[Question #4396] Epididymitis

30 months ago
3 weeks ago I had unprotected sex including oral and anal insertion with a male friend that I know well and trust. About a week after I started feeling dull pain in my right testicle. Clinic tested for chlamydia and gonnorhea. Both negative but treated anyway. 
I have been on levoflaxocin for 6 days and the pain has gotten better but is still there along with redness of scrotum. Have not had other symptoms of painful urination or discharge that I've noticed other than slight pain once in a while during urination when I'm really worried and thinking about it.
1- is this likely to go away?
2- what is the likely cause? E.coli
3- if it is entric organism can I infect my female partner at this point?
4- does drinking alcohol while on antibiotics like this make it less effective? 6 beers/day
5- how long do symptoms commonly last after treatment?
6- with epididymitis would test result show positive for stds if I had one? Can I test while on antibiotics so I can show my girlfriend that it's not from an std?
What other stds cause epi?
Sorry so many questions at once. Doctors becoming expensive and this has got me full of anxiety and worry..
Edward W. Hook M.D.
Edward W. Hook M.D.
30 months ago
Welcome to the Forum.  I'll be glad to comment.  Epididymitis can be caused by the same bacteria which cause urinary tract infections or the organisms which cause STIs (primarily gonorrhea and chlamydia).  In some men it may also be associated with prostatitis which is also typically effectively treated by levofloxacin but sometimes takes a longer course of action.  Determining which was the culprit would have been best determined by testing before you started antibiotics but levofloxacin is effective therapy for most of these organisms and the fact that you have improved is a good sign.  Persons with epididymitis are typically treated for at least two weeks.  If there are any residual symptoms, you should probably be re-examined by the same person who examined you initially towards the end of therapy to determine if the treatment should be extended. 

In answer to your specific questions:
1- is this likely to go away?
Epididymitis typically responds well to antibiotics.

2- what is the likely cause? E.coli
See my comment above.  E. coli is among the bacteria which can cause epididymitis.

3- if it is entric organism can I infect my female partner at this point?
If it is an enteric infection your female partner is not at risk,  If it is gonorrhea or chlamydia, depending on where you got the infection and when you last had sex with your female partner, she may need testing and treatment.

4- does drinking alcohol while on antibiotics like this make it less effective? 6 beers/day
No, drinking should not reduce the effectiveness of therapy.

5- how long do symptoms commonly last after treatment?
Varies from person to person.  That is the reason a follow-up evaluation is suggested.

6- with epididymitis would test result show positive for stds if I had one? Can I test while on antibiotics so I can show my girlfriend that it's not from an std?
If you had an STI, testing after six days of therapy may or may not still show the STI.  You really should have been tested before the antibiotics were started.

Hope this information is helpful.  Glad to hear that you are improving.  EWH


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30 months ago
A week after the encounter when I first noticed the pain I was tested and results were negative for chlamydia and gonorrhea before initial treatment. If I were having those symptoms of testicle pain would those tests be accurate during that time frame? I haven't had sex with my partner since that encounter and am scared to as I am still feeling slight pain after 7 days of treatment now. Going to follow up with doctor after a few more days. I have researched alot about epididymitis since on Google and it keeps scaring me because everything says different things and alot talks about it being common that it comes back after treatment and that the pain can last a while after treatment.  
2 weeks after treatment if I go do testing again could I be confident that this is not caused from and std? Also you say if it is entries organism cause I cannot infect my partner. Does that mean it would not give her a uti. Sorry I am very confused. Heard different answers from different doctors and really want to get the facts straight. 
Thank you very much for doing what you do and taking the time to answer my questions.
Edward W. Hook M.D.
Edward W. Hook M.D.
30 months ago
Thanks for the additional information.  Your tests taken a week after the encounter and before treatment prove that you did not have Gonorrhea or Chlamydia.  At time the results are reliable.  Thus your infection was ost likely an enteric bacteria like E. coli.  As such you are on the right treatment.  With this sort of epididymitis, your GF is safe.  You cannot give her a UTI.   EWH---
30 months ago
I will keep this one short.. also heard that trich can cause epi. Since symptoms are getting better can I rule that out as the cause? Would levafloxacin help symptoms if it was trich that caused this? Tested for trich a couple days ago (while on levafloxin) awaiting results.
30 months ago
Also is it safe to have sex with my wife?
Edward W. Hook M.D.
Edward W. Hook M.D.
30 months ago
That you heard that trich can cause epididymitis suggests to me that you are spending too much time on the internet.  There are no good data to support this statement.  All too much of what is found on the internet is taken out of context, out of date or just plain wrong.  I would not worry about trich and am confident yoru trich test will be negative since men do not get rich from other men.

I see no reason not to have sex with your wife in terms of concerns about STIs.

I hope these responses are helpful.  As this is the third response to your questions, this thread will be closed later today without further responses.  I hope my comments have been helpful.  EWH
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30 months ago
Very! Thank you so much