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Pain on urinating, discharge, tingling inside urethra. on zithromax. urine test detected chlamydia, gonohrea. HIV test negative. Treatment ?

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I was diagnosed with Chlamydia after having gone to the clinic and being tested (urine) for Chlamydia and Gonohrea since I was experiencing pain while urinating and not seemingly not completely voiding, slight discharge ( It was difficult to tell if it was clear or puss-like since it was noticed on my underwear when it was already dry), urgency of urination, tingling inside my urethra, and feeling like I would have to urinate even after I had just urinated. I was given 1 gram of zithromax. After the 7 days had past, I was still experiencing slight symptoms such as tingling in my urethra, slight inflammation (redness) at the tip of my penis--which I did not notice before--and slight pressure/pain in my testicles.
I went to get another STI screening (urine for trich, and swabs for Chlamydia and Gonohrea, Serology for HIV, Syphilis, and Hepatitis C) about 2 weeks after the 7 days, but this time not only for Chlamydia and Gonohrea but for Trichomonas, Syphilis, Hepatitis C, and HIV. It all came back negative.
However, I still have slight tingling from time to time, very slight redness at the tip of my penis, and pressure/pain in my testicles (mainly 1).
And It's now been 4 weeks since the 7 days have past.
Why am I having these symptoms if I was successfully treated?! Please be as descriptive as possible. Also, any suggestions? P.S. I have abstained from any kind of sexual intercourse since my positive Chlamydia test result.
Posted Tue, 8 May 2012 in Sexually Transmitted Diseases
Answered by Dr. Rajiv goel 6 hours later
Thanks for the query.

As stated you seem to have contracted chlamydial infection during intercourse.

All your symptoms suggest the same.

You have been treated well with zithromax but if some symptoms are still persisting then you should take doxycycline under the care of your doctor.

Inform your sexual partners of infection. They should be treated or tested so the infection is not passed back and forth.

Be retested if your symptoms continue or you think you have been reinfected. Having the infection once does not confer immunity to repeat infection.
Use latex condoms during sexual intercourse.

There is also a possibility that you may have contracted fungal balanitis also during the same episode and you should be treated for the same too.

Hope i have answered your query.I will be available for follow up.
Above answer was peer-reviewed by
Follow-up: Pain on urinating, discharge, tingling inside urethra. on zithromax. urine test detected chlamydia, gonohrea. HIV test negative. Treatment ? 12 hours later
What leads you to the conclusion that I may have also contracted fungal balanitis?
Also, what is causing this pain/tenderness in my testicle?
Lastly, should I get tested for fungal balanitis and if it comes back negative then should I start taking doxycycline? or should I take it as soon as I see my doctor again?
Answered by Dr. Rajiv goel 23 hours later
Hi and thanks again,

1. Fungal infections are opportunistic infections. They colonize when conditions are favourable such as lowered body resistance. Bacterial infections such as chlamydia and gonorrhea can sometimes reduce body resistance. Further use of antibiotics can also favour fungal growths. Hence we often find fungal infections coexisting with bacterial infection.

Due to the same reasons, we often find fungal infections commonly when some is affected by sexually transmitted infection.

This offcourse is my assumption which can be confirmed by proper examination and tests such as KOH preparation or fungal growths. You may discuss this with your primary doctor.

2. Testicular pain may probably be due to orchitis secondary to the same infection. A thorough examination is also useful here. With appropriate antibiotics this should also resolve.

3. I would suggest a reexamination, repeat testing under the consultation of your treating physician. Doxycycline may be started after discussing with them.

Hope this helps.

Wish you a speedy and healthy recovery.

Above answer was peer-reviewed by
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