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Dr. Andrew Rynne

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What causes persistent epididymal soreness and cyst, and kidney pain despite completion of the treatment for infection?

Answered by
Dr.
Dr. Monika Dede

Infectious Diseases Specialist

Practicing since :2003

Answered : 867 Questions

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Posted on Wed, 9 Jan 2019 in Infections
Question: August 2015
I had Chlamydia, was tested positive and treated with the two antibiotic pills taken once which seemed to cure it. 6 months on something still didn't seem right so I was tested again but it came back all clear, they also tested for syphilis, gonorrhoea and HIV. All came back clear.

January 2016
I started to experience the symptoms very irritable and swollen on the right testicle, I went to the doctors explained above ref Chlamydia and they gave me a 9 day course of doxycycline as they suspected epididymitis. Which did work initially, then the symptoms came back once the course was finished, the doctor then put me on a 4 weeks course. But I had alot of pain and swelling in the right epididymi. The 4 week course of doxycycline did stop the infection I believe at the time but still had swelling and soreness.

I had a UT scan to reveal I had a epididymal cyst, the doctor advised it would cause no harm and I would have to live with it. It is about the size of a pea. The skin over my epididymi is red sore and stringy, not normal, like its infected as my epididymi is sore.

Over the past 18 months I have visited three urologists who have tested for urine culture, semen culture, an E Coli infection was found about a year ago and was treated with cirpofloxin but these were separate symptoms which came on quickly and cleared up with the course of antibiotics.

January 2017
I was still left with the follow symptoms after the E Coli cleared up (which have got worse, see below)
Symptoms (mostly after ejaculation)
Red Meatus
Red Tip after ejaculation
Burning after ejaculation
Right epididmy swelling and sore
Lower back/flank pain comes and goes.


I have completed private urine cultures with the the following results but the doctors dismiss these saying its a contaminated sample as WBC count is 0 or very low.

Private Test results:
May 2017: 10,000 - 100,000 cfu/ml Enterococcus faecalis XXXXXXX 2017: 10,000 -100,000 cfu/ml Enterococcus faecalis
August 2017: >100,000 cfu/ml Enterococcus faecalis XXXXXXX 2018: >100,000 cfu/ml Enterococcus faecalis


ABX tried
6 weeks Doxy
6 Weeks Cipro 500
8 Weeks Cipro 750
2 weeks Nitrofuratin



January 2018
Where I am now...
I have left these symptoms for 12 months based on two urologists advice saying I'm just sore after my E Coli infection but over the past 12 months the symptoms have steadily got worse, it burns for hours after ejaculation sometimes all day and all night, the infection/pain feels like it has now progressed into my kidneys and they are sore a lot of the day, it's painful when I drink anything other than water, if I can other liquids I get sharp pains from my kidneys as it filters through.

Where do I go from it here? it feels like I have an infection but I can't seem to get a diagnosis.

It feels like to me, every time I take antibiotics its clears up any symptoms to my body down to my right epididymi (with cyst), then once the abx finish it starts to spread back up from the right testicle like almost the right epididymal cyst is stopping the infection being killed off each time. Each time the symptoms come back stronger. But I get told over and over that isnt the case...

Just as a side note my prostate (touch wood) has been fine, urinating normal, good flow, no pain at all, semen can be a little thick it seems but that could be from the infection from the right epididymi?

My biggest concern is where to go from here and now my kidneys are really sore with lower back pain, I am worried about damage to them?
doctor
Answered by Dr. Monika Dede 7 hours later
Brief Answer:

I suggest a recent abdominal and testicle ultrasound and lab exam.

Detailed Answer:

Hello,

I have read carefully your long history and I need to know if the antibiotics you have taken are according the results of the antibiogram of urine culture.

It is a good news that you are negative for HIV and STD. Furthermore I think you have to do the following:

1. Recent abdominal and testicle ultrasound and
2. Lab examinations like:

a). Blood urea creatinine, (for kidneys),
b). Blood sugar (diabetes),
c). PSA(tumoral marker for prostate)
d). PCR for tuberculosis in urine in order to check your kidneys and to define better the diagnosis.

I hope my answer helps you. Let me know if I can assist you further.

Regards,

Dr. Monika Dede,
Infectious Diseases Specialist
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Monika Dede 12 hours later
Thank you for the reply.

The antibiotics were given based on the findings of E. coli and the sensitivity

Then given for the entrocococous again based on sensitivity. But this infection still seems to show after treatment, if an infection?

I forgot to mention. I have had two testi ultrasounds both round 3 cysts. Would they need to look for anything else?

I have requested a kidney function test but the kidney pain is only in the last 4 weeks, the ejaculation soreness and other pain has been for a year.
doctor
Answered by Dr. Monika Dede 19 hours later
Brief Answer:

You should explore these epididymus cysts.

Detailed Answer:

Hello,

Thank you writing back.

I suggest to explore these epydidymus cysts.

You should know that Enterococus faecalis it is not a normal flora in penis but just in rectum area and could infect the genital area during a continous anal sex .

You should do a kidney functional test even if you have pain the last 4 weeks.

I hope my answer helps you. Let me know if I can assist you further.

Regards,

Dr. Monika Dede,
Infectious Diseases Specialist


Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Monika Dede 7 hours later
Thank you for the reply.

I have a couple of questions regarding e faecilis.

Is it hard to eradicate? As cipro 750 for 8 weeks didn’t seem to remove it.

Can it exist without cloudy urine etc?
doctor
Answered by Dr. Monika Dede 22 hours later
Brief Answer:

The best treatment could be according the antibiogram.

Detailed Answer:

Hello,

You should know that Enterococus faecalis bacteria don’t usually cause problems in healthy people. But people with underlying health conditions or a weakened immune system are more likely to get sick. These infections often spread in hospitals.

Recently it is been known an increase in drug-resistant of E. faecalis and many antibiotics don’t work against infections caused by these bacteria.

Usually we use Ampicillin or Vancomycin as a good choice for the treatment but the best treatment could be according the antibiogram.

Yes it could exist even without cloudy urine.

I hope my answer helps you.

Regards,

Dr. Monika Dede
Infectious Diseases Specialist
Above answer was peer-reviewed by : Dr. Kampana
doctor
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