---

Hi Doctor. Thank you for your reply. So few days back, I noticed a jock itch type of itching near my inner thighs. But now when I looked at it. It looked reddish. Has some liquid on it. It does have a pus kind of smell. Doesnt exactly seem like round blisters but it does itch and burn. Not sure if it was because I was itching or if they are herpes. Can this followed by the other symptoms mean that this is genital herpes?

As you know, we provide up to three responses to each clients question. This will be the third and final response, which I’m afraid is going to be somewhat repetitive. Let me in assize that nothing you have described suggests an STI in anyway. Focusing on the possibility of STI will only delay, effective efforts to find out what it is and how to deal with it. This should be done with your own doctors. ---