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Avatar universal

What's wrong with me?

I am currently working in Thailand and will fit the stereotype nicely of being the foreigner abroad who goes and gets himself into a bit of trouble, and come to report problems after sex.

I am gravely concerned. I have been a bit of a naughty boy and recently went (without symptoms) for a check up on my sexual health, which I do regardless every six months.

The doctor here wanted to check my blood, and that was it. Since I have to pay for my health checks here, unlike England, I thought to have everything done. That is, blood and urine, and even a swabbing, just in case. Well, it turns out that my choice was sensible since the results that came back from the blood and urine were clear, but my swab gram stain results came back as reporting the following:

Specimen: Urethral swab.

Gram stain result: Gram Positive Cocci (moderate)

PMN's: Few

This was with a WBC of 5-10.

I was given 3x 1000mg tablets (Ciprofloxacin) which I took and completed over the following three days. The 8th and 9th day after visiting the hospital (6th and 7th day after medication) I noticed some light green/yellow discharge from the tip of my penis.

It is important to note that this residue wasn't 'leaking' out of the urethral opening, but only came out when I squeezed the penis up like a tube of toothpaste. The amount was small, maybe like 2 drops of water, but I thought to go back and get checked again, whether I needed it or not. This is where things get interesting.

I was tested again, swabbed, but this time it wasn't an inserted swab, just maybe a little in and around the tip of the penis, after the doctor squeezed something out. I waited for the results, and this is what came back.

Specimen: Discharge (Penis)

Gram stain result: Gram NEGATIVE cocci (Moderate)

PMN's: Moderate

White blood count: 0-1
The doctor told me I did not have chlamydia. My blood and other tests and screens for syphilis and HIV came back A O.K, clear for all. The doctor also insisted, despite the change of bacteria from Gram Positive to Gram Negative, which I know to be quite important for diagnostic purposes, that I did not have gonorrhoea either.

To again clarify some points.

The discharge was not white, or clear or like cottage cheese, but rather light yellow/green.
The discharge wasn't coming out of me unless I squeezed my penis to force it.
The discharge was around one to two drops of water in volume.
The discharge stayed together when I removed it with rolled tissue, behaving like saliva when I touched it, a little sticky, but quite fluid.

I don't know what to do, since I have seen two separate doctors now, both prescribing me the same drug, one telling me it was gonorrhoea (first test, despite gram positive results) and the second saying it absolutely is not, more likely NSU.

The testing is very expensive and has me feeling really down, what's wrong with me?
11 Responses
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Avatar universal
Hi Dazzletoad

What was the outcome?

Regards
S
Helpful - 0
Avatar universal
Just an update, 16 days after initial treatment this is what I have found.

Ciprofloxacin had been effective in reducing and somewhat diminishing the fluid that was coming from my penis. Each round of the two 3-day (3x 1000mg) dosages had caused the discharge to subside.

However, in each case, a few days after the medication had been stopped the discharge reappeared. The doctor, whom I visited just two nights ago told me that NSU can take months to treat in some cases, up to three. If it takes months to treat in some cases, why did he give me medication for only three days, like the other doctor?

Another thing is why prescribe the same medication for both gram positive and gram negative infection?

And why prescribe the same medication which has evidently not worked the first time around, or for the last 16+ days?

I decided to take matters into my own hands and threw a toss up over azithromycin and doxycycline antibiotics and decided on azithro. I purchased a 6 day course, took 2 pills the first day and will continue on 1 per day till the rest are gone.

If a course of an alternative antibiotic doesnt work (which is prescribed as medication against NSU in normal cases) then I will return to the hospital and make an appointment with the urologist. I will keep this updated.
Helpful - 0
Avatar universal
Thank you so much Grace, great advice.

I will post an update on here in a week or so to let you know what happens either way, but it seems my problem has disappeared. No discharge lately and no other symptoms seem to indicate where this is going.

The contamination thing could answer to the change of stain results. I will make sure to take care too :P

Again, many thanks for your answer ^^
Helpful - 0
101028 tn?1419603004
honestly I'd question the 2nd gram stain results since they really didn't do the swab properly.   it very well could be contaminate.

at this point since you really don't have symptoms, I'd leave the lil guy alone for a week and let him heal. should you get a return of painful discharge, I'd be seen again for urine testing. no reason to continue to swab you in your urethra and add to your discomfort at this point since all your std testing is negative.  make sure they manually examine your prostate too should your discharge and/or pain return.



Helpful - 0
Avatar universal
Hey Grace,

I got blood taken for the HIV test and syphilis. They took urine for chlamydia I assume, and maybe any other signs of gonorrhoea. The first doctor tested blood and urine, and swabbed me.

The results were clean other than the swab which was gram positive. I only got swabbed from him, no culture or dna testing on the results.

The second doctor, whom I saw 9 days later, took urine and swabbed me too, but non insertion, only some discharge which he squeezed from my penis. Again, urine was ok, but the gram stain changed to gram negative. In this instance, like the last, the lab didnt do any further testing, it was a matter of 'The bacteria arent paired, and maybe neisseria family, but aren't dipplococcus'.

On the second doctors contrary opinion, I decided to come and look for some more help here. It is worth mentioning that these doctors are thai, and thai STD clinics (almost non existent independently apparently), even in hospitals, aren't always reliable and there have been numerous misdiagnoses.

I know my answer is a bit bloated, forgive me.
Helpful - 0
101028 tn?1419603004
so they are only doing gram staining and not cultures and/or additional proper std testing on you?

grace
Helpful - 0
Avatar universal
Likewise to you.

I had unprotected sex, and went for a check thats that.

Blood testing came back clean for HIV and Syphilis. I was checked and chlamydia wasnt a problem.

I came here hoping for a different opinion since my first check my gram stain came back 'gram positive', and the follow up a swabbing came back 'gram negative'. If that isn't worrying I don't know what is.

You can give an opinion other than talking garbage like 'milking the penis doesn't mean symptoms'.

Perhaps you oversaw it too my friend, but I was seen by two doctors. The medication given would work on gonorrhoea but be less effective on chlamydia, and despite the fact I seem to have gotten better, the reason I am here is to try to understand what happened to me.

Your opinions are valuable to me, but not the redundant ones...
Helpful - 0
Avatar universal
Your sarcastic comments do not play here.

If concerned see a Dr, you have been tested and treated by a Dr and he/she is your best resource.

Don't even know what you did sexually so can't even say if you had a STD risk.
Helpful - 0
Avatar universal
Thank you for that 'in depth' answer. I should point out the first time when I checked it, I wasn't necessarily squeezing my penis, as more looking at it and noticed the liquid, which led to me taking it out.

Discharge or any abnormal fluid coming from my penis is by definition a symptom, since it is an abnormal loss of bodily fluid that isn't urine or semen.

Either way, my symptoms are subsiding. I thought there may have been a bacterial imbalance created by the medication, but that can't be the case since the continued use of another 3 day Ciprofloxacin issue has resulted in less of this fluid being produced.

I thought maybe an irritation or response from the initial swabbing may have caused some problem for me too.

I have read into it, and was looking for a more, say, expanded answer than the one previous.
Helpful - 0
Avatar universal
Milking the penis does not mean you have symptoms.
Helpful - 0
Avatar universal
I should probably also note that my penis displays no redness, no rash, no discolouration, I have no itching or swelling or tenderness, on or around the penis or the testicles.

I don't get burning from urinating either, but my mid urethra feels sore, that I think is from man handling it.
Helpful - 0
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