Infectious Balanitis: Symptoms, Treatments, and Testing - Urology

Infectious balanitis

---

On July 10, the patient experienced oral sexual activity, and starting from July 14, they began to feel pain, which woke them up at night.
They developed a rash, and touching the glans caused pain.
On July 19, they consulted a doctor and started a 7-day course of Ciprofloxacin (taking 3 tablets a day).
By July 26, they were still taking it for 5 days but stopped the antibiotics.
On August 13, two red spots appeared on the lower area, which were painful.
On August 16, during a second consultation, they were prescribed Ciprofloxacin and Azithromycin for 7 days (taking 2 tablets a day).
On August 17, the red spots enlarged and turned yellow in the center.
By August 18, the red spots began to fade, and on August 23, they were given a 2-week supply of the same medication, but there was already antibiotic resistance.
On September 6, they continued taking it for a week but did not fully recover.
On September 13, they switched to only taking Azithromycin (and the rash and pain returned).
On September 19, another doctor prescribed Doxycycline 100 mg, which was ineffective.
Blood and urine tests returned normal results (possibly due to low bacterial counts being undetectable?).
An internal medicine examination revealed a gastric ulcer and elevated bilirubin levels.
On September 27, they stopped the medication, but on September 30, pain returned, and they started taking one Doxycycline daily.
On October 2, the condition worsened, and on October 3, they purchased Norfloxacin 400 mg (taking 2 tablets a day).
On October 4, they experienced pain but began to improve.
By October 5, they felt better, and on October 6, they had sharp pain.
On October 7, they felt somewhat better and continued taking medication.
By October 26, they still had not fully recovered, and gastric pain returned (total of 23 days of treatment).
On October 27, they received Ceftriaxone and Levofloxacin.
On October 28, they received another injection, and on October 29, they received injections for 3 consecutive days.
On October 30, they resumed taking Ciprofloxacin (3 tablets a day), and on October 31, they continued with the same regimen, but it was ineffective.
On November 1, they received Ceftriaxone and Levofloxacin again.
On November 2, they received another injection, and on November 3, they received another injection.
On November 4, they had a total of 7 days of injections, with some smoother areas under the skin but still had red spots.
On November 5, they started taking Norfloxacin 400 mg (2 tablets a day).
On November 6 and November 7, they experienced some sharp pain (the medication seemed ineffective).
On November 8, they received Gentamicin injections.
On November 9 and November 10, they received injections for 3 consecutive days.
On November 11, they began taking Ceftriaxone and Levofloxacin (2 tablets a day).
On November 12 and November 13, they received injections for 6 consecutive days.
On November 14, they continued taking Ceftriaxone and Levofloxacin (2 tablets a day).
On November 15, a rash reappeared.
On November 16, they received Ceftriaxone and Levofloxacin (which seemed to be the most effective treatment so far).
On November 17, they continued with the same regimen.
On November 18, they received the same treatment.
On November 19, they received Moxifloxacin.
They continued treatment through November 20, 21, 22, 23, 24, and on November 25, after 7 days of treatment, inflammation persisted.
On November 26, they continued with 4 more days of injections.
On November 27, they noticed yellowing of the sclera.
On November 28 and November 29, they received the last day of 4th generation Moxifloxacin, which showed some improvement, but they still had not fully recovered.
On November 30, they received Ceftriaxone and Ciprofloxacin for 2 days.
On December 1, after 16 days of treatment, they still had not fully recovered.
On December 2, they began to experience side effects and stopped all treatments.

Apologies for the lengthy message.
Currently, they wish to undergo a drug sensitivity test.
How many days after stopping the medication should they wait before testing? What specific tests should they undergo? What types of bacteria could they potentially be infected with? Would testing too soon result in undetectable results? Should they wait until the condition worsens before seeking further examination? Thank you.

---

Kunao, 30~39 year old female. Ask Date: 2018/12/03