[Question #1488] symptoms after test and treatment, very worried situation

81 months ago

Hi doctor, I live in South America, and I really need your help here. 


Married 5 years ago. After a fight with her, I made two terrible mistakes. Firts: 11/17 receive oral sex from a woman (good reputation person) for 2-3 minutes. Them, the 11/21 receive unprotected oral sex from another woman for 10-20 seconds (not so good reputation person). After that, the very next day the 11/22 I began to feel strong burning sensation after urination and discomfort in the urethra...so I began to masturbate to see if with the eyaculation the pain was the same (and it was) and after doing it like 3 times to try it, i found like a small spot of a white discharge (like pus, but very very small, like half drop) after pulling from the base several times my penis looking for something... after this, I was so freak out that I took 1.5 of Azitromicin that night.


 Next day (11/23), I visit my doctor, with pain after urination and having now like a very clear discharge, size of a small drop (like pre-cum) but only if I pull my penis from the base very hard. The doctor to be sure after the Azitromicin, requested me to do a urine urocultive, a Gram coloration test (I think is the same gram stain) and a urethra cultive swab... and after having doing that, to receive a Rocephin 1gr shot.


 Three days later (11/25), all the test came negative of anything (no bacteria) everything was normal... I don't know if those test are specific for Clamidia or Gonorrhea, but my doctor said that if I have it, the urethral swab cultive and Gram coloration it will be positive for those. 


Well, anyway, the (11/30) seven days later after receiving the shot of rocephin, I have repeat the same three test. Urine uroanalysis, urethral swab, and Gram coloration... all negative for bacteria, everything is normal, but my symptom persist..(discomfort and pain during/after urination and a very small drop of clear like pre-cum discharge after like pulling/pushing my penis hard). 


So I visit other doctor, and he told me that Gonorrhea can't be because my gram test came neg twice, and also because I took the rocephin shot of 1gr. that it could be NGU, he send me this: 1gr of Azitromicin for three days, 2 Gr of tinidazol (flagyl) only one time, 500 mg Ciprofloxaxine for two days, and 200 mg of Doxycicline per day for 10 days.


  I finish ALL that including the Doxycicline (today is 12/11) and I'm having the same symptoms (I think no so hard like the beginning) but I have it (burning after urinate and that very clear small discharge if I pull/push my penis)... I'm so freak out about this, because my wife wants to have relations with me, is vacations time, and I think I have a std... I think that I can't make more those tests because my body is full of antibiotics right now, and I don't know what to do.


 Questions:1- those test are good to diagnosis? 2- why I'm having same symptoms After all those antibiotics? 3- do I have gonorrhea, or NGU, or what? 4- can I have sex with my wife again? 

5- I need to test for HIV? Even for those small oral sex events? Or you think better to request to those woman's to do the HIV test to be more calm? Please help... 

Edward W. Hook M.D.
81 months ago

Welcome to our Forum.. I happened to come to the site soon after your post arrived and will comment on your concerns.  To receive and answer so quickly however is quite unusual.  Follow-up responses will almost certainly be slower. 

Before I get to your specific questions, let me provide a general comment.  It appears from your post that you are very anxious and perhaps feeling guilty about your recent exposures.  As a result, you are also over reacting.  I sincerely doubt that you had any STI to begin with as STIs are rare following oral sex but if you did, virtually all bacterial and protozoan (i.e. trichomonas)STIs would have been cured by the therapies you have received.   Further, the "discharge" you have found is almost certainly normal secretions that you have squeezed out of your penis.  I urge you to stop squeezing- if there were a true, disease-related discharge, you would not need to squeeze/strip your penis to find it. 

 Questions:1- those test are good to diagnosis? 

No further diagnostic testing is needed.   Further testing after the treatment you took is a waste of time.

2- why I'm having same symptoms After all those antibiotics? 

Please see my comment above.  Sometimes when persons concentrate on their genitals following an exposure that they wish they had not had, they notice normal sensations that would usually be overlooked.  I suspect that this is what you are experiencing.

3- do I have gonorrhea, or NGU, or what?

