Investigation:
Urine routine & microscopy urine NAAT (PCR) for: Gonorrhea Chlamydia Mycoplasma genitalium Trichomonas Urethral swab culture & sensitivity HIV, Syphilis (VDRL/RPR), Hepatitis B & C Urine culture
Do NOT start new antibiotics before tests
Your symptoms suggest a persistent urethral infection, particularly under concern when thereās ongoing discharge and pain despite treatment with Azithromycin and Doxycycline Hyclate. The failure of these antibiotics to resolve your symptoms may indicate antibiotic resistance or an infection not adequately covered by these medications. Common conditions like gonorrhea, chlamydia, or non-gonococcal urethritis come to mind, but they typically respond to these antibiotics. Therefore, further investigation is crucial. Start by revisiting your healthcare provider for a more comprehensive evaluation. Itās possible you might need a urethral swab or a urine test to precisely identify the bacteria or pathogen involved. Resistance testing could inform the selection of a more effective antibiotic. Ensure that any sexual partner is informed and evaluated to prevent reinfection. Avoid unprotected intercourse until you complete treatment and are symptom-free. Persistent symptoms could also rarely be due to other non-infectious causes, so itās important to explore those with your physician if infections are ruled out. While specialists like urologists or infectious disease experts might assist further, your primary care doctor should be your first point of contact. Donāt delay; untreated infections may lead to complications, which could add to your discomfort and health concerns.
Hello dear I think as per clinical history it seems urethral infection probably UTI It is not completely eradicated. Iam suggesting fresh tests. Please get them done Urine analysis Urine culture Kidney USG Cbc Rft Esr Please share the result with urologist in person for better clarity Please donot take any medication ( already som much taken and still the treatment ineffective) without consulting the concerned physician Regards
Hello Richard Thanks for sharing these detailsāyour symptoms (urethral discharge, pain during urination, redness, and persistent colored discharge) suggest ongoing urethritis, possibly due to a resistant or atypical infection, or even a non-infectious cause. Since youāve already completed a course of both azithromycin and doxycycline (which cover most common bacterial causes like chlamydia and gonorrhea), and your symptoms have returned or persisted, further evaluation is definitely needed.
Hereās what you should do next: 1. See a Urologist or STD Specialist: You need a thorough evaluation, including a physical exam and possibly a urethral swab or urine test to identify the exact cause (bacteria, fungus, or other organisms). 2. Repeat Urine and Discharge Tests: Ask for a urine routine, urine culture, and specific tests for gonorrhea, chlamydia, mycoplasma, and trichomonas. Sometimes, fungal or viral infections can also cause these symptoms. 3. Consider Non-Infectious Causes: Rarely, inflammation or irritation (from soaps, creams, or trauma) can mimic infection. 4. Avoid Self-Medication: Donāt start or change antibiotics on your own, as this can make things worse or mask the real cause. 5. Sexual Partner Evaluation: If youāre sexually active, your partner(s) should also be evaluated and treated if needed, to prevent reinfection.
Immediate Care: - Drink plenty of water. - Avoid irritants (soaps, lotions, harsh cleansers). - Practice good hygiene but donāt over-clean the area.
Rx- Flucanazole 150 mg. - once a day for 7 days .
Thank you
