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Burning in penis and foot with itchy eyes. HIV?

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Symptoms: burning, tingling in penis head and left leg/foot


Well, I seemed to have stumped the doctor I was seeing. I made an appointment last week, and I waited in his office for an hour. The nurse took my weight and blood pressure, and left me there waiting. I finally walked out and told them I had to go to work. So, I am looking for another doctor.

I did not think my condition would be so baffling. It's been a month now, and still no answers, no diagnosis. I got tested for the majors STDs - HIV, Herpes, Chlamydia, Gonorrhea, Trichomoniasis and all results were negative. I had a urinalysis done and it showed no bacterial growth in the urine. So the doctor prescribed Azithromycin for me to take - 2000mg at one shot, but then told me not to take it because he didn't know about my liver (Hepatitis B). And yet I checked with my gastroenterologist and he said I could take the Azithromycin. Anyway, that doctor was at a loss as to what I may have.

It's been a month and my symptoms are still there. The burning in the penis is gone and has been absent for a long time now since I used Clotrimazole cream for the last three weeks. However, my left leg and left foot still has burning, tingling, itching, and occasional sharp needle-like pain. I applied the Clotrimazole cream on the sole of my left foot and it did nothing.

The symptoms on my leg and foot are not constant, however. When I first wake up in the morning, the left and foot feels fine. And last weekend it felt much better. But today it is back to the same sensations. I would describe the sensations as a warmth in my leg/foot, or sometimes a cool sensation, like it was on ice. I also feel a dull ache in and around the perenium area and on my left buttock, as well as a dull pain in the back of my pelvis bone. This points to something going on with the pedundal nerve, as it goes from the frenulum of the penis to the leg. Does it go to only one leg or both?

So, what is going on? Is there any other test I can try to determine if I am infected with something, whether bacterial or fungal? Maybe the infection got into my blood? It feels that way. Could it be staph, mono, Epstein-Barr, etc.

In the last couple of days, some new symptoms showed up. Waking up yesterday morning, my throat was sore, but it was mild and went away during the day. It was like mild ache at the bottom of my throat. This morning when I woke up it was there again, and comes and goes during the day. Again, rather mild and not severe. In addition, my right eye started to become slightly red, and feels dry and irritated. It has been this way for a few days now. At first I thought it might be pink eye, so I went to the pharmacy to buy some eye drops for it. I didn’t use anything yet on the eye though.

Can you shed light as to what this might be? Is my infection, whatever kind it is, starting to spread? Pink eye, strep throat, etc?

Since the sore throat started, I am thinking HIV infection again. My HIV test came back negative, but that was done only two weeks after my suspected exposure. In the last week of July I had sex (with a condom) with a stranger. Her place was not clean. I did use her shower (at the time I thought the floor of her shower stall was nasty). I did use her towels, which come to think of it, probably were not clean. I did not have oral sex with her, whether giving or receiving. So I would have thought the likelihood of HIV infection to be pretty low.

Anyway, since I have perplexed my local doctor, I am hoping you can give me some insight on what other tests I could try, and what other infections I might have gotten to give me these symptoms.

Any input would be greatly appreciated.






Category: Sexually Transmitted Diseases(STD)Specialist

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Dr. Deepu Sebin Sebastian is online now

Expert:  Dr. Deepu Sebin Sebastian replied 4 Days.

Hello.
Thank you for your query at DoctorSpring.com
I understand your concern.
Yes it is slightly baffling because most of your symptoms seem unrelated and i can assure you it is not because of HIV. Let's get one thing straight first. If you used the condom properly, it is enough to prevent against STDs including HIV. Sharing towels won't cause any STDs, and hence as you said the likelihood of you getting HIV is extremely low. There is always a theoretical possibility of condoms failing in case you did not use it properly or there was a tear. But in your case nothing like this happened, so please do not worry.
The next symptoms that has persisted and causing a lot of problems is this tingling sensation and occasional pain. It can definitely be nerve related and not necessarily it has to be transmitted to both legs. I will advise you to take Tab. Neurobion Forte, once daily for a month, since it will improve the nerve conduction, in case there is any problem with that.
All other STDs has also been ruled out, so let's move beyond that.
The clotrimazole powder won't be useful if you put it in the foot, there is no need for that.
You have a current throat infection and for that i will advise you take Tab. Levofloxacin 500 mg twice daily for 5-7 days. The throat issues along with the eye infection will settle down on taking that.
Since this problem of tingling has been persistent it is better to get a MRI of the lumbar spine which will help in seeing if any nerve has been compressed which is causing the symptoms. I am advising this for conclusive evidence. It can purely be due to nerve conduction problems, and in that case the vitamin supplementation ( Neurobion Forte ) will be helpful. But if you do manage to get a MRI of the lumbar spine, it will make the picture much clearer.
Hope this was helpful,
Regards.


