[Question #13147] Epididimysys

2 months ago

I made a foolish mistake last week and got an Asian massage. She gave me a gentle handjob but proceeded to further finger in my rectum. Three days ago started having significant groin, pain and testicle pain. I'm concerned that maybe she was with someone prior to me and still had stuff on her hands or whatever that could've transferred infection to me. I am in the medical field and did not have access to injection, but did prescribe myself cefexime 800 mg at one time along with 2gram of azithromycin at one dose. I took that on Wednesday at 4 o'clock and today I'm feeling about 70% better. I still have the groin pain and things, but I feel like it's getting better. No discharge or anything and never had.

1) how successful would that treatment be and should I go for the 500 rocephin injection along with 10 days of doxycycline?

2) would it be wise to get a pcn shot?

3) being that my symptoms are subsiding to a degree. Would you think that that course of antibiotics will be sufficient to clear any infection?

4) I have not tested so I did not confirming anything, but treatment is working. Should I test, and if so, when?

5) how reliable with testing be since I started on antibiotics?

6) I'm currently out of town. I'm wondering if any alcohol consumption would diminish the antibiotic I took yesterday.?

7)I have a strange smell in groin as well and seems to be less.

8) what further would you do in this situation??

Edward W. Hook M.D.

2 months ago

Welcome back to the Forum. I'll be glad to comment. My sense is that you have not done yourself any favors by self medicating for the symptoms you describe. Your receipt of masturbation by your masseuse was a no risk event for all STIs including HIV - receipt of masturbation is a no risk event and no one has ever acquire an STI from transfer of genital secretions from one infected person to another on their hands- you are not going to be the first. Further, you have clouded the effort by taking antibiotics when you did not know what you had. Rather than further self-medication I suggest that you see a trusted physician who can try to sort things out for you with a careful physical examination and testing. In answer to your specific questions:

1) how successful would that treatment be and should I go for the 500 rocephin injection along with 10 days of doxycycline?

You do not know what is going on. Further treatment might or might not work but it will only confuse things. There is a saying that "A physician who treats himself has a fool for a patient."

2) would it be wise to get a pcn shot?

3) being that my symptoms are subsiding to a degree. Would you think that that course of antibiotics will be sufficient to clear any infection?

See above.

4) I have not tested so I did not confirming anything, but treatment is working. Should I test, and if so, when?

See above. I would get evaluated as soon as possible.

5) how reliable with testing be since I started on antibiotics?

Testing may or may not be compromised

6) I'm currently out of town. I'm wondering if any alcohol consumption would diminish the antibiotic I took yesterday.?

Alcohol consumption would not impair the effectiveness of antibiotics

7)I have a strange smell in groin as well and seems to be less.

Nothing to add

8) what further would you do in this situation??

Go see a doctor.

EWH

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2 months ago

So I understand it wasn't the best move to treat myself, but I was in pain and was getting worse. Sometimes you just have to go with your gut as a physician and treat empirically without all the information you need. ALL THE SYMPTOMS fit of a STD whether it be GN/CN and I took that and treated. With that said and as dr to dr

1)if I am getting better with treatment (800 mg cefexime/2g azithromycin, should I still f/u with urgent care or my dr?

2)if gonorrhea, how long does discord stay after treatment?

3)what is complicated vs uncomplicated gonorrhea and what is difference in treatment?

4)trying to keep quiet in my community as medical community small and talks and lack of discretion sometimes so that's why im here

5)if she had secretions from other client on her fingers and inserted into me, very possible I got infection from her and I blame myself.

6)if getting better though and reasonable that you got gonorrhea or chlamydia, would you as a treating physician and without lab tests(that now are unreliable)treat with the rocephin 500mg IM/doxy 100 mg bid x 10 days?

I made a HUGE mistake and have to keep discreet as people around here talk. But I know I got something infectious from her and have to cure IMMEDIATELY as our anniversary is coming up and I want to be safe.

Thank you

Edward W. Hook M.D.

2 months ago

You and I are going to disagree. The symptoms you describe ( "significant groin, pain and testicle pain" ) do not suggest an STI and the activities you describe did not put you at risk for STI.

1)if I am getting better with treatment (800 mg cefexime/2g azithromycin, should I still f/u with urgent care or my dr?

I would. Your symptoms remain unexplained.

2)if gonorrhea, how long does discord stay after treatment?

I presume you mean discharge, not discord. You did not mention the presence of discharge in your original post. If you had discharge due to an STI, it would have resolved in a few hours after successful treatment.

3)what is complicated vs uncomplicated gonorrhea and what is difference in treatment?

Persons with complications of gonorrhea typically require longer periods of treatment.

4)trying to keep quiet in my community as medical community small and talks and lack of discretion sometimes so that's why im here

If you are health care provider, you know that patient confidentiality is essential. You should be able to seek evaluation for your symptoms'

5)if she had secretions from other client on her fingers and inserted into me, very possible I got infection from her and I blame myself.

It is not possible for STIs to be transmitted in this way.

I repeat, there is no reason nor evidence to suggest that your symptoms were due to an STI

EWH

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2 months ago

So epididymis hasn't been "officially" diagnosed but 99% positive that's the issue at hand. I'm assuming that by symptoms onset, Gonorrhea/similar is the organism.

1)what was meant to sat period is: how long after taking Suprax will "discomfort"(not discord) go away? There has never been any discharge?

2) I know that Suprax is bacterialcidal, but one dose of 800 mg can kill gonorrhea? Don't need to take longer?

3)can one rely on treatment if symptoms are subsiding?

4)regarding #3, can one rely on one dosage if symptoms go away, or could infection still linger without symptoms and still infectious?

5)does complicated gonorrhea include epididymis?

6)if epididymis/related to gonorrhea , which IS STRONG possibility, is it reasonable to think one dose of Suprax would kill it?

7)last, is 2g once of azithromycin as effective as doxycycline for 10 days?

8)do you really need to retest in 90 days to make sure of cure of both gon/chly

I understand your reasoning, I do, but I need to. Nix this STAT!!!

Edward W. Hook M.D.

2 months ago

It is said that "A physician who treats himself has a fool for a patient.". You are either not understand what I have told you or are ignoring it to pursue your own misunderstanding. This will get the final response and then the thread will be closed. Please do not return, I have nothng more to add.

You do not know that you have gonorrhea and the symptoms you describe do not suggest either epididymitis or gonococcal urethritis.

1)what was meant to sat period is: how long after taking Suprax will "discomfort"(not discord) go away? There has never been any discharge?

More evidence that you DO NOT have gonorrhea following your no risk encounter. Well over 90% of persons with gonococcal urethritis and nearly all with gonococcal epididymitis have an obvious discharge

2) I know that Suprax is bacterialcidal, but one dose of 800 mg can kill gonorrhea? Don't need to take longer?

This dose would cure most gonococcal urethritis.

3)can one rely on treatment if symptoms are subsiding?

Not when you do not know what you have. Your symptoms may have ressolved on there own.

4)regarding #3, can one rely on one dosage if symptoms go away, or could infection still linger without symptoms and still infectious?

Repetitive. See above

5)does complicated gonorrhea include epididymis?

Yes

6)if epididymis/related to gonorrhea , which IS STRONG possibility, is it reasonable to think one dose of Suprax would kill it?

Single dose therapy is not the recommended treatment for gonococcal urethritis.

7)last, is 2g once of azithromycin as effective as doxycycline for 10 days?

Amost

8)do you really need to retest in 90 days to make sure of cure of both gon/chly

Not if symptoms have resolved

This thread is over. EWH

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