[Question #7359] Cuts on penis and a potential Candida problem?

5 months ago
I engaged in mutual masturbation and 10 seconds of frottage with another man, briefly rinsed my hands with water and then wiped my hands off with paper towel. I used that paper towel to wipe off remaining semen in between my fingers and then I used that towel to wipe my genitals, including the tip of my penis (although I don't know if that section of paper towel was wet). I have tested negative with a 4th generation test at 26, 39 and 46 days. I am debating getting another test at 12 weeks, after seeing some online sources say there is a 1% to 5% chance of it turning positive. I also want to make sure the results cover HIV-2. It is not my idea of a good time to go to a STD clinic in the middle of a pandemic for "peace of mind." I only want to ensure my health and the health of my loved ones. Please advise if I am 100% in the clear or if I need to retest. The main reason I wanted to reach out though is my continued symptoms. A big one is dry mouth and oral thrush. I have never had this before in my life so something is clearly happening. The other big one is that a vertical cut near my circumcision scar that first appeared a month after the incident keeps healing and then a week later reopening out of the middle of nowhere. Other smaller cuts have formed. It's not due to masturbation or sex as the dermatologist wanted to believe, because I have had few erections since this happened 2 1/2 months ago. I had sex once and the erection persisted the entire night while I lay sleepless in bed (another problem). I believe something in my circulatory or nerve system is messed up - cold hands and feet, randomly seeing stars and occasional electricity-like shocks in my feet. I also have pain in my left testical, red burning scrotum skin and a recurring rash on my shaft that the doctor thinks is fungal. I have lost 25 pounds in the last several months. I think I have blood sugar issues, but no family history of diabetes. I'm begging you not to dismiss this as anxiety. 

Edward W. Hook M.D.
Edward W. Hook M.D.
5 months ago

Welcome back to the Forum although it saddens me that you found it necessary.  to paraphrase Einstein, "One definition of insanity is to do the same thing again and again and expect different results."  You have received answers from both Dr. Handsfield and me within the past month- those are not going to change.  you do not have HIV (including HIV-2)!! 

Additional comments:

1.  i don't know what your "online sources" are but you are either being misled or misinterpreting what you have read.  The risk of infection from unprotected insertive rectal intercourse with an untreated partner is less than 1 in 1000, i.e. 0.1%.  For you to think that you risk from wiping yourself with a paper towel which may have been contaminated with genital secretions from a partner of unknown HIV status makes no sense whatsoever. 

2.  If you've had an erection lasting overnight, have recurring "cuts", and have lost 25 pounds there is a problem which warrants evaluation by a trained healthcare specialist- I'd suggest an internist.  What you know for sure however at this time is that it is NOT HIV from the exposure you have described. 

I must warn you that the Forum dose not permit repetitive questions.  There is little more that Dr. Handsfield or I will have to say on the matter and your continuing problems should be addressed by a physician who can see you in person, not on-line.  EWH

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5 months ago
Hi Dr. Hook. I had hoped that whichever doctor replied would take time to give a more thoughtful response. That's not "insane." If 6 weeks is definitive, as you two often say, then what could it be? It seems like some sort of blood or viral infection, so maybe HTLV? A non-wart-forming strain of HPV? I never tested for the Hepatitis viruses, do you suggest it?  (I was vaccinated for A and B when I was young. I am 35.) I know you and I have had the "what else could it be" conversation, to no avail, but I had hoped to hear Dr. HHH's take on the matter. Would it be possible to run it by him? As you can know, I tested negative for chlamydia, gonorrhea, trich and syphilis. I also saw a doctor, and he ran CBC, metabolic panel and thyroid tests that showed no irregularities. Glucosamine was a little high on two tests a month apart. The paper towel was definitely contaminated, not maybe contaminated. And paper towel keeps liquid in tact on the surface more than a soft cotton towel. Listen, I know it's a long shot, and I didn't even consider it until I started having night sweats, tingling in extremities and other symptoms a month later. At that time, I did go to an urgent care for a trich test, and they shoved a wand up my urethra. I had hypothesized that maybe that pushed whatever urethral infection I had into the bloodstream. Also, would you please at least weigh in on what Candida is, whether it can be transferred from skin to skin in the frottage and if it could be causing my ailments. It seems to be a very difficult subject to research online, at least with reputable sources.  It would certainly explain the thrush, unhealing wounds in my penis and the possible scrotal yeast infection. The online sources I refer to re: window period are WebMD (99% of people...), The Body (remained deadset on 3 months even with 4th gen tests), CDC's use of "most people will be detected at 45 days"  and someone on Quora named Noriko Hansen, who claims to be a HIV researcher at Stanford, who said 5% odds of turning positive after 6 weeks. I read one post from Dr. HHH that said he has seen many patients who tested negative of STD's yet complained of symptoms reminiscent of hyperglycemia and Candida. Maybe there's something there?
5 months ago
Also, the two penises were in close proximity so it is possible that some of his semen shot onto the tip of mine as I was close to ejaculation (sorry for the graphic description.) I know there have never been documented cases of this, but I doubt STD clinics around the world funnel every test result to the CDC...
Edward W. Hook M.D.
Edward W. Hook M.D.
5 months ago

I'm sorry you were dissatisfied with my response.  I thought long and hard about how to answer your question given its repetitive nature and the fact that both Dr. Handsfield and I had given you our thoughts in which we both gave you similar advice.  I used the example of Einstein's statement not to suggest you are crazy or that you do not have a medical problem but to indicate that it is not HIV and for you to persist in thinking it might be will only delay you addressing it in a productive fashion. 

