The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
After having unprotected sex, I have acute testicular pain with pain in the buttocks on the left side. I also have knee pain on the left side with a white rash on the scrotum with genital itchiness. I also have a burning sensation at the end of urination and generalized weakness without interest in sex.
Hi,
Welcome to icliniq.com.
Having testicular pain after unprotected sex indicates an infection and it needs to be investigated. You need to send the investigations done and I will help you treat the condition.
Patient's Query
Thank you doctor,
I have attached the reports. I have a white rash on the scrotum and it keeps on coming. I did a test for chlamydia, gonorrhea and urine culture. The results came back negative. I took Ciprofloxacin for fourteen days and I do not have any changes.
Hi,
Welcome back to icliniq.com.
The picture (attachment removed to protect patient identity) shows laceration due to itching. The itching occurs due to a fungal infection and it is treated with an antifungal cream which has to be applied topically. It is necessary to do an investigation for STD (sexually transmitted diseases) and ultrasound scrotum to check the testis and a swab for gonococcal and chlamydial infections. If you have a discharge, then you need to do testing for syphilis, HSV (herpes simplex virus), hepatitis B, C, and HIV (human immunodeficiency virus). Then you can start taking medications. If you do not have a discharge, then you do not need to do these tests. You can take Ciprofloxacin 500 mg twice daily for two weeks, tablet Metronidazole 400 mg thrice daily for a week, and topical Canesten (Clotrimazole) cream twice daily for a week.
Patient's Query
Thank you doctor,
I do not have a discharge. I have a negative result for syphilis, HSV 2, hepatitis B, hepatitis C, and HIV. I have a positive result for HSV 1.
Hi,
Welcome back to icliniq.com.
Its alright.
Patient's Query
Thank you doctor,
I have taken a course of Ciprofloxacin for two weeks already. But I do not have a change. Is it good to use Canesten even when the rash is not there? Because rash comes and goes on. Can a chlamydia test give a false negative result?
Hi,
Welcome back to icliniq.com.
You do not need to worry. But the pain during urination has to be sorted out and you can have prostatitis. It is necessary to do a semen culture to detect the organism. You can apply Canesten as you have itching and it helps to resolve it. But wait for taking antibiotics till you get the results of the semen culture.
Patient's Query
Thank you doctor,
Do I need to request for semen culture from my doctor and a prescription for Canesten? Please say its specific dosage.
Hi,
Welcome back to icliniq.com.
It is a cream of five grams and it is one percent.
Patient's Query
Thank you doctor,
Can I have any other antibiotic other than Ciprofloxacin to treat my infection?
Hi,
Welcome back to icliniq.com.
Do not try taking any antibiotics because you might develop resistance and so wait for the results of the semen culture first.
Patient's Query
Thank you doctor,
Does semen and urine culture are accurate in identifying the infections?
Hi,
Welcome back to icliniq.com.
Urine is sensitive for urinary tract infection over ninety-eight percent. But it is very weak in identifying prostatitis with less than forty percent. For genital infections, it is best to do semen culture.
Patient's Query
Thank you doctor,
Will you let me to know the results of semen culture?
Hi,
Welcome back to icliniq.com.
Yes sure.
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