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Dr. Andrew Rynne

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Entrococci in semen and having mild burning sensation. Any infectious disease?

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Dr. V. Sasanka

Urologist

Practicing since :1995

Answered : 529 Questions

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Posted on Sat, 29 Dec 2012 in Men's Health
Question: I was tested to have entrococci in semen , the doctor gave levofloxain 500 for 6 weeks. Now, I have been taking it for more than 25 days but with no improvement . I still have a mild burning sensation . My symptoms are feeling burning after some time of ejaculation and continues so but gradually become mild but in few days, especially after the doctor gave me omnic ocas 0.4 besides levofloxacin 500 mg once a day . By the way the result of my semen culture was as follows : pus 18-20/HPF RBC 1-2 /HPF
Growth of entrococcus . Sensitive to Vancomycin , Gentamicin 200, Ciprofloxacin, Levofloxacin . This culture was for semen . I have no other symptoms. Only burning feeling most of the time. My urine culture was negative. PSA was normal. CT scan and ultra sound was also normal.Please note that when I am urinating , there is no burning but mild burning later afterwards. Sometime I have some sort of pain on top of penis . I would like to ask, how I got infected with sort of infection ? Is it an STD? Besides, I would like to ask if it an infectious disease ? Would it be transmitted to my partner in any way ?

What is your opinion and advice.
doctor
Answered by Dr. V. Sasanka 21 minutes later
Hi,
Semen cultures are notoriously inaccurate, and do not always reveal the culprit micro-organism, as the semen travels through the urethra where it could have picked up some other bacterium.
Levofloxacin is not a bad choice, and usually is a commonly prescribed drug for similar infections. It needs to be given for fairly long time for optimal effect, maybe for more than 8 weeks in fact. Doxycycline also could be useful
In the meantime, if you find that you still have burning in urethral passage after you void, you might get relief from mild urinary alkalinization with citrate solution. Also, some drugs called alpha-blockers also could be of help in voiding urine with less discomfort. You will however need a prescription from a doctor to be able to use them.
I doubt if the infection you have received is sexually transmitted. I consider it unlikely from the information you have given. You can use protection with condoms if you are concerned about transmission of infection to your partner.
Hope I have been able to help you.
Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. V. Sasanka 15 minutes later
Hi doctor ,
Is it possible to take another antibiotic such as doxycycline or ofloxacin or ciproflexin besides levofloxain 500mg . If so, what you recommend , and what would be the dose and for how long ? Remember that I have been taking levofloxain for 25 days up to now . Awaiting your reply ASAP. I have uploaded my semen culture results. Hope you would help me . I am worried about my case .
Thanks
doctor
Answered by Dr. V. Sasanka 10 hours later
Hi,
I think you should continue with your use of Levofloxacin at the present dosage. It almost works as well as Ciprofloxacin or Ofloxacin, and having started it, there is no need to discontinue it just yet. As I said, quite often we need to give treatment for almost 8-12 weeks.
I do understand that you are worried about your problem. You should realize that you have already placed your case in the hands of a reasonably competent urologist who seems to have started you on the usual kind of treatment this requires.
Your anxiety is only going to worsen things further - you will be paying attention to symptoms which under other circumstances you would have ignored, and not been troubled.
Take plenty of oral fluids, and as I mentioned earlier, you can try requesting your urologist to see if he thinks you will benefit from the use of citrate syrup, an alpha-blockers. I have seen the report of urine examination which you have uploaded, and there seems no major issue there.
Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. V. Sasanka 1 hour later
I do thank you very very much . You have been so helpful. Thanks again. Wish you all the best.
doctor
Answered by Dr. V. Sasanka 9 hours later
Glad to have been of help.
You are welcome.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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