To expect us to provide you a diagnosis over the internet is an unrealistic expectation and it would be malpractice for us to try to make a diagnosis over the internet.  What we can do is tell you the scientific data as it applies to situation.  These data, base on literally millions of persons, tested millions of times, is that your tests PROVE that you do not have HIV.  The sources you refer to are simply wrong. Your tests are completely reliable and there is no need for testing related to the encounter you have described. Testing of HIV, including HIV-2 is conclusive after six weeks.  Further, a biological FACT is that viruses (and bacteria) adhere to the fibers present in both cloth and absorbent paper so that even if your partner.  If you prefer those sources of advice, that of course is up to you.

Similarly, there is no reason to presume that the problems you are experiencing is an STI of any sort.

As for candida.  Candida is a fungus, a type of yeast which is present in nearly everyone.  It is not an STI in the traditional sense although on rare occasion partners can both have candida infections at the same time.  From time to time candida will overgrow causing local irritation or even a thick white discharge on mucosal surfaces.  Factors which pre-dispose persons to yeast infections include most areas (such as where skin surfaces contact each other, providing a moist, dark environment), having recently taken antibiotics or steroids or other immunosuppressant medications, and poorly controlled diabetes.  The infections can usually be treated with topical medication or a prescription medication called fluconazole.

As I said earlier, I am not contributing this to anxiety.  In my response above - "If you've had an erection lasting overnight, have recurring "cuts", and have lost 25 pounds there is a problem which warrants evaluation by a trained healthcare specialist- I'd suggest an internist.  What you know for sure however at this time is that it is NOT HIV from the exposure you have described." I suggested that you see a health care provider who can examine you, take an in person history and try to help you sort out what is going on.

EWH 

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4 months ago
Hi Dr. Hook, I went to a doctor today regarding the intermittent pain in my testicle and stinging feeling in the tip of my penis. I had hoped to get a PCR test for MGen, but he insisted it was hard to test for. I insisted on some labs, and I see that he tested for Mycoplasma Hominis. Anyways, he said testing for MGen was difficult and the best course of actions was to do a shot of ceftriaxone followed by a 10-day course of doxycycline. And if that doesn’t work, then he said we could try cipro in case it’s prostatitis or another type of antibiotic if it’s resistant to doxy. I am worried about taking unnecessary antibiotics and had hoped for a more targeted approach with testing. I know that my exposure was low, but I read on Web MD that MGen can be passed through genital rubbing. Anyways, I am wondering how effective do you think doxycycline would be against MGen, and how long it will take after treatment for me to be able to do a more proper urine analysis (if the treatment does not work).
4 months ago
One other question: Is it too late to do a urine test now that I have had this ceftriaxone shot?
4 months ago
Would the antibiotics interfere with the results of a herpes blood test (he refused to give it to me)? Also, I have not been tested for hepatitis, since I was vaccinated for A and B as a child (I’m 35). Do you think I am clear on the hepatitis front?
Edward W. Hook M.D.
Edward W. Hook M.D.
4 months ago
With all due respect to the doctor you saw, I would consider seeing a different provider for this problem. Testing for mycoplasma genitalium is widely available. Ceftriaxone has no activity whatsoever against mycoplasma genitalium So testing at this time will provide accurate results regarding that organism.  Atest for mycoplasma hominis will provide results which are meaningless no matter whether they are positive or negative. At the same time the provider you saw seems skeptical that you have an STI and I share that perspective.

At the same time you appear to continue to collect misinformation through your trips to the Internet. There are no data to suggest that mycoplasma genitalium is transmitted through the middle rubbing or the sort of exposure that you have described.

Like your doctor, I also would have recommended strongly against a herpes blood test. Your complaints there is no resemblance whatsoever to herpes infection and the herpes blood tests are unfortunately problematic in the day not uncommon they have false positive results and can miss true infections. In your own case even if you had a positive herpes blood test that would not mean that that is causing your continued symptoms.

Similarly, given your vaccination status there is no reason for concern about hepatitis A or B. The vaccines for these organisms are highly protective. Hepatitis C is not sexually transmitted except rarely through receptive rectal intercourse.

As you know, on this forum we provide up to three responses to each client’s questions. This is my third response and this is your second set of questions related to these concerns. Our responses will not change. I must warn you that should you return to the forum with continued questions about this encounter and related symptoms there is a likelihood that your question will not be answered and your posting fee will not be returned. We have a little more to offer on this matter. I wish you the best.  EWH
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4 months ago
Thank you for your response. I messaged my doctor about the “Microplasma Hominis Urea/Plasma Culture” and he said it was the “same test” when I asked about M Gen. Does that sound true? I wanted to like this doctor, but it seems like he is really unfamiliar with this bacteria.
Edward W. Hook M.D.
Edward W. Hook M.D.
4 months ago
He is incorrect EWH---