Urethritis

[Guest]

OK, amateur doctors, how can you get urethritis, other than from unprotected sex with a clamydia-infected partner?

For the second time this year, I returned from a trip to Malaysia, and within 36 hours had urethritis discharge - even though no sex of any type for 10 and 12 days, respectively (and the second time, I had my only recent sex partner / live-in Thai GF checked - and she was clean).

I'm baffled. In Malaysia, I stay at a great five-star hotel. I go there for business - maybe 10 times each year.

Both cases of "mystery" urethritis cleared up easily with Vibramycin. The second time, I had just finished successfully treating a fungal "jock rash" for 10 days with an anti-fungal cream (Phoebus cream, manufactured here in Thailand).

Opinions of the more experienced are welcome.

Thanks.

Bangkok Butterfly

[ June 26, 2001: Message edited by: peesooahbkk ]

[Guest]

As someone with lots of doctors in the family, as well as some friends in the medical line who like to swap nasty medical case histories at mealtimes, here my (admittedly layman's) opinion:

You can get urethritis from unprotected sex but also just "by itself", for example if your liquid intake is insufficient and the bacteria which accumulate in the urinary tract are not flushed out.

A doctor friend of mine steadfastly refuses to use swimming-pools as - so she says - some nasty forms of urethritis are known to be tranferred through the water (the chlorination may not always be up to scratch).

You might also have recurrences because the original infection is not cleared up completely. You HAVE to get that fixed, otherwise the infection could travel upwards into your prostrate or kidneys, and that's when your real problems begin.

[tomc12]

There are many causes of urethritis. Gonorrhea and chlamydia are of prime importance to sanukers. NGU is caused by Chlamydia in 15-30% of cases, while no definite pathogen is found in 20-50%. Trichomonas causes a few cases as does asymptomatic bacteruria and the bacteria associated with bacterial vaginosis and fungi. Ureaplasma and Mycoplasma are sometimes detected but are not definite causes. Chemical agents, like chlorine, can cause irritation of the urethral opening, but swimming in chlorinated pools is not associated with bacterial urethritis.

Symptoms of NGU can begin anywhere from 1-5 weeks after contact, but around 50% of males are asymptomatic. It is unclear to me whether you are engaging in self-treatment or not. The problem with that is you need follow-up cultures to determine the difference between clearing of the symptoms and clearing of the infection. Since this is your second episode in 6 months, the question is whether you were cured from the initial one or experienced a relapse. Sometimes you have to take Vibramycin for 3-6 weeks to clear up NGU.

[Guest]

Thanks to both of you who responded.

The interval between my two "non sexual" cases was about 10 weeks (I have also had the sexual kind, about six months back). My steady live-in GF has been medically checked after both instances, and was "clean" of "U" (we do not use condoms, she is on the pill - but both times we had not had sex for well over a week before my symptoms, due to my being on business travel). First time, Vibrmycin for one week (3 x 100 mg daily) - symptoms disppeared by day 3. This last time, Vibramycin for one week, symptoms were gone after day #1 of medicine. I'm still taking Vibramycin through this Thursday (I had pills left over, and I will take them until they are depleted).

Bumrungrad doctor never mentioned treatment longer than 7 days, as long as symptoms disappeared quickly (he did indicate that if symptoms lingered, or returned after I stopped medication, it might mean a resistant strain, and I should return for new lab test).

I never even considered incomplete "cure" after 10 weeks - particularly with live-in GF clean throughout.

I just returned this morning from a trip to the same Penang hotel that stuck out to me as the one "common variable" linking my two strange outbreaks. I went over my routine in detail, and it occurred to me that the two trips that resulted in "U" the morning after my return to BKK had one minor variable that differentiated them from the many other uneventful visits I have made to that hotel. Both times, I entertained clients at a very expensive hotel restaurant, and on those two trips only, I did eat several raw oysters from an appetizer buffet. In both cases, the night before I returned to BKK (meaning I had "U" discharge beginning 36 hours after eating the oysters).

I'm now thinking that eating raw oysters anywhere in SE Asia may be a really bad idea, and that this might conceivably have been a vector.

I am well familiar with contracting diarrhea from eating tainted food - this has happened to me innumerable times. It does not seem to much of a stretch to assume that maybe some pathogens that enter the body via eating may target the urinary system, instead of the intestines.

I remember nearly dying from food poisoning once in Holland (circa 1983), a couple hours after eating a plate of steamed mussels at a Saturday morning market. While driving back to my Army base in Germany on the autobahn, I went from healthy to exploding from all orifices within about 30 seconds. I remember braking hard from 180 km/hr (I had a Mercedes sports car then), opening the drivers door and undoing my seatbelt as the car slowed, and collapsing into a self-made puddle on the highway shoulder. That's all I remember for several days. Luckily, I had an Army buddy with me who ate something else, and he somehow got me into a local hotel, got me cleaned up, and summoned a local doctor. They stuck an IV into me to rehydrate me, and my buddy must have nursed me for two days, until I returned to consciousness.

I wonder what I was thinking by eating raw oysters in Penang?

Thanks again for your input.

Cheers!

Bangkok Butterfly