Chronic Unexplained Symptoms: Allergy-like Reactions After Sexual Encounter

Unexplained chronic symptoms (currently resembling allergies)

Hello doctor, I previously engaged in unsafe sexual behavior while traveling, but it was only oral sex.
Initially, I didn't feel anything, but after two days, I started experiencing mild itching and tingling all over my body, a low-grade fever, and pain in the glans with clear discharge.
At that time, I was taking antibiotics and also receiving PEP.
Shortly after, I began to have painful bowel movements with blood, along with anal fissures.
Logically, since I was experiencing diarrhea, I shouldn't have developed anal fissures, but I noticed blood when wiping, and my anus was extremely itchy.

Now, about a year has passed.
Although I haven't had severe symptoms, I have been experiencing persistent symptoms resembling allergies, such as rhinitis and enteritis.
Initially, I didn't pay much attention to it, but recently, after engaging in sexual activity with a new girlfriend, the same symptoms I experienced initially reappeared a few days later: skin itching, anal fissures, anal itching, and low-grade fever.
Currently, we don't have any significant symptoms, but if I stay up late, I experience anal itching, and my rhinitis and bronchitis flare up.
I initially thought it was just a decline in my health, but later, my girlfriend started showing similar symptoms.
I took two weeks of doxycycline and second-generation cephalosporins, and I also had blood tests for IgG herpes, which came back negative, as well as tests for syphilis and HIV, which were also negative.
Is there anything else I should check for, or are there any infections that could be similar to my symptoms?

Liu Xiansheng, 30~39 year old female. Ask Date: 2021/07/13

Dr. Chen Jiansheng reply Urology

Please schedule a medical examination.

Reply Date: 2021/07/13

More Info

It sounds like you are experiencing a complex set of symptoms following a sexual encounter, and it's understandable to feel concerned about your health. Based on the information you've provided, it seems that you have undergone various tests for sexually transmitted infections (STIs) such as HIV and syphilis, which have returned negative results. However, you are still experiencing persistent symptoms, including skin irritation, anal discomfort, and respiratory issues.

Firstly, it is important to recognize that while STIs can cause a range of symptoms, not all symptoms are necessarily linked to an STI. The symptoms you describe, such as itching, low-grade fever, and gastrointestinal issues, could be indicative of several different conditions, including allergies, infections unrelated to sexual activity, or even psychosomatic responses to stress or anxiety about your health.

1. Allergic Reactions: The allergy-like symptoms you are experiencing could be due to a variety of allergens, including food, environmental factors, or even products used during sexual activity (like lubricants or condoms). If you suspect an allergy, consider keeping a diary of your symptoms in relation to your diet and exposure to potential allergens.

2. Gastrointestinal Issues: The presence of blood in your stool and anal discomfort could suggest a gastrointestinal issue, such as hemorrhoids or anal fissures, especially if you have been experiencing diarrhea. Chronic diarrhea can lead to irritation and damage to the anal area, resulting in pain and bleeding. It is crucial to consult a gastroenterologist for a thorough evaluation, which may include a colonoscopy to rule out any serious conditions.

3. Psychosomatic Symptoms: Anxiety and stress can manifest physically, leading to symptoms such as itching, pain, and gastrointestinal distress. Given that your girlfriend is experiencing similar symptoms, it may be worth exploring whether anxiety about health and STIs is contributing to your physical symptoms.

4. Further Testing: Since you have already tested negative for common STIs, it may be beneficial to discuss with your healthcare provider the possibility of testing for other infections, such as viral hepatitis, or even less common STIs that might not have been included in your initial screenings. Additionally, consider testing for conditions like candidiasis (yeast infections), which can cause itching and discomfort.

5. Follow-Up Care: It is essential to maintain open communication with your healthcare provider. If your symptoms persist or worsen, or if new symptoms develop, do not hesitate to seek further medical advice. A referral to a specialist, such as an allergist or a gastroenterologist, may provide more insight into your ongoing issues.

In conclusion, while it is understandable to be concerned about the possibility of STIs following a sexual encounter, the symptoms you are experiencing may not be directly related to an infection. A comprehensive approach that includes further testing, evaluation for allergies, and consideration of psychosomatic factors may be necessary to address your health concerns effectively. Always prioritize open communication with your healthcare provider to ensure you receive the appropriate care and support.

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