[Question #6794] Advice on Potential Exposure

64 months ago

Experts: I am a 41-year old male in good health. I have been married for 20 years and both my wife and I have been uniformly monogamous (prior to this exposure). On 3/3, I went to an exotic dance club and had a 30 minute dance with a Caucasian female in her early 20's. I was fully clothed the entire time. She was fully nude. She french kissed me for several minutes and I gave her digital sex with my fingers for several minutes. She never touched my penis other than rubbing herself against me through my clothes. I may have used the restroom (thereby touching myself after touching her) during my time at the club and I masturbated (alone) later that evening. On 3/10, I visited an acute care center (sore throat, achy eyes, possible cold sore on my inner lip). The doctor agreed that I had respiratory inflammation and noted that I had a canker sore (NOT a cold sore). He put me on a 10-day course of Amoxicillin (875 mg, 2x per day). 8 days later (15 days after exposure), I started experiencing pain after urinating and pain (burning sensation) in my urethra. That has progressed and I now have modest burning pain in my urethra pulsating back to my prostate. My testicles are not particularly sensitive to the touch (although infrequently ache) and I have no visible sores or discharge (although perhaps an abrasion?). On Wednesday (3/25), 6 days after my Amoxicillin course, I completed a 10-panel STD test including HIV RNA, which all came back negative. Yesterday, I went back to the doctor and they put me on 14 day CIPRO course (500 mg 2x per day) for potential Prostatitis. Last night, my wife wanted to have sex and put me inside her, but I stopped within 15 seconds and told her I didn't feel well. I am terrified I might have infected her. That has been our only sexual experience since 3/3. How worried should I be? Should I disregard my STD test since it could have been tainted by the Amoxicillin. I would be grateful for your advice.

H. Hunter Handsfield, MD

64 months ago

Welcome to the forum. Apologies for the longer than usual delay in replying.

Your strip club event was entirely risk free for HIV and all STDs. None of these can be transmitted through clothing, or by masturbation, even with hands in contact with a partner's genital area or saliva. Despite what you may have read online and elsewhere, your symptoms are not suggestive of either HIV or STDs. It sounds like you caught a cold. You might have caught it from the dancer, but probalby not: the incubation for cods and similar respiratory infections is 2-5 days, usually not as long as a week. That sounds like a viral infection; most doctors would not have prescribed amoxicillin (or any other antibiotic) in this situation.

As for your genital symptoms, your doctor's diagnosis of prostatitis may be correct, but it is also possible that the main problem is gentially focused anxiety: although this is not a formally described medical condition, over my decades in the STD business, and especially on this forum, it is apparent that men who come to regret a sexual decision and fear STDs develop exactly the sort of genital discomforts you describe. The symptoms are similar (or even idential) to some cases of prostatitis, so distinguishing the exact cause can be difficult. Antibiotics make no difference in genitally focused anxiety or, for that matter, for most prostatitis. (Google "chornic pelvic pain syndrome": I'll bet you'll find a lot of parallels with your symptoms. GFA is very similar and maybe the same thing as CPPS.) I would guess your doctor doesn't strongly suspect a bacterial infection and prescribed the ciproflocaxin "just in case". (Amoxicillin also would be effective against most bacterial causes of prostatitis. Developing those symptoms while taking amoxicillin is good evidence it isn't an infection. So don't get your hopes up about cipro: I doubt it will have much effect on your symptoms. In any case, prostatitis is not an STD, ever.

There is no reason not to have sex with your wife. In fact, many urologists and other experts advise their patients with prostatitis or CPPS to continue or even increase their sexual activity. It certainly won't hurt to have sex -- no risk of any kind to you or your wife. I also do not see a need for any STD tests at this point.

If your symptoms continue, I suggest you discuss all this with your doctor -- perhaps even printing out this thread as a framework for discussion. In the meantime, please do not worry. You have no STD or any other infection from the dance events a few weeks ago.

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

HHH, MD

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64 months ago

Thank you, Dr. Handsfield. That’s very comforting and I am grateful to have your expert opinion.

Out of an abundance of caution, if I were to retest due to the potential “masking” impact from the Amoxicillin treatment, what date should I complete that test? Based on my research, it would seem that May 1st (3 weeks after my last Cipro pill) would be the right date. Is that correct?

And if I do retest, which tests could potentially have been tainted such that a retest would be required? I assume the bacterial-based infections such as gonorrhea, chlamydia, and syphilis are the ones that could have been tainted by the amoxicillin. Do you feel good about the HIV RNA test at 22 days? If so, no need to retest.

I recognize that all of this is purely theoretical and will let you get back to more serious business, hereafter. Thank you again.

H. Hunter Handsfield, MD

64 months ago

Retest for what? Retesting implies rechecking for a known infection, but you had none. Your negative STD panel shows you didn't catch anything. It's a poplular assumption but an urban myth that antibiotics suppress bacterial infections to make testing negative even though the infection is still present. It occurs rarely if ever. If some bacteria is sensitive to amoxicillin, it will be cured; if resistant, it would be detected while taking the antibiotic or soon afterward. In other words, negative testing at this point will prove you're not infected at the time of the test. It cannot tell whether you were infected and then cured. However, it was impossible for you contract any STD from the event descrited anyway.

Did you read up on CPPS?

Really, don't worry about this. Keep working with your doctor if your prostatitis/CPPS symptoms continue, but there are no complications or serious outcomes from these problems, either for you or your wife. Just chalk all this up as a learning experience and move on without worry.

That concludes the two follow-up exchanges included with each question and so ends this thread. I hope the discussion has been helpful.

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