Question: Hello I live in Egypt if that matters for your diagnosis . I am also a software programmer , i do not work in the medical field . So the classic story . On 1 XXXXXXX 2013 i had sex with a girl ( this is the first time i had sex ) .She is not a sex worker but you can say she plays around a lot . It was protected but we had a sort of unprotected contact plus oral sex . I also took Viagra . On the second day my throat felt very sore . I was stressed about this issue. I also got from her a UTI and went to see a doctor . I took antibiotics and the UTI was clear . During the UTI i did not see pus yellow or green , just clear discharge some times after urination . I did urine analysis after that and also a urine culture and every thing seemed perfect in both . Even before the antibiotics the WBC in urine seemed a bit elevated , that doctor did not want to give me antibiotics but i insisted on taking them . I took an injection and 2 pills . The doctor told me i have prostatitis though cause i had waist pain and testicle pain that persisted until now . My sore throat never went away , so i visited ENT . The ENT told me your throat is perfect i dont see any problems but your acid reflux is bad . your nose is also affected by the acid , ( he used some endoscope to check my throat and nose ) About 4 weeks later i notice my tonsilar lymph nodes swollen . At that point i was so scared of HIV . I never got fever , rash , sweats , cough , running nose , or flu like symptoms ( classic HIV i assume ) , just the lymph nodes .I dont get flu since years thanks to the vaccination . I was scared that i got a strain of HIV that did not show the normal HIV symptoms but enlarged my lymph nodes . I can feel something in my neck when i look to the right or left but no one can see it . I can feel it with my finger when i look to the right or left . Also small one on the side of my neck maybe lentil sized . but the tonsilar ones are kinda big , but not seen at all . I went to see another ENT and he said do not worry about the lymph nodes . He searched with his hands and said i cannot find them even the one on the side of my neck . He also checked my throat and told me it seems perfect , he said i will not prescribe any medicine to you cause you do not suffer from any thing except acid reflux . I went back to my urologist , cause of the prostatitis issues , he didnt want to do further tests , but i insisted . I did semen culture and the WBC was very high . 1.2 million . I went back to him and he put me on Cypro for 1 month . I dont see much improvment with that antibiotic , still pain in my groin area and the lymph in my groin is felt . I can feel them . I also wonder why i never got fever for the prostate infection ? My temp is 36.5 which is way below normal throughout this entire time . I measure my temp maybe 5 times daily . I was stressed about HIV and thought about it a lot . I hate to stress about something so i decided to be sure i dont have HIV to put my mind to rest . I waited 4 month and 20 days and did the following tests . Did the test on 20 October for Hep B Hep C HIV All came negative . This put my mind at ease a lot , cause those diseases are the big deal as far as i know . I thought if i dont have one of those then i am ok , any thing else is curable . Is the 4 month 20 days period good to be sure 100% that i didnt catch HIV ? I heard some people say 3 month and some say 4 weeks and some say 6 months . Knowing that i did not get any rash in my body or genitals , i assume i dont have syphilis or HSV . I am right in this ? Can someone have syphillis but not show the classic rash on the phase 1 and 2 of the disease ? Is it possible that i have some other STD like chlamydia in my throat that causes the lymph nodes to enlarge ? But is it possible that the ENT cannot see a chlamydia throat infection ? Do you suggest i do chlamydia or gnorhea throat culture ? Is it possible that i have another STD that is in the blood only but not showing any symptoms except the lymph nodes in the neck ? Could the bacteria in the prostate be wondering in the blood or something and proceeding towards a Sepsis and that causes the lymph in my neck ? I also want to know what are the risks of prostatitis since i know i have this now ? Can this hurt my body in some other way or it will be always contained in the prostate ? Can there be complications from it ? Can the infection in the prostate cause lymph nodes in other places of the body to enlarge ? What are other STDS out there that could enlarge my neck lymph nodes ? OR the lymph nodes are not related to an STD at all and its all about the throat inflammation from Acid , which i can feel every day in the morning . I wake up with burning feeling in my throat that goes away after i drink and so . Do you think i might have Mono , that did not show flu symptoms but enlarged my lymph nodes? Also can a mono infection cause my lymph nodes to remain swollen like this for several months while not showing flu like symptoms ? Another thing worth mentioning i get tingling feelings near my colar bone , and pins and needles in my neck , behind the ears , back of the neck , front of the neck , the feeling of insects walking on my neck ( but without the insects ) . Is there any STD that can cause such symptoms ? I know i am straining my muscles from the anxiety a lot . I took my anxiety to a new level really during the last few months . I will never have sex again and i wont get married even . Peace of mind is a great thing . I am sorry i am flooding you with questions but really i am stressed about having something that no one can find . I also want to let you that i was being treated from anxiety , my condition was up and down last years . I been on seroxat for sometime , but i read that is a bad medicine and decided to stop it . I went through hell to clear it from my body , i do not want to tell you this long story . My heart the left shoulder always hurt and i checked for all heart issues and they found nothing . I am also talking to another doctor on your site that might help me find another drug to help with the anxiety issues , maybe long term anti depressant or something . Thank you for reading all this , i know it sounds complicated , but this is what happened .

