health STD & AIDS

[johnnies]

Hi guys,

 

Can someone please suggest a good derma or urologist that I can consult regarding a tiny growth in my shaft?

[TyoPaeng]

Hi MDs. I hope you can help respond regarding this hypothetical situation.

 

A guy has been abstaining from sex for almost a year. He recently met a girl and has been dating her for the past 5 weeks or so. They sometimes engage in unprotected sex. The girl claims to have been abstaining for quite sometime before meeting the guy too.

 

The guy suddenly got some burning sensation when peeing and a few days later noticed some discharge on his penis which is sometimes white, sometimes yellow and sometimes yellow-greenish. He went to a urologist and without doing any more test the doctor diagnosed the case as urethritis. The doctor said that they now don't usually do any more test to distinguish it if it is gonococcal or non-gonococcal urethritis and that they usualy just treat it as gonococcal since the antibioutics will also treat the non-gonococcal case. The guys was given a prescription for Azithromycin (2x250mg single dose) and Doxycycline (100mg, 2x/day for 7 days).

 

Now, the guy is almost sure that he got it from the girl since the girl has been his only partner for almost a year. However, he does not know how to approach her since he is not sure if it is gonorrhea or not. The girl has also not reported feeling anything unusual. One more thing, the guy also performed oral sex on the girl but did not smell anything foul to suggest an STI.

 

My guestions:

1. Was the doctor right in giving antibiotics without having any laboratory test done?

2. Could the guy be just having a really bad case of UTI? Can UTI result to the discharge on the penis? If yes, is it possible that he did not get the UTI from the girl?

3. Is it possible for the girl not to have symptoms if it is gonorrhea?

4. This is not a medical question but you might have some idea on how to approach this due to past patients you had who had a similar situation. How can the guy discuss this with the girl without it looking like he is accusing her? How can he convince the girl to have herself tested and what tests are needed?

 

Thanks in advance for those who will respond. This thread has really been very informative and kudos to the MDs who are giving advises here.

[zenislev]

Meron po bang side effect ang macrodantin 100mg?

[mwah]

@TyoPaeng -

 

I would agree with empiric treatment for nonspecific urethritis since Gonorrheal and Chlamydial infections are frequently found together.

 

Chlamydial urethritis could present with yellowish/yellowish greenish discharge associated with pain during urination in most males. On the other hand, majority of women with chlamydia do not have symptoms.

 

There's no easy way to deal with this kind of thing with a partner. It really boils down to the type of relationship that they have.

Edited April 26, 2009 by mwah

[peterparker]

Hi MDs. I hope you can help respond regarding this hypothetical situation.

 

A guy has been abstaining from sex for almost a year. He recently met a girl and has been dating her for the past 5 weeks or so. They sometimes engage in unprotected sex. The girl claims to have been abstaining for quite sometime before meeting the guy too.

 

The guy suddenly got some burning sensation when peeing and a few days later noticed some discharge on his penis which is sometimes white, sometimes yellow and sometimes yellow-greenish. He went to a urologist and without doing any more test the doctor diagnosed the case as urethritis. The doctor said that they now don't usually do any more test to distinguish it if it is gonococcal or non-gonococcal urethritis and that they usualy just treat it as gonococcal since the antibioutics will also treat the non-gonococcal case. The guys was given a prescription for Azithromycin (2x250mg single dose) and Doxycycline (100mg, 2x/day for 7 days).

 

Now, the guy is almost sure that he got it from the girl since the girl has been his only partner for almost a year. However, he does not know how to approach her since he is not sure if it is gonorrhea or not. The girl has also not reported feeling anything unusual. One more thing, the guy also performed oral sex on the girl but did not smell anything foul to suggest an STI.

 

My guestions:

1. Was the doctor right in giving antibiotics without having any laboratory test done?

2. Could the guy be just having a really bad case of UTI? Can UTI result to the discharge on the penis? If yes, is it possible that he did not get the UTI from the girl?

3. Is it possible for the girl not to have symptoms if it is gonorrhea?

4. This is not a medical question but you might have some idea on how to approach this due to past patients you had who had a similar situation. How can the guy discuss this with the girl without it looking like he is accusing her? How can he convince the girl to have herself tested and what tests are needed?

 

Thanks in advance for those who will respond. This thread has really been very informative and kudos to the MDs who are giving advises here.

 

let me try to answer your queries:

 

1. i believe the doctor is justified in giving broad-spectrum antibiotics for adequate coverage of whatever organism/s is causing the symptoms, maybe that is his style... but personally i would still order a gram stain at the least, just to know for sure what the causative organism is if there are any...

 

2. it`s not just an ordinary UTI but an STD, and based on the history and presentation of symptoms, it can be gonorrhoea, chlamydia, or both and he most probably got it from the girl..

 

3. approximately 30-60% of people with gonorrhoea are asymptomatic or have subclinical disease, kaya more often than not you won`t know if the girl has it.. Women with gonorrhoea may complain of vaginal discharge, difficulty urinating (dysuria), projectile urination, off-cycle menstrual bleeding, or bleeding after sexual intercourse.

 

4. it all depends on the level of understanding that they have.. if they are both consenting adults, they should be open-minded about these very sensitive things.. the right approach should be made and i`m certain that things can be worked out... if ever the girl should consult an OB-GYNE for the proper work-up which would include but not limited to a pap smear, speculum exam, ultrasound of reproductive system... additonal tests may be done if the need arises..

 

 

 

:mtc:

[peterparker]

Meron po bang side effect ang macrodantin 100mg?