Patient replied :

Thank you for your input. I went to another doctor this morning for the sore throat, and he looked at it. He said he saw some redness in my throat and prescribed Amoxicillin 500 mg 3x a day for a week. I then went to a clinic and got tested for strep throat and it came out negative. Should I continue to take Amoxicillin then? Could the sore throat be from mono or some other infection? Would Amoxicillin take care of those as well? The doctor also took a look at my right eye and noted a redness. He prescibled some prescription level eye drops. The nurse at the clinic checked my lymph nodes and they are not swollen. I have never had a fever nor have I had high temperatures or cold sweats. Also, I have not had a running nose, or nasal drip, or sinus drainage. I am still awaiting the results of another HIV test I gave blood for today, as well as another urinalysis and a CBC blood count for levels of white blood cells. Again, I value your input.


Expert:  Dr. Deepu Sebin Sebastian replied 3 Days.

Hello.
Thanks a lot for your appreciation!
Mono would have been considered if you had very high fever with enlarged lymph nodes. We can't rule it out completely. The only way to know is if you get yourself clinically tested. I will advise you take amoxycillin as your doctor advised and see if you're getting better in 3 days. Even if you have mono, you will recover on your own since it is a viral infection and resolves by itself.
Let me know about the CBC counts when you get it.
Regards.


Patient replied :

Got the CBC result today. I uploaded it for your review. Let me know your thoughts.
I believe now the sore throat comes from mucus build-up in the throat. The mucus got infected with bacteria or something and is causing inflammation of the throat. I can feel something lodged at the bottom of my throat.
I think my wanting to throw up the other night was my body's attempt to expel the mucus from the throat, but since I was in a public place, I suppressed the urge to throw up and swallowed hard, pushing down further.
Is this a feasible theory? If it is, can you point toward any OTC medication that can dissolve or remove the phlegm or mucus?
I started taking the Amoxicillin today, along with the eye drops.


Expert:  Dr. Deepu Sebin Sebastian replied 2 Days.

Hello.
Thank you for uploading your report.
I went through it and the good thing is all parameters are within normal limits, which means that the body is able to fight the infection well and it's not severe.
I will advise you take Syp. Ascoril twice daily ( 2 teaspoon corresponding to 15 ml approximately )- it is an expectorant and will help in expelling your mucus out.
And yes you're absolutely right. The mucus in the throat does cause all these issues. It is an irritant and hence also makes the throat more susceptible to other subsequent infections. That's why this mucus should be coughed out whenever possible. You should also try saline water gargling three times a day, as it is also effective in sending this mucus out.
Continue amoxycillin for 5 days and you can expect full recovery.
Regards.


Patient replied :

Hello, I took your advice and bought some expectorant this morning. I didn't find the syrup, but found a bottle of tablets of 400 mg of guaifenesin, which I took (1 tablet every four hours). It cleared up the mucus stuck in my throat and I was able to swallow much easier. The sore throat also subsided, though not completely. I just took some Ibuprofen for the inflammation of the throat about an hour ago, and that helped too. After two days on Amoxicillin, I still have pain in my left foot. In fact, while sitting at work today, the pain went to my ankle and I could barely walk. I just had a new thought. This may not be an infection from the genital area that worked its way down, but rather from the foot up. It may have nothing to do with the lumbar either. A few years old patientago I stepped on a nail with my left foot. The nail went through my shoe and punctured the front region of my sole. I got a tetanus shot right away, and nothing became of it. I forgot I still had that puncture wound as there was never any pain. But the puncture wound never completely healed and there is a black spot-like scar to this day. Could it be, that when I was in the other person's unsanitary shower (or wherever), that some germs got into my system via that puncture wound in the foot? It certainly feels like it. I know infections are either viral, bacterial, or fungal. Which one do you think it is? If I am taking Amoxicillin now, do you think that would take care of any bacterial contanimation in my system? If it is fungal, what do you suggest I do (to either treat it or rule it out)? Thank you. Your advice has been very helpful.


Expert:  Dr. Deepu Sebin Sebastian replied 1 Day.

Hello.
Foot infections or rather germs tht enter into the foot, only happens when your bare foot comes in contact with the soil, and that too not one exposure but multiple exposures are required. For example, guinea worm infection used to occur like that. In your case, i don't think it has to do anything with germs enetering through your wound. And mostly if there is an infection of the foot it will be localized with inflammation and pus. It can't travel all the way up to the system.
Now even if there was some bacterial infection it will be treated by the Amoxycillin.
Fungal infections has a very typical manifestation where they start with hypopigmented spots and present with itching. No viruses can spread through the foot.
It may be due to a muscular pain. Have you been working out? Or is it possible that you have been walking a lot? Or any kind of strain to your legs? Did the pain subside after taking the Ibuprofen? Is the pain throughout your leg and foot? Do you have any dilated veins that you can see?
Once you answer to these questions, i can help you further.
Regards.


Dr. Deepu Sebin Sebastian
Category: Select Speciality
Experience: 
MD, Internal Medicine - Stanley Medical School
Medical School - MBBS - Govt. Medical College, Kottyaam

Diagnostic Prediction - Stanford School of Medicine
Received Specialty training in Critical Care, Cardiology, Neurology, Gastroenterology, Nephrology from Stanley Medical College and in Endocrinology, Rheumatology.

Hematology and Geriatrics from Madras Medical College.
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