[Question #3116] Did I acquire STD

38 months ago
Well, I'm back again.  Perhaps I should just stop having sex.  Here we go.  December 3rd had unprotected vaginal sex.  Knew lady for a week.  Wore condom but it broke and we did not know until it was over.  
December 19 noticed very mild burning sensation before urinating.  It stopped completely after stream started.  I thought about it for a couple hours and took an Augmentin tablet 875/125.  Took another one the morning of the 20th.  Thought about it some more and went to a clinic on the 21st.  Asked for the full panel.  Could the augmentin cause a false negative?  Did I ward off impending discharge with it?  Everything is back as negative except for G,C,T.  Won't have those until Tuesday.  Burning sensation is still there but a little bit better.  Urinating much more often now.  And feel like I am peeing sometimes when I am not.  No tenderness or inflammation at all around meatus.  No discharge at all.  Dull, intermittent (non burning) pain in penis now.  Dull constant pain between scrotum and anus.  It is NOT tender to touch.  Urine stream is still very slow to come out.  The mild burn is now there sometimes and other times not.  Still very mild and always gone once urination starts.  I suppose I am wanting you to look into a crystal ball to cure my anxiety until Tuesday.  I know you can't.  But I have a lot to lose if I am positive for these.   I have tried to remember everything relevant.  Please tell me your opinions.  And thank you SO MUCH in advance.
Edward W. Hook M.D.
Edward W. Hook M.D.
38 months ago
Welcome back to the Forum. I do not think you need to give up sex going forward but there are things that you can do to make your future exposures to new partners less risky.  Condoms are a good start but, as you experienced, they do fail from time to time, most often during sex with a new partner (but still less than 2% of the time).  Another thing you can do to reduce risk is to not self-medicate when you are concerned about STIs. Different STIs require treatment with different antibiotics and there are no longer ANY STI for which  one or two Augmentins are routinely recommended for treatment.  Self medication of the sort you practiced will only confuse things. 

The Augmentin you took could change the manifestations of an STI, if present and could make a test falsely negative.  Your test results will be very helpful, and I suspect show that you were not infected.  You may wish to re-test if the results are negative and your symptoms persist although I suspect you are not infected (Remember, most people do not have STIs and most exposures do not lead to infection).  As far as your symptoms are concerned, urinary frequency is not suggestive of STIs, nor are intermittent symptoms of any sort such as pain in the penis or discomfort between the base of the penis and the anus.

I hope this information is helpful.  To summarize, the overall risk for infection is low but if you were unlucky, the Augmentin could have masked an infection.  I would suggest:
1.  Awaiting test results
2.  If your test are negative, while this is good news, the results are not definitive and I would suggest re-testing.  I hope this comment is helpful.  EWH
---
38 months ago
Thank you Dr. Hook!  If you don't mind,  I would like to explore this further just a bit.   If it's not STD, then this is just coincidence?  This has never ever happened before.  The fact it came on 16 days after caught my attention.  Isn't that time for incubation.  Do you normally see some sort of discharge with this?  I am holding on to that as a positive and some sort of indication that maybe I am not infected.  while agonizing over taking that Augmentin.  I was so wound up I was not thinking right.  I agree about the self medicating.  But I am at the point that a bottle of alprazolam,  if I had it would not work.   And finally Dr. Hook, if I am positive for any of those three, are there any symptoms I should have that I am not?  I do not mean to bother you, but I am really freaking out here.  LOTS to lose if positive.  Thank you again so much for your time.
38 months ago
Dr.  Hook I forgot to mention the burning again.  Could you elaborate for me on that?  It is mild and occurs while the urine is trying to form the stream and goes away every time as soon as the stream is formed.  What else could that be?  Thanks again for this.
Edward W. Hook M.D.
Edward W. Hook M.D.
38 months ago
Coincidence- unlikely.  Far more likely that you are focused on the possibility of having an STI and on the look out for symptoms.  As a result, you are noticing normal sensations which most persons filter out from their consciousness.  The presence of discharge is by no means absolute, particularly among persons who have taken potentially sub-therapeutic doses of antibiotics.

There are no symptoms that are "required" related to the presence of STIs. 

