[Question #3791] Persistent discharge is now getting EXTREMELY annoying

34 months ago
Hi again Dr. Hook / Dr. Handsfield,

First of all I really hate to ask you another question as I would be coming back with the same question. However, it seems like it gets to a point where I think my persistent symptoms are now getting on my nerve and I don't wanna live with them. 

Long story short:
Unprotected sex - a month later experienced itchy urethra and white discharge. Tried all possible antibiotics, but symptoms keep coming back.

I just completed a thread with Dr. Hook 3 days ago. The last response I got was my persistent discharge might not be recurrence of my infection. But now I'm getting more discharge than before and it turns to white-green-ish colour. I feel pain (burning sensation) when I pee in the morning and trouble sleeping at night due to itchiness. 

I went to my GP and due to my raising SGPT level in my blood test, he said its better to try Cefuroxime (3x500MG) (1.5G per day) for 2 weeks because this antibiotic might not have effects on my SGPT level.

Straight to my questions:
1. What must I do now, should I be worried, is this a threat to my fertility, is the antibiotic prescribed the right one, what are your suggestions ?

 
Thank you Doctor. Please find me a way to cure this annoying bacteria.
34 months ago
Just want to add up a few things:
1. Is there a chance the recurrence comes back because I drank Yakult (Probiotic) ?
2. I googled on the internet and found out the regular dose for Cefuroxime is 250MG daily and I'm taking 1.5G daily. Is it too much of a dose ?

Thank you
Edward W. Hook M.D.
Edward W. Hook M.D.
34 months ago
I'm sorry to see that you are having trouble moving forward.  I note that on my last reply I did not warn you about our prohibition on repetitive anxiety-driven questions so I am going to answer your questions.  Had I warned you, I might have just deleted your repetitive post.   We have this policy because our answers do not change with repetitive questions and because repetitive questions neither benefit the person asking or others who come to this site for information. My replies will be brief because they have been made before.

1.  There is no evidence that this is an STI as opposed to symptoms which were coincidentally associated with a sexual encounter you now describe.  On this forum the most common cause of penile "Itch" in situations similar to yours is detection of NORMAL sensations that are detected because of greater than usual attention to the area, looking for possible symptoms. 
2.  A certain, small amount of penile discharge is men, particularly on awakening.  This is usually not detected unless persons are looking for it.  It can be increased, as can irritation by repetitive self-examination.
3.  There is NO evidence of an STI here. Your tests are negative.  You have been repeatedly treated with antibiotics effective against typical STI with no change in your symptoms.
4.  Enterobacter cloacae is not an STI pathogen.  It can cause urinary tract infections, including rarely prostatitis (which again, is NOT and STI and sometimes requires prolonged (4-6 weeks) therapy.

In answer to your specific follow-up questions:
1. What must I do now, should I be worried, is this a threat to my fertility, is the antibiotic prescribed the right one, what are your suggestions ?
There is no change in my assessment or advice.  Your doctor sounds like he is doing a good job and has the advantage of being able to examine you and perform tests.  Work with him.  Cefuroxime is often highly effective for Enterobacter.  I see nothing here to suggest you need to worry about future fertility.

1. Is there a chance the recurrence comes back because I drank Yakult (Probiotic) ?
I am not familiar with this probiotic.  I doubt that your probiotic had any effect on how your antibiotics workers. 

2. I googled on the internet and found out the regular dose for Cefuroxime is 250MG daily and I'm taking 1.5G daily. Is it too much of a dose ?
Taking 1.5 grams of cefuroxime daily, divided into two or three doses is fine and widely used.

I have little more to say.  Repeated questions will not be answered.  You need to stop obsessing over this and work with your own doctor to address this non-STI problem.  EWH

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34 months ago
Hi Dr. Hook,

I'm sorry if my questions were very anxiety-driven but this problem keeps on affecting my everyday activities. Also, it worries me when I heard that this is the first encounter for my GP to treat patient with recurrent UTI until this long, that's why I was panicked and sought help from this forum.

