I am a 32 year old male. I recently had a case of dysuria. I would describe it as more of an itchy irritation than pain. It was localized deep in my urethra at the base of my penis. There was also some white penile discharge. This lasted for about three weeks before I went to an STD clinic and was tested for every major STD. They took urine and blood samples. The results were negative across the board.

I then went to a convenient care clinic about a week after the first test. They performed a penile swab and a urine culture. I was prescribed a 10 day cycle of doxycycline hyclate. This cleared up my symptoms, but the tests again came back negative for bacteria.

I work away from home (and my wife) for weeks at a time. The symptoms started while I was at work which was about two or three weeks after having sex with my wife. This last sexual encounter occurred while we were on vacation in the Dominican Republic. It was on this same trip in which I caught a case of diarrhea that lasted about 8 days. The diarrhea had been gone for about two weeks when my dysuria and discharge began.

I had the same dysuria and discharge symptoms about 13 years old patientago in college. My tests results were negative then as well but I was diagnosed with chlamydia anyway and given a single dose of azithromycin which cured me quickly.

Please tell me the most likely cause of my recent infection. What are the chances of false negatives? What is the likelihood I could have had a non-STD related UTI vs. the chance of an STD?