Please see my comment above regarding the intermittent burning you mention.  I think you are probably over-reacting and allowing your anxiety over this mishap to worry you more than you realistically need to.  EWH
---
38 months ago
Thank you Dr. Hook.
38 months ago
Good evening again Dr. Hook.  Aside from a heartfelt thank you, I had no intentions of writing back.  That has changed over the course of the day.  The discomfort under/behind/anterior to (not really sure how to describe it) my scrotum and going towards the anus has elevated into full blown, fairly bad pain.  It is tender to touch/palpation now as well and feels a bit swollen.  It also seems to be radiating into my right testicle.  The testicle is not swollen though.  Also, handling or touching the testicle does not exacerbate the pain in it.  And it is making its presence known whether I am sitting, walking, whatever.  Yesterday, you mentioned that discomfort in this area was not really suggestive of an STI.  Do you have any idea what I could be dealing with here?  Is this a prostate inflammation of some kind?  The discomfort in my penis is still there.  The burning when I start to pee is still there, but still mild, and goes away once the stream starts.  And the stream is still slow to get going or get started.    
Edward W. Hook M.D.
Edward W. Hook M.D.
38 months ago
I'm sorry that you continue to feel poorly.  Nonetheless the symptoms you report are not those of a typically STI.  Conceivably you could have acquired prostatitis or a UTI, neither of which would be an STI.   At this time my recommendation would be to go see your doctor (self-medication would again be a mistake) and request a urine test to check for STI as well as a careful examination (which, if the doctor thinks this could be prostatitis might involve a rectal examination).

As you know, this is my 3rd reply to this series of questions so, as per Forum Guidelines I will leave the thread open for a day or two so that you can report back on what you decide to do and what the doctor says but further replies from me are most unlikely.  I hope that this suggestion is helpful.  EWH
---
38 months ago
Thank you Dr. Hook.  And a very Merry Christmas to you.  I appreciate your reply and I understand the policy on responses fully.  I appreciate your feedback.  

As I mentioned in the first post of this thread, the results of urine testing for C,G,T will be back tomorrow.  My question to you is driven by continued increasing anxiety, as I am sure you are very well aware.  

You did mention that the Augmentin buffoonery on my part could possibly skew the results towards a negative for those three and cause them to be less than 100% conclusive.  I will be going again in a few weeks to re-test on this and I most certainly will make a doctors visit over this development in my pelvic area.  In the event that you care to leave this open,  I will post the result of the tests tomorrow.  Perhaps that would be beneficial to all who read this.  

Thank you again for your time and efforts to help me.  This service that you doctors provide is wonderful and greatly appreciated.
38 months ago
Good afternoon Dr. Hook.  I hope you had a merry Christmas!  

Ok, the urine tests for C,G,T came back negative.  I was able to speak with the doctor on call at the clinic.  

She told me with no hesitation,  the same thing you did about taking that damned Augmentin.  She did elaborate a bit though and believe that I did not need further testing.  As a matter of fact she was almost stern about it.  When I asked her why, she stated the type of test I had would pick up the presence of dead bacteria as well as live and that even if I had killed all of any infection (which according to her, augmentin has no chance of doing), that I did not have adequate time to flush all the dead guys out of my system.  Do you agree with that?

Further, I just got home from seeing my GP early this afternoon.  I mentioned walking into the STD clinic and he rolled his eyes at me.  He says he understands her point, but another test surely won't hurt anything.   He performed a digital rectal exam and considering how I nearly jumped off his table when his finger hit the gland, he is sending me for a scan of my pelvis area.   He said all that he could tell me was, "it feels enlarged and your reaction corroborates that.  Lets get a scan to start with and I am calling in some antibiotics for you as a precautionary measure."  I am not a fan of taking pills but I will do it.  He is prescribing two of them.  I remember one is  Azithromycin.  I do not remember the name of the other.

So, do you agree with this Dr. Hook?  Thank you for your time over the last couple of days!  
Edward W. Hook M.D.
Edward W. Hook M.D.
38 months ago
Final response.  Your situation is complicated.  I agree with the STD Clinic provider that there is a chance of residual dead bacteria with STD testing at this time.  I would not test further.  If your follow-up tests taken by your GP are negative this will prove that either no infection was present to start with (most likely possibility) or, if an infection was present it was cured.  If the test is positive, you should re-test at some point after you complete your current antibiotics.  The results of your examination by your GP suggest that you have prostatitis and should be treated with antibiotics.  I agree with your GP that you should be treated.  At this point, I suggest you follow his instructions.

With this final comment this thread will now be closed.  EWH
---