Not sure what this could be

[Throwaway887654]

Background: Had unprotected oral sex with 3 males in one night (I'm also male), both gave and received, also one instance of them touching my anus (briefly).

Few days after I get standard STD symptoms, discharge (cloudy white/watery), pain while peeing and general urethra pain & redness. Then couple days after this I get high grade fever, night sweats, cough (mild), general flu like symptoms. Then the sore throat and I mean the worst sore throat I've ever had, swallowing was horrifically painful. The encounter was while I was abroad (off coast of Africa), came back and went to GP - tested for gonnorhea & Chlamydia via urethra & throat swabs (by now discharge had basically cleared). One of the swabs came back positive for Chlamydia, started on doxycycline for 7 days. Things start to improve, discharge all gone and sore throat improving but now new symptoms appear, mild conjunctivitis, cough continues (still mild), tonsillitis, swollen lymph nodes (armpits and especially in groin area), start to notice usual bumps/brown skin appearing around urethra and on glans, still have urethra pain and redness. Finished Doxycycline still have these symptoms, went back to GP who advised to go to a GUM clinic, I asked for extra Doxycycline too, which I'm still taking. Went to GUM clinic, more tests for gonnorhea, Chlamydia (throat/rectal - they said no point in urethra since there's no discharge) they were uninterested in the bumps/brown skin on my glans. They also took bloods for HIV/syphilis & Hep B, waiting on these results.

So basically I'm unsure right now, I'd expect the doxy to clear the Chlamydia by now after the first 7 day course, I'll continue to take the other 7 days to be sure. Could the brown skin bumps/growth by the start of HPV warts? Should I be worried about tropical diseases as I was off coast of Africa? What could I ask the GUM clinic/GP to do further tests for? Any advice would be much appreciated, I could order some azithromycin but I'm worried about causing resistance unnecessarily.

Thanks

[auntiejessi]

So hear me before dismissing it entirely, okay?

You don't give me a really precise timeline, but it sounds like it's all been over the course of a few weeks. You also don't mention what part of Africa you were in, other than off the coast, but in any case, have you considered that you also got Omicron?

The reason I ask is because I had it, and many of your symptoms sound like mine - the night sweats, sore throat, general flu symptoms. The symptoms of Omicron are different than other variants of covid - there's less loss of smell and taste, more back pain and night sweats.

I don't know what the brown spots are. The HPV associated with oral sex usually is the high risk kind and doesn't present with genital warts. I'm a little baffled that no one wants to look at it. Maybe show a dermatologist? There is something called penile melanosis, but it's not associated with STDs, travel, Africa, etc - https://www.healthline.com/health/penile-melanosis

I'm not at all familiar with tropical diseases, but an infectious disease specialist would be if it doesn't clear up.

For sure don't take any more antibiotics. There is already resistance to azithromycin, so don't take that.

[Throwaway887654]

Yes I probably should have mentioned that was my first thought, so I got a PCR test as soon as I got home and it came back negative.  I also had Omicron a month before that so reinfection so soon after was already unlikely, but not impossible.

It was Gran Canaria, Spanish territory just off the coast of Africa.

Maybe it could be a side effect of the antibiotics, something like candida overgrowth or lichen planus? They're not presenting on the foreskin and don't yet look like the usual "cauliflower" shape of HPV but it's early days. Not sure if there are any other bacteria that cause brown skin patches/bumps to grow. I'm aware of penile melanosis as I've had a patch of darker skin on the glans that's been there for many years, what I'm experiencing is definitely different to that though as the skin is raised.

Maybe I'll ask the GP to refer me to a dermatologist, seems like doctors really don't want to take a proper look, not that I can blame them but it's a bit frustrating!

Thanks for your help so far :)

[auntiejessi]

The testing with Omicron has been spotty - at least people here are getting negatives even on the PCR when they have it, but given that you recently had it, I agree that though it's possible, it's probably not likely.

I think a dermatologist would be a great start. I suppose it could be candida or lichen planus, Have you used anything on it? I don't want to suggest anything, but I'm wondering if it's responded or not responded to anything.

It is frustrating - there are things that happen on the genitals that are not related to STDs, and doctors need to look.

[Throwaway887654]

I agree with you on that, tbh I would expect it to be positive since I had it recently, they usually stay positive for up to 3 months. But yeah it came and went very quickly, although maybe my immune system just responded to it fast and cleared it up, who knows.

I'm guessing any general dermatologist then, there aren't special ones for the genital area?
I have started to use castor oil, I can't see much difference and actually as the days go by I'm finding more area affected and the ones that were present seem to be protruding more...I guess it'll become pretty obvious it's HPV soon enough.
I did buy some warticon but since most the affected area is the glans and meatus I don't think I can use it there. I've not tried yet maybe I'll try treating the part on the foreskin that's cropped up and monitor that.

It really is, my GP has agreed to do a urine culture and a general blood test for me just to rule out any other bacteria that might be causing it. Oh and the tests from the GUM clinic came back negative.

Now I'm also worried about oral HPV warts since I've had a globus sensation the past day or so, not sure how common that is.

Thanks for replying, just explaining things is helping, this whole thing has really knocked my mental health for six.

[auntiejessi]

No, no specialty derm, unless you find one that lists that on a profile or website somewhere. It's not an official speciality, but might be an area of interest.

Yeah, if I had a penis, I wouldn't put Warticon on the glans and meatus. I'm not sure I'd put it on the foreskin. I might start with something gentler, like a hydrocortisone cream, though only use that for a few days. I think Warticon has acid in it. Check the ingredients though. If it's not HPV, you'll be literally burning the skin.

Oral HPV usually has no symptoms. A globus sensation might be anxiety, or reflux/GERD, etc. It's not associated with an STD.

Most oral STDs present with no symptoms. If you're concerned with oral STDs, ask for an oral swab for gonorrhea and chlamydia, and get a syphilis test. Those are really the only things you need to worry about from giving oral.

Hang in there. I know having a condition that you haven't identified is tough.