NGU vs any other STI

[Adrian01]

I had a one night stand with someone a few weeks ago, allowed them to perform unprotected oral. About a week later I noticed a small amount of yellow discharge from the tip of my penis and nightsweats for a few days (soaked the sheets). I had an online STD panel completed (Hep B/C, HIV 1/2, early detection HIV, gonnerhea, chlamydia,syphilis) all negative. The following week, the pus was gone but I have burning towards the tip of penis (urethral) and now pain in the left testicle towards the back. Being concerned I went to the clinic. They gave me Rocephin, 1g zithromax and Flagyl 400mg bid x7d completed last Monday. My symptoms are still present. Question: Wondering if I have NGU or HPV or ? I'm surprised this combination didn't handle symptoms. I have not had sex with my partner for a while so I don't think it's caused by reinfection. Symptoms present about 3-4weeks. Scared and not sure what to do next...retest, another clinic visit or wait it out? Any advice would be appreciated.

[Edward W Hook, MD]

Welcome to the Forum. I'll try to provide some help but I think that to address the issue you will need to be re-evaluated by a knowledgeable professional  NGU is the most likely STI to occur following receipt of oral sex and the timing and symptoms you describe are characteristic of this problem as well.  If this was NGU however, I too would have expected the therapy you had to work.  This is the reason you need further evaluation with evaluation of your urinary tract and prostate as well.  

Testing was a good idea and your negative tests, along with the symptoms you describe, make other STIs unlikely.  This is certainly not HPV as your symptoms are not suggestive of HPV and it takes months for HPV to become clinically apparent when it does, lesions are visible but there are no symptoms.  From your description other STIs seem unlikely as well.  Can you tell me, did your symptoms change at all after the medications you received and if so, how?

EWH

[Adrian01]

Thank, I will follow up tomorrow

[Edward W Hook, MD]

The symptoms you described were certainly suggestive of NGU and it sounds like many of the NGU symptoms (penile discharge and discomfort at the end of the penis) got better with treatment.  Your continuing symptoms may be unrelated or simply represent heightened awareness on your part.  I would suggest you seek further evaluation.  EWH

[Adrian01]

Thanks for the quick response. Just to clarify, based upon my symptoms, you suspect NGU? After the medication, the burn in my urethra stopped at the tip of my penis but started at the base. Pain level much less. Pain in my left testicle remained and again penile drainage has stopped.