STD Symptoms and Treatment: A Urology Perspective

Q: STD Symptoms and Treatment: A Urology Perspective

Hello： 1) Syphilis requires a blood test for diagnosis because the symptoms can vary, and no physician can diagnose it based solely on symptoms. <br>2) HIV should be tested again after about 100 days for more reliable results. <br>3) Both syphilis and HIV are transmitted through

Sexually transmitted diseases (STDs) infection transmission?

Hello Doctor: I had unprotected sexual intercourse 15 days ago.
A week later, I noticed small red bumps on the glans.
After consulting a urologist, I was diagnosed with a fungal infection (Candida) and received medication.
During the treatment, initially, I experienced occasional itching at the tip of the glans, and later, I also had occasional itching in the groin and lower abdomen near the penis (unsure if it was due to hair irritation).
After 7 days of treatment, the fungal infection significantly decreased, leaving only small localized red spots.
However, I developed a small round ulcer at the inner edge of the glans, which hurt when rinsing with water.
The urologist mentioned it was a bacterial infection but did not specify which type, and prescribed antibiotics along with antifungal topical ointment.
On the 6th day of treatment, I noticed small rash-like bumps appearing on my limbs, but they were scattered (one on the shoulder, one on the arm, etc.).
On the 8th day, I observed multiple small red spots on the back of my hand that looked like an allergic reaction.
I would like to ask the doctor: 1.
The symptoms of bacterial infections that resemble STDs seem to align with syphilis, but syphilis symptoms appear to be painless ulcers with a raised border.
Besides the ulcer, I only have a slight burning sensation when urinating (less intense than the burning sensation from spicy food), and I have not noticed any colored discharge.
The ulcer feels smooth to the touch, so should I assume it is just a simple bacterial infection? 2.
Given that it has only been 15 days since the sexual encounter, I have undergone an HIV-RTPCR test.
Is there a need for additional STD screenings? 3.
I cannot determine if the small red spots on my body are due to a drug allergy or a spreading infection.
Should I continue seeing the urologist, or should I also consult a dermatologist? Additionally, I always wear underwear to bed and wash my hands with soap after applying the medication.
If someone borrows my bed and belongings, is there a risk of infection? 4.
I have an HIV screening every six months for work, and it has always been negative.
My CBC results often show LYM% below normal values, but even so, it seems unlikely for systemic rash symptoms of STDs to appear as early as two weeks.
From a medical perspective, is there a possibility that my situation indicates an STD? I have been very anxious lately and am hesitant about whether to undergo early STD screening, considering it is only the second week and the cost is high.
Thank you for your patience in reading this, and I hope I have conveyed the information I wanted to express and what you need to know.
Thank you.

32123, 20~29 year old female. Ask Date: 2018/09/06

Dr. Du Shixi reply Urology

Hello: 1) Syphilis requires a blood test for diagnosis because the symptoms can vary, and no physician can diagnose it based solely on symptoms.
2) HIV should be tested again after about 100 days for more reliable results.
3) Both syphilis and HIV are transmitted through sexual contact; transmission is unlikely through general direct or indirect contact.
4) It may not happen that quickly, but individuals with compromised immune systems may be at risk; it could be a common infection.
Maintain cleanliness and dryness, and if you have engaged in unsafe sexual practices, regular testing is recommended.
Wishing you good health.

Reply Date: 2018/09/06

More Info

Understanding STD Symptoms and Treatment: A Urology Perspective
Based on your description, it seems that you are experiencing a complex situation following unprotected sexual intercourse. You have been diagnosed with a fungal infection and are now dealing with symptoms that suggest a possible bacterial infection as well. Let's address your questions one by one.

1. Differentiating Between Infections: You mentioned that the lesions on your glans (the head of the penis) are painful and that you have experienced some itching. While syphilis can present with painless ulcers, the symptoms you describe—especially the pain and the presence of red spots—are more consistent with a bacterial infection or a secondary fungal infection rather than syphilis. It's important to note that sexually transmitted infections (STIs) can present with a variety of symptoms, and not all cases will fit the textbook descriptions. Therefore, while it is less likely that you have syphilis based on your symptoms, it is still crucial to follow up with your healthcare provider for further evaluation.

2. Testing for Other STIs: Given that you had unprotected sex 15 days ago, it is advisable to get tested for other STIs, including gonorrhea, chlamydia, and herpes, in addition to the HIV test you have already done. Many STIs can be asymptomatic or present with mild symptoms, and early detection is key to effective treatment. The Centers for Disease Control and Prevention (CDC) recommends that sexually active individuals, especially those with new or multiple partners, get tested regularly for STIs.

3. Skin Symptoms and Specialist Consultation: The small red spots on your body could be due to a drug allergy, a reaction to the infection, or even a separate dermatological issue. It would be wise to consult a dermatologist to evaluate these skin lesions, especially since they have appeared after starting treatment. Continuing to see your urologist is also important, as they can manage your urogenital symptoms and any potential STIs.

4. Risk of Transmission: Regarding the risk of transmission to others, it is generally low if you maintain good hygiene practices, such as washing your hands after applying medication and wearing clean underwear. However, it is always best to avoid sharing personal items like towels or bedding until you are sure that you are not contagious. If you have an active infection, it is advisable to refrain from sexual activity until you have been cleared by your healthcare provider.

5. Concerns About STIs: Your concern about the possibility of having an STI is valid, especially given your recent sexual encounter. While your previous HIV tests have been negative, and you have been consistently screened, it is still important to remain vigilant. The symptoms you are experiencing could indicate an STI, and early treatment is crucial to prevent complications.

In summary, it is important to continue following up with your urologist regarding your current symptoms and treatment. Additionally, consider getting tested for other STIs to rule out any infections. If the skin symptoms persist or worsen, a consultation with a dermatologist would be beneficial. Remember to communicate openly with your healthcare providers about all your symptoms and concerns, as this will help them provide the best care possible.

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