Unexplained Symptoms After Sexual Encounter: Seeking Medical Guidance

Q: Unexplained Symptoms After Sexual Encounter: Seeking Medical Guidance

Dear readers：<br>A. <br>Regarding the response to "the most expensive urology clinic"： Frotin, Cefspan, Doxynin, and Azithromycin are all antibiotics, differing in the sexually transmitted pathogens they cover. <br>It is unclear if you have experienced any unusual symptoms after

I don't know what this disease is. It seems like a rare condition?

Hello Dr.
Liao, I had sexual intercourse on October 2, 2016, with a male partner.
I was the receptive partner, and he suddenly sat on me, which startled me, but there was no penetration.
Later, we used a condom, but afterward, I experienced itching.
I went to the hospital for urine tests multiple times, and the results showed urine sediment with white blood cells, red blood cells, epithelial cells, and nitrites, but everything was normal.
I also visited a urology clinic where I underwent the most expensive PCR tests for Chlamydia and Gonorrhea, and those results were negative.
I was tested for HIV and syphilis as well, all after four months, and those results were also negative.

At that expensive urology clinic, after my urine test, I was prescribed: 1.
FROTIN 250 mg, one tablet twice daily for 10 days; 2.
Cefspan 100 mg, one tablet twice daily for 10 days; 3.
Doxynin, one tablet twice daily for 5 days; and then 5 days of AZITHROMYCIN 250 mg, taken once daily.
Since completing the medication, I have noticed redness on the glans and just above the glans (it feels inflamed and has a white-red appearance).
When I retract the urethra, I can see blood streaks inside, and occasionally I feel a burning sensation.
Additionally, if I do not clean thoroughly after ejaculation, the areas where semen touches the glans become red and bumpy, resembling folliculitis.

I find this very strange, and when I seek medical attention, the doctors seem disinterested.
I hope you can guide me on what kind of tests I should pursue at the hospital.
I am unsure if this could be a new type of virus or bacteria, as it feels like a peculiar condition.
I have also done fungal blood and urine cultures, which were normal.
Could this be related to the semen?

Niming, 30~39 year old female. Ask Date: 2017/06/06

Dr. Liao Zhongxin reply Internal Medicine

Dear readers:
A.
Regarding the response to "the most expensive urology clinic": Frotin, Cefspan, Doxynin, and Azithromycin are all antibiotics, differing in the sexually transmitted pathogens they cover.
It is unclear if you have experienced any unusual symptoms after completing the four medications; after a full 10-day course, the treatment should be complete.
B.
Regarding the response to "red area above the glans and urethra": It is natural to feel anxious after engaging in high-risk sexual behavior, even after receiving treatment and testing.
The following recommendations are provided: Most sexually transmitted infections have an incubation period of less than three months.
It is advisable to seek further consultation and screening at a nearby medical facility.
If tests remain normal after six months, there is no need for concern, as long as personal hygiene is maintained.
Thank you!

Reply Date: 2017/06/06

More Info

It sounds like you are experiencing a range of concerning symptoms after a sexual encounter, and I understand how distressing this situation can be. Based on the information you provided, it appears that you have undergone extensive testing for sexually transmitted infections (STIs) including HIV, syphilis, gonorrhea, and chlamydia, all of which returned negative results. However, you are still experiencing symptoms such as itching, redness, and a burning sensation in the genital area, as well as blood in your urine.

Firstly, it is important to note that while STIs are a common concern after unprotected sexual encounters, not all symptoms are indicative of an STI. The symptoms you describe could be due to a variety of factors, including but not limited to:
1. Irritation or Allergic Reaction: Sometimes, the use of condoms or lubricants can cause irritation or allergic reactions, leading to symptoms like itching and redness. If you used a new type of condom or lubricant, this could be a potential cause.

2. Urinary Tract Infection (UTI): Although your urine tests did not show signs of infection, UTIs can sometimes present with symptoms like burning during urination and discomfort in the genital area. A culture test may be more definitive in identifying a UTI.

3. Non-Specific Urethritis: This condition can occur due to various non-infectious causes, including trauma or irritation from sexual activity. It can cause symptoms similar to those of STIs without the presence of an identifiable pathogen.

4. Fungal or Yeast Infection: Even though you mentioned that fungal cultures returned negative, it might be worth considering a yeast infection, especially if you have had a history of such infections. Symptoms can include itching, redness, and discharge.

5. Folliculitis: The red bumps you described could be folliculitis, which is an inflammation of hair follicles that can occur due to irritation or infection. This can be exacerbated by friction or moisture.

Given that you have already undergone extensive testing and treatment, it may be beneficial to seek a second opinion from a different healthcare provider, preferably one who specializes in urology or infectious diseases. Here are some steps you might consider:
- Follow-Up Testing: Request additional tests that may not have been performed initially, such as a comprehensive STI panel that includes less common infections. You might also consider testing for viral infections like herpes simplex virus (HSV), which can sometimes be overlooked.

- Referral to a Specialist: If your current healthcare provider is not addressing your concerns adequately, consider asking for a referral to a urologist or an infectious disease specialist who can provide a more thorough evaluation.

- Symptom Management: In the meantime, you can try over-the-counter remedies for itching and irritation, but avoid any products that may further irritate the area. Keeping the area clean and dry can also help alleviate symptoms.

- Document Symptoms: Keep a detailed record of your symptoms, including when they occur, their severity, and any potential triggers. This information can be invaluable for your healthcare provider in diagnosing your condition.

In conclusion, while it is understandable to be concerned about the possibility of an undiagnosed infection, there are many potential explanations for your symptoms that may not be related to STIs. Seeking further medical evaluation and possibly a second opinion can help you find the answers you need and alleviate your concerns. Remember, your health and well-being are paramount, and you deserve thorough and compassionate care.

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