Thank you so much for the answer . So if i never had that strange rash in body or so i would never be sick with syphilis right ? What about the lymph nodes in my neck , i have like 3 of them now . What could they be ? I also forgot to mention that i have some strange pins and needles feeling in my chin and front of the neck, the back of my ears . Is that a symptom of any viral infection you know of ? Can i have a throat chlamydia infection that the ENT cant see by the diagnosis ? or something like this will be very visible to him ? One last thing , can the Acid reflux infalmation cause those lymph nodes , some days they are felt and big , some days i cant find them . Can the acid reflux be a a reason for those nodes ? Is there any STD you know of that will just cause lymph nodes in the neck without fevers or any thing ? Thank you very much .

Also i had some questions about prostatitis . I didnt read any where that this condition causes the lymph nodes in the groin to enlarge . Does prostatitis cause enlarging of the the groin lymph nodes ? Can it affect the armpit lymph node or the neck lymph node ? Also my WBC count in semen was 1.2 million the doctor said it was so high . Why is my temperature normal if i have such bad infection in the prostate ? My temp is like 36.5 most of the time . Is that normal ?

Hello The thing is i am sure my prostatitis happened after the sexual encounter . I never had testicle pain in my life before that day . Also i never felt the the lymph nodes in this area , now i feel them itchy , at exactly the same spot where they are enlarged . Some times i feel heat sensation in that area also . So i am pretty sure that i got the prostatitis from a bacterial infection . I dont know how can i send you the pdf of my test reports , can we use email ? The urologist assured me that 1.2 million is a bad infection and he gave me a Cypro for one month . He told me we might go on for 3 month on Cypro to clear this infection . The problem is i still get waist pain and testicle pain on some days . I stopped the antibiotic cause i think this is not the right antibiotic for me . Now i am going to repeat the semen test again i will get the second result tomorrow after a month and half of antibiotics . I dont think we can assume the urolgist is wrong about this ? I feel he was wrong about the medication though . Maybe Cypro is not the correct choice for the kind of bacteria i have . Did the urologist make a mistake to prescribe a certain antibiotic without asking for the culture ? It is possible that i caught Chlamydia or something that caused the chronic bacterial infection . And if i do not have bacteria , why is my groin lymph nodes enlarged ? Please give me a way of uploading the pdf of my report to you . Thanks

Hello dr XXXXXXX I uploaded my first analysis report . Please let me know what you think .

Hello I will upload my second semen analysis tomorrow when i get it from the lab . This will be after one month and half of Cypro antibiotics . The thing i notice in the report is the 1.2 million WBC , isnt the normal less than one million ? Also the urolgist i saw in Egypt told me the normal range is 200,000 and that 1.2 million is way beyond normal . I felt he made sense cause i really had symptoms like waist pain , sometimes a bit burning sensation , and testicle pain was so real. Also the itchyness in the groin is so real this part cannot be anxiety . And there is also the lymph nodes . I just do not trust his choice in antibiotics and i feel that the antibiotic should be based on culture results not just analysis . My urine tests were all normal even the urine culture was normal . I do not have Pdf formats of them but i am sure they are ok . I can repeat my urine test if you want , the tests here do not cost me much and i want to come up with the best diagnosis . I feel that you are really an expert in this and i am very confident in you addressing my concerns . Thank you for your patience and your prompt replies . Oh and also i test blood test twice and it had absolute lymphopenia reported . There was a period of time between them . So i am sure there is an infection going on . Total Leucocytic count 8100 ref 4000-10500 segmented 74.6 % 6043 ref 2000-6500 Lymphocytes 18.2 % 1475 ref 1500- 3500 Monocytes 2.3 % 187 ref 300 - 1000 Count is within normal limits for age and sex except for absolute lymphopenia . Platelets are normal . I dont know why my monocytes are so low , this is what scared me of HIV at the first place . But for sure there is an infection going on cause the differential seems messed up

Hello dr XXXXXXX Thank you for reply . I did doppler scrotal as per my urologist request , i assume this is ultrasound ? Any way the result is 100% normal . Is it ok that i do a semen culture using masturbation , i dont feel good doing the massage and i do not think the urologist will do it anyways . Is the culture from normal ejaculation inaccurate ? Thank you again .

Thank you again dr XXXXXXX I am attaching to you now the second semen analysis , i just got the results now . I see a big reduction in the WBC , and i think this is good news . Tell me your recommendation based on this result ? Do i need one month of the medication you wrote of period as maintenance therapy ? Or get back to my urologist and see what he says ? Or continue on the same antibiotic that he gave me for another month which was Cypro 750 twice daily . Thanks i dont really understand what is the Total Abnormal Forms , it seems to be incresed from 30 to 50 . but i dont worry about that i am just curious what it means . the same thing about the Spermatogenic Cells decreased from a million to 100K , i dont know what it means , but i dont worry about it a lot . I am very pleased with the decrease of pus cells from 1.2m to 200k , i think 200k is kinda healthy limit ?

Hello Final question :) Can you tell me your recommendation based on this result ? Do i need one month of the medication you wrote of period as maintenance therapy ? Or get back to my urologist and see what he says ? Or continue on the same antibiotic that he gave me for another month which was Cypro 750 twice daily . Thanks