Q. There are red spots on the penis with no itching. Kindly advice.

Answered by
Dr. Rabia
and medically reviewed by Dr. Nithila A
Published on Apr 15, 2019

Hello doctor,

Male received protected oral and gave protected anal sex to a sex worker. She sat on his chest. It was a licensed establishment which claimed she had been tested regularly. Three days later ended up in the hospital with diarrhea (yellow with mucus) and intense fatigue like never before. They performed many tests and found nothing. Symptoms cleared. Ten days later did STI and STD tests which found nothing. After three weeks he started getting intermittent red spots on the penis. Now balls are very red with no itching.

Dr. Rabia



Welcome to icliniq.com.

According to your description, it can be a bacterial infection (other than STD as tests are negative). An infection acquired through gastrointestinal tract can present like this. The antibiotic course was done for diarrhea or not?

Yes, the skin of the scrotum is very red and inflamed (attachment removed to protect patient identity). And indeed requires the antibiotic course for it. Kindly follow this prescription.

1. Tablet Co-Amoxiclav 1 gm BD for one week.

2. Tablet Metronidazole 400 mg TDS for one week.

3. Apply Fusidic Acid ointment BD over the area.

4. Apply Vaseline (Petroleum Jelly) three times.

5. Maintain hygiene of the area.

6. Wash with mild soap and water.

7. Avoid irritants over the area.

Thank you doctor,

STD and STI tests were done ten days after the sexual encounter. Could this be HIV or hepatitis based on symptom and description of activities? I did a fecal microbiome analysis which noted streptococcus. Three weeks of strong antibiotics were taken and now on probiotics.

The rash still comes and goes. I had a colonoscopy and endoscopy last week. Colonoscopy is normal, In endoscopy, noted non-specific inflammation, at biopsy in the duodenum and mild gastritis. Mild hernia. All else normal. The specialist thinks just eczema. I am stressing out. Please help.

Dr. Rabia



Welcome back to icliniq.com.

After streptococcus infection of the gastrointestinal tract, streptococcus skin infection can occur as in your case scenario. Clinically it is very red and inflamed if it is eczema even then it is infected. Regarding HIV, it can present with diarrhea, rash, inflamed glands but in HIV rash is more widespread like on the trunk or whole body instead of localizing on the genital area.

Hepatitis is not a possibility. If you still have doubt, you can go for an HIV test, but this is less likely. It is more like streptococcus perineal erythema.

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