 

 

Macrodantin (Nitrofurantoin) can cause nausea and vomiting, fever, rash, hypersensitivity pneumonitis. It can also cause pulmonary fibrosis. All these side effects are much more common in the elderly.

 

Patients should also be informed that nitrofurantoin colours urine a dark orange-brown; this is completely harmless.

 

 

 

:mtc:

[zenislev]

Macrodantin (Nitrofurantoin) can cause nausea and vomiting, fever, rash, hypersensitivity pneumonitis. It can also cause pulmonary fibrosis. All these side effects are much more common in the elderly.

 

Patients should also be informed that nitrofurantoin colours urine a dark orange-brown; this is completely harmless.

 

 

 

:mtc:

 

 

err.. wala naman po akong nararamdaman na katulad nyan.. kundi.. nag-LBM ako... and my urine is light yellow. Nung first day, light yellow green... (im not sure pero parang ganun.)

 

anyhow, nag LBM ako about an hour or two after ko uminom nung dalwang Azyth 500mg.

 

as usual.. may pain pa rin ako sa bladder, this time, parang tinutusok lang ng pin.

[peterparker]

err.. wala naman po akong nararamdaman na katulad nyan.. kundi.. nag-LBM ako... and my urine is light yellow. Nung first day, light yellow green... (im not sure pero parang ganun.)

 

anyhow, nag LBM ako about an hour or two after ko uminom nung dalwang Azyth 500mg.

 

as usual.. may pain pa rin ako sa bladder, this time, parang tinutusok lang ng pin.

 

 

forgot to include abdominal pain and diarrhoea among the adverse reactions to nitrofurantoin...

 

 

:mtc:

[peterparker]

err.. wala naman po akong nararamdaman na katulad nyan.. kundi.. nag-LBM ako... and my urine is light yellow. Nung first day, light yellow green... (im not sure pero parang ganun.)

 

anyhow, nag LBM ako about an hour or two after ko uminom nung dalwang Azyth 500mg.

 

as usual.. may pain pa rin ako sa bladder, this time, parang tinutusok lang ng pin.

 

 

btw, the most common side effects of Azithromycin if present are gastrointestinal; diarrhea (5%), nausea (3%), abdominal pain (3%) and vomiting. Fewer than 1% of patients stop taking the drug due to side effects. Serious allergic reactions, nervousness, dermatologic reactions, and fatalities have been reported but are extremely rare.

 

 

:mtc:

[Bitoy]

Edited due to wrong thread.

Edited April 26, 2009 by Bitoy

[zenislev]

btw, the most common side effects of Azithromycin if present are gastrointestinal; diarrhea (5%), nausea (3%), abdominal pain (3%) and vomiting. Fewer than 1% of patients stop taking the drug due to side effects. Serious allergic reactions, nervousness, dermatologic reactions, and fatalities have been reported but are extremely rare.

 

 

:mtc:

 

 

kaya pala... Doc, Im working kasi.. Kailangan ko pa bang mag leave para mag rest or ok lang na pumasok ako sa opisina?

[peterparker]

kaya pala... Doc, Im working kasi.. Kailangan ko pa bang mag leave para mag rest or ok lang na pumasok ako sa opisina?

 

 

nope, i don`t think kelangan mo pa mag leave if you can tolerate it naman.. in any case, it`s up to you naman, and i would think bibigyan ka ng medical certificate ng doctor mo if you want to take a leave of absence from your work...

 

 

:mtc:

[NASTYMERLIN27]

i never thought it would come to this...

 

please do tell me im wrong...

 

a friend of mine who works at a bar( we're getting close by the way..but nothing in bed..) told me she's having problems down there and thinks its just uti..she professes that she really doenst "do" people

 

when i saw the meds, its doxycycline, cefixime, & quedox

 

now i know what are these are for, but can somebody tell me..is it just a coincidence or its really the real deal...

 

is it really that she has a) syhiliis , gonorrhea c) chlamydia or hopefully its just a bad case of uti.

 

she profess to be very much of a saint but now i dont know...

 

pls help.

 

im trying to convince her to see a doctor, and she's not telling me an ything..

 

help po

[peterparker]

i never thought it would come to this...

 

please do tell me im wrong...

 

a friend of mine who works at a bar( we're getting close by the way..but nothing in bed..) told me she's having problems down there and thinks its just uti..she professes that she really doenst "do" people

 

when i saw the meds, its doxycycline, cefixime, & quedox

 

now i know what are these are for, but can somebody tell me..is it just a coincidence or its really the real deal...

 

is it really that she has a) syhiliis , gonorrhea c) chlamydia or hopefully its just a bad case of uti.

 

she profess to be very much of a saint but now i dont know...

 

pls help.

 

im trying to convince her to see a doctor, and she's not telling me an ything..

 

help po

 

 

ok, in the first place bro, did you ask her who gave her these meds, and why is she taking them..?

 

the only reason i can deduce from this is that she has something, most likely an STD judging from the meds she is taking...

 

something tells me that you really like this gal.. and it`s up to you how you can convince her to trust you..

 

try to tell her that you are concerned for her well-being, and convince her that it`s for her own good that she should consult an OB-GYNE if she has problems down there like you mentioned...

 

 

 

 

:mtc:

[zenislev]

Doc Peter,

 

Pasensya na po sa pagiging makulit pero bakit po kaya may discharge pa rin ako? saka pag nagmanifest po ba yung side effect nung gamot ibig sabihin di sya gumagana sa akin?

 

wala na naman pong pain sa bladder ko pero yun lang may discharge pa rin na konti.