The Cefuroxime didn't work for 3 days, so my GP prescribed me with both Ofloxacin and sulfamethoxazole-Trimethoprim. As a result, I am having horrific insomnia and haven't slept for 2 days in a row. UTI symptoms are getting better with these antibiotics however.

Questions from me:
1. Which of these antibiotics do you think caused my insomnia ? I don't think my anxiety has anything to do with this. Is it wise to let go either one that's causing my insomnia? I googled on medscape.com, both antibiotics are effective against E. cloacea, unlike Cefuroxime.

2. In your experience, does anyone who get persistent and prolonged symptoms like mine and taking numerous amounts of antibiotics likely to have anything that will be damaged permanently or perhaps spread the infection to other parts of the body ?  

This infection really is torturing me. I really hope this will be the last antibiotic treatment for me.


Edward W. Hook M.D.
Edward W. Hook M.D.
34 months ago
1.  The ofloxacin is the more likely one to casue insomnia.  I think if you ar eimproving, you should keep taking the antibiotic if at all possible. 

2.  No.

EWH
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34 months ago
Hi Dr Hook,

This is now getting more interesting. I just did another swab test and different bacteria were found.

Swab test: staphylococcus haemolyticus.

Questions are:
1. Are the bacteria acquired normally by sexual activities or might be possible from something else ?
2. Does this mean I acquired another infection, or the first test was done improperly, or perhaps I acquired 2 infections at the same time ? I never did any sexual activities for the last 2 months except masturbation.
3. I googled to find that this is a very-antibiotic resistant bacteria. Are the ofloxacin and Trimehoprim-sulfamethoxazole the right antibiotic ? Or say if these medication failed, whats the next antibiotic would you recommend for staphylococcus haemolyticus ?
4. Does this antibiotic resistant bacteria definitely will be cured using antibiotic taken orally ? Or is this might need some painful injection of antibiotic in the future ? 
5. Are there any chance that I would have to live with these symptoms forever ?

Those last questions will end the tread. Thank you so much in advance for your precious answers. 
34 months ago
Sorry Doctor Hook to add one thing:

According to www.medscape.com, Delafloxacin is effective for this bacteria however I have checked with my GP that this is not available in Indonesia. 
Edward W. Hook M.D.
Edward W. Hook M.D.
34 months ago
Final responses.  Future posts on this exposure and events are likely to be deleted without a response.  Your repeat test results serve to confirm what I have been trying to tell you for some time, that your symptoms are NOT due to an STI.  Staph Haemolyticus is a well described cause of bacterial UTI and related infections.  It is NOT an STI.  On occasion it can take longer to treat because it can develop antibiotic resistance and form biofilms which make it difficult to treat.  You need to work with your doctor (NOT this site) to determine the best treatment. 

1. Are the bacteria acquired normally by sexual activities or might be possible from something else ?
See above.  These bacteria are normally found in the genital regions, they do NOT cause STI but they do cause UTI and related infections.

2. Does this mean I acquired another infection, or the first test was done improperly, or perhaps I acquired 2 infections at the same time ? I never did any sexual activities for the last 2 months except masturbation.
You are fixated on the idea that this is an STI.  It is not.  UtIs are caused by normal bacteria that, often for unknown reasons, infect the urinary tract.  I have no idea why your earlier results were different.

3. I googled to find that this is a very-antibiotic resistant bacteria. Are the ofloxacin and Trimehoprim-sulfamethoxazole the right antibiotic ? Or say if these medication failed, whats the next antibiotic would you recommend for staphylococcus haemolyticus ?
The best antibiotic for treating this can be determined by testing your bacteria in the laboratory.  Trimethoprim-sulfamethoxazole and quinolone antibiotics like oflocacin often are effective for these infections. 

4. Does this antibiotic resistant bacteria definitely will be cured using antibiotic taken orally ? Or is this might need some painful injection of antibiotic in the future ? 
It is very unusual for this infection not to be treatable with oral antibiotics.  Again, testing the bacteria and following your response to therapy by your doctor will determine what o treat it with and how long to treat it.

5. Are there any chance that I would have to live with these symptoms forever ?
Unlikely.

End of thread.  You have been warned about repetitive future posts on this topic.  eWH
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