[Question #5780] Clear discharge for almost 5 months of unknown etiology
71 months ago
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I’m 36 yo with a h/o NGU (2- 3x) resolved each time w/ azithromycin
or doxycycline now w/ persistent urethral discharge x 5 months and urinary symptoms.
I had a sexual encounter with a woman on 3/1/19. She performed oral sex on me and my penis
brushed up against her vagina before I wore a condom for the rest of the
encounter.
I developed clear urethral discharge with a tingling
sensation 1-2 days later. On the 3rd
day I took a Z pack which I completed. Symptoms
persisted and NAAT for ureaplasma, mycoplasma was negative, G&C cultures was
negative, HIV/RPR/HSV1&2 was also negative. I took metronidazole to cover for
potential trichomonas.
17 days later same symptoms persisted so I took doxycycline bid
x7 days. Still no resolution in discharge
persisted and I progressed to have dull pain in my abdomen and testicles. Testicular
ultrasound revealed possible epididymitis and hydrocele.
Took levofloxacin x 17 days. This relieved the pain in my
testicles but I still had: clear discharge, occasional dysuria and dribbling
when urinating, urinary frequency, urgency, dark and foul smelling urine, and
intermittent dull LLQ pain.
Cystoscopy, r/o urethral stricture only trabeculations in my
bladder were noted. An u/s of my
prostate revealed 2 calcifications (possibly from previous infections).
An ID doctor thought I had NGU and prescribed 3 weeks of doxycycline. Symptoms did not resolve. All repeat STD
blood and urine testing were negative.
About 100 days after the sexual encounter the results of a
first void urine culture came back positive for m. morganii & e. faecalis. I took 13 days of Cipro. Subsequent cultures were negative. Doctors believe the specimen may have been
contaminated.
Results of urodynamic testing are currently pending.
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Edward W. Hook M.D.
71 months ago
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71 months ago
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Dr. Hook, thank you for your prompt response.
1. The clear discharge is present all day. I wake up with discharge and throughout the
day my foreskin is moist, which wasn’t the case prior to this encounter (except
for the two or three previous times I was diagnosed with NGU). I also have
increased pre-ejaculate, which is not normal for me. I’ve
requested smears and no urologist nor infectious disease doctor will do it.
My first question is do you have any suggestions on where I
can get a smear done in the New York area?
2. Both M. genitalium and M. hominis were negative.
My second question: is it possible that I’m harboring
bacteria from oral sex in my urethra and this is now part of my flora?
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Edward W. Hook M.D.
71 months ago
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