You MAY have had non-chlamydia NGU following your exposures but at this time, you would have been cured by all the medicine that you took.

4- can I have sex with my wife again? 

There is no reason to abstain from unprotected sex with your wife related to the exposures you have described. 

5- I need to test for HIV? Even for those small oral sex events? Or you think better to request to those woman's to do the HIV test to be more calm? 

There is no need for HIV testing.  There are no proven cases of HIV acquired by receipt of oral sex.  You will not be the first.

I hope that the information I have provided will be helpful to you.  I urge you not to worry further, not to seek further testing, not to squeeze/strip your penis further, and not to worry.  EWH

81 months ago
Thank you very much for your respond. 

 You right with your statement that I'm freak out/anxious about the situation that I have experience with this two woman's.

  I think that maybe I got like you said a NGU (or even Gono) and with all the treatments that I have take it, is now full cured,  and the only explanation for the burning sensation that I still have is like  "remain symptoms" that doesn't mean that and infection is still there, right? 

 My last question, and more for general purpose and knowledge about STD. In a very hypothetical situation like this (that of course was my case with the second girl that I know do not have good reputation), from a very short receiving oral sex of 10-20 seconds, and the person REALLY get infected with Gono (because the person giving, have Oral Gono) if she also have HIV, can I get too the HIV in that very small contact? Let me try to explain it better, the HIV virus go by hand with Bacterial deseases? Or a person that get Gono from a person that also is HIV+, can get only Gono and no HIV because the risk relation was a very low risk one  (like receiving oral for 20 seconds)? 

   Because I think that I have read in other questions/webpages, that only if you have an STD from the past (like for example Urethral Gono) you have more probabilities of getting HIV from a HIV + person, because almost all STD (like Gono) have inflammation responds and that means that is more easily to get the virus into your blood system, is that right? Or I'm wrong, and is like the above comment, that HIV go by hand with the STD's, and if you get a STD you get for surely HIV if that person is HIV+.
   Thanks for your time, effort and all the work you have been doing for so long... you are a very important person for a lot of people searching for answers! Congratulation from quite a lot of person that come here only to read 

Edward W. Hook M.D.
81 months ago

There is no reason to think that you are still infected with ANY STI from the encounters you describe, if you were ever infected (which I doubt).

No one has ever been proven to have gotten HIV from receipt of oral sex- no one!  Even if your partner had HIV and gonorrhea and you got gonorrhea, there would still be no known risk for HIV!. 

While persons who have STIs are at increased risk for HIV, there are still NO proven cases of HIV acquired from oral sex- None, Zero, not one!  Thus there is no risk to you for HIV.    EWH

81 months ago
Thanks for your reply and time doctor.

   100% cleared about the chance of HIV, so that subject is already close, thanks for your explanation.

  Concerning my problem in the urethra, since your reply past Sunday until today (4days) i have clear my mind doing exercise, working healthy and not squeezing my penis anymore! Even just taking my daily bath, not looking for any discharge, anything.

   But,  mainly after urination, I'm still having a notable burning sensation and discomfort (Believe me, is a real sentation that bother me a lot, causing me being in mad mood)... I don't know if after all the treatment's that I had taken (Ceftriaxone 1gr, Cipro 1gr, Zitro like 4.5gr, doxy 10 days, and tinidazol) there is like a "remain symptoms" that take some time to clear, and that is the only explanation in this case, what do you think? 

  I'm a focus person and your advise will be sincerely taken to look for a good vacations time with my family. 

 Need more test? Visit a new doctor? Treatment? Thanks... 
Edward W. Hook M.D.
81 months ago

Congratulations on moving forward.  It sounds like you have a good strategy for clearing your mind of these concerns and it is working. 

Discomfort AFTER urination is not a symptom typical of STI.  My guess is that the continued irritation reflects the healing process for the urethra and I am confident that it does not suggest any STI.  I anticipate that it will continue to improve.  I certainly do not think that additional testing or treatment is needed.  If it persists more than another week, my advice would be to see a urologist.

This is the third reply to this set of questions. Therefore, as per our Forum Guidelines, this thread will be closed later today.  EWH