Dear Doctor(s)

Dr. HHH reassured me regarding my exposure in my previous post  (diacerein use) so not concerned about hiv (unprotected fellatio performed on me and protected vaginal sex).

A few days later, i started having a burning feeling at the tip of my penis (inside) that came and went. Mostly very mild but a few times quite strong. (Several years ago i was diagnosed with nonbacterial prostatitis; i had similar complaints for a few months but then it disappeared completely without any medication). 20 days later, my doctor -absent a urine culture- put me on doxycyclin, 200 mgs daily for a week. Although it started hurting less afterwards, it did not disappear completely. To this day, i still have it to a much lesser extent that i can barely tell and a urine culture after antibiotics showed 'no growth'. Is it possible that my long gone prostatis was triggered by a bacterial infection?

My other 'symptoms' following the incident:

-Mild flu 1 week later - lasted 4 days/no fever.

-2 weeks: joint pain that came and went (both elbows) for 10 days.

-2-3 weeks: very itchy red spots. Looked like mosquito bites but much smaller. Hands, wrists & ankles. Kept getting them for a week. Stopped for 2 weeks now started getting them again.

-4 weeks: pallate started hurting. Dentist said it looks 'irritated'. Gums are very itchy. Going on for 2 weeks.

In light of these, would you say any of these 'symptoms' are consistent with any STD / STI and do you recommend i test for any particular one? I understand these problems may be completely unrelated to the sexual encounter, but because they started coming after it, i cannot help but wonder.

Regards.

Could an STD be responsible for "a burning feeling at the tip of my penis (inside) that came and went"? Very unlikely. First, infection symptoms generally cannot be intermittent ("come and go"). Second, the main symptom of urethral STDs is discharge, rarely burning without discharge. If your doctor swabbed your urethra and found increased white blood cells, then it would have been appropriate to treat you with doxycycline -- but it was not appropriate to do that without looking for that evidence of urethritis. In any case, that the symptoms did not entirely disappear within a few days is additional evidence that no infection was responsible. That said, it is conceivable that these symptoms are due to recurrent prostatitis, if you definitely had prostatitis in the past. (Prostatitis is almost always a questionable diagnosis; it's usually difficult to be certain about it.) But if so, it isn't because of a bacterial infection, or any STD, or anything related to the sexual exposure on your mind. Nonspecific prostatitis often comes and goes on its own. Fortunately, it's generally harmless and doesn't require treatment.

No STD causes the other symptoms you describe. And I would remind you of the low risk of the exposure you described last time, not only for HIV but for any and all STDs.

So I don't recommend any further testing. I really see nothing to be worried about. Of course if your joint pain, possible skin rash, etc continue or recur, check with a doctor. But you can be confident they are entirely unrelated to any infection from the sexual exposure.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

I recently found out that in my town the following test is offered at a much reasonable price. If the information i am giving is enough to make a judgement, for future reference, could you kindly comment on the reliability of the following test to rule out an hiv infection 100% on the 42 day mark;

Finally i would like to thank you for the help you are offering on this forum once again. The Internet is a vast ocean of information for pretty much anything and sexual health is no exception. However, some of this informarion is outdated and some plain wrong. I think it is extremely important for anyone to have a forum like this, where they can find accurate and most up-to-date information. 

Thanks for the compliments.