STD Symptoms and Misdiagnosis: A Urology Perspective

Q: STD Symptoms and Misdiagnosis: A Urology Perspective

Hello： Since the sexually transmitted disease tests at the hospital have returned normal, your abdominal pain and frequent urination, along with the ultrasound and CT scan results, suggest that there should not be significant issues in the urology department. <br>As for the weigh

Is it caused by a sexually transmitted infection (STI)?

On March 17, 2021, I engaged in an online relationship and had sexual contact.
I used my fingers for digital penetration, inserting them into his vagina for over a minute through a small cut on my finger.
However, I also touched my own genitals for a short period after the digital penetration.
The other person performed oral sex on me without a condom, but I did not perform oral sex on him.
We kissed, and I licked his nipples.
We did not have penetrative sexual intercourse.
The next day, I experienced abdominal pain and itching in my genital area.
I visited a general clinic and saw a dermatologist, who prescribed an ointment, but it did not help with the itching.
Two weeks later, I went to a testing center to check for HIV, syphilis, HPV, gonorrhea, and chlamydia, all of which returned negative results except for syphilis, which had a very low positive value.
A small clinic prescribed antibiotics for three days, and after that, my syphilis test suddenly turned negative when I had blood drawn at a hospital.
Over the past six months, due to anxiety, I have undergone multiple tests for HIV, syphilis, HPV, gonorrhea, and chlamydia, all of which have been negative.
However, about two months after March 17, I suddenly experienced frequent urination, but my urination was normal, without pain, and my genital appearance was also normal, with no discharge or other abnormalities.
During this six-month period, I tested positive for Staphylococcus in my urine and was treated with antibiotics, which resolved the issue.
However, I also found white Candida in my urine and stool.
I did not take antibiotics for the Candida; instead, I drank a lot of water, ate fruits, and took health supplements for several weeks.
The hospital tests indicated no Candida in my urine, but they were unwilling to test my stool for Candida, although E.
coli was present in my urine.
I continued to drink plenty of water, and eventually, the hospital reported no bacteria in my urine.
Now, six months later, I still experience pain in my lower abdomen and frequent urination.
The area around the corona of my penis, near the urethral opening, is often red, swollen, and itchy, causing inconvenience in my daily life.
When it is red and swollen, there is sometimes a shiny, oily appearance on the surface.
I have seen different dermatologists and urologists, but many ointments and medications for frequent urination have not been effective.
I would like to know if my situation is caused by a sexually transmitted infection (STI) since I have not found relief.
Could you provide me with guidance on how to address this issue? The urine culture at the hospital included tests for chlamydia and gonorrhea, and I have no symptoms indicating that I have chlamydia, gonorrhea, or HPV.
I underwent blood tests, ultrasounds, and CT scans for my abdominal pain, all of which were normal.
Can STIs and Candida cause abdominal pain? My weight has been steadily decreasing, but all tests at the hospital have returned normal results.
My syphilis was positive for only three days before turning negative after three days of antibiotic treatment.
Do I actually have syphilis, or was there an error in the testing? I have already undergone circumcision, and my glans is exposed, with no foreskin covering it.
I apologize for writing so much and for any inconvenience this may have caused you.

Xiao Qiang, 50~59 year old female. Ask Date: 2021/10/11

Dr. Du Shixi reply Urology

Hello: Since the sexually transmitted disease tests at the hospital have returned normal, your abdominal pain and frequent urination, along with the ultrasound and CT scan results, suggest that there should not be significant issues in the urology department.
As for the weight loss, it may require an internal medicine evaluation.
It is recommended to follow up on sexually transmitted disease testing at the hospital every six months to a year.
Wishing you good health.

Reply Date: 2021/10/11

More Info

Understanding the symptoms of sexually transmitted diseases (STDs) and the potential for misdiagnosis is crucial for effective treatment and management. Based on your detailed account, it appears you have experienced a range of symptoms and undergone multiple tests, which can understandably lead to confusion and concern.

Firstly, it’s important to clarify that the symptoms you are experiencing—such as abdominal pain, genital itching, and discomfort—can be caused by a variety of factors, not solely STDs. The fact that you have tested negative for several common STDs, including chlamydia, gonorrhea, and syphilis (with a transient low positive result), suggests that these infections may not be the primary cause of your symptoms. The rapid change from a positive to a negative syphilis test after a short course of antibiotics could indicate a false positive or a very early stage of infection that was effectively treated.

The presence of staphylococcus in your urine and the subsequent treatment with antibiotics may have resolved any urinary tract infection (UTI) you had, but it’s also possible that the symptoms you are experiencing now are related to irritation or inflammation rather than an active infection. The white discharge you mentioned could be related to a yeast infection (candidiasis), which can occur independently of STDs and is characterized by itching, redness, and a thick, white discharge. However, your urine tests did not confirm the presence of Candida, which complicates the picture.

Regarding your abdominal pain, it is essential to consider other potential causes. Conditions such as gastrointestinal issues, urinary tract problems, or even stress and anxiety can manifest as abdominal discomfort. Since you have undergone imaging studies (ultrasound and CT scans) that returned normal results, it may be beneficial to explore gastrointestinal evaluations further, such as an endoscopy or colonoscopy, if symptoms persist.

As for your concerns about the possibility of STDs causing your symptoms, it’s important to note that while some STDs can lead to complications that affect the urinary tract or cause systemic symptoms, the absence of typical signs (such as discharge, pain during urination, or visible lesions) makes it less likely that an STD is the sole cause of your current issues.
In terms of management, here are some recommendations:
1. Follow-Up Testing: Given the complexity of your symptoms and the previous test results, it may be worthwhile to consult a specialist in infectious diseases or a urologist who can provide a more comprehensive evaluation. They may recommend additional tests or a different approach to your symptoms.

2. Symptom Management: For the itching and redness, topical treatments such as antifungal creams (if a yeast infection is suspected) or hydrocortisone cream (to reduce inflammation) may provide relief. However, these should be used under the guidance of a healthcare provider.

3. Lifestyle Modifications: Maintaining good hygiene, wearing breathable cotton underwear, and avoiding irritants (such as scented soaps or lotions) can help manage symptoms. Staying hydrated and maintaining a balanced diet may also support overall health.

4. Mental Health Support: Chronic health issues can take a toll on mental health. If you find yourself feeling anxious or depressed about your symptoms, consider speaking with a mental health professional.

5. Regular Monitoring: Keep a symptom diary to track any changes or patterns in your symptoms, which can be helpful for your healthcare provider in diagnosing and managing your condition.

In conclusion, while your symptoms are concerning, the extensive testing you have undergone suggests that a straightforward STD diagnosis may not be applicable. It is essential to continue working closely with your healthcare providers to explore all potential causes and find an effective treatment plan.

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