Hello.
Thank you for posting your query at DoctorSpring.com
The warm sensation on the glans and frenulum, most commonly is due to a sexually transmitted infection such as chlamydia/ gonorrhoea/ herpes.
However the good news is you do not have any associated discharge or sores and hence it does not look like a STD. Also you had protected sexual intercourse. That negates the chances of acquiring STD by a large extent.
The other causes can be an allergic manifestation, balanitis and can even be due to candida infection. In case your partner had vaginal candidiasis, it is possible to be transmitted even with the condom being on, since the scrotum will invariably come in contact with the lesion. Chances are remote, however possible.
I am hoping you do not have any whitish discharge or burning micturition. In case you do I need to start you on antibiotics.
I will advise the following :-
1)Topical Clotrimazole 1 % ointment to be applied twice daily for a week.
2) Topical Hydrocortisone to be applied 2-3 times a day.
3) In case there is a lot of irritation and itching, Tab. Claritin 10 mg once at bed time can be taken,
If the symptoms do not subside in 2 days and there is burning micturition or fever, Tab. Doxycycline 100 mg twice daily can be taken for a week.
Hope this was helpful,
Regards.
Patient replied :
No, I do not have any painful urination or any discharge of any kind.
I did not get tested for Chlamydia or Gonorrhea, could it still be one of these two?
I will start on the topical. If I don't have the painful urination and whitish discharge, is the course of action still antibiotics?
Hello.
Thank you for the follow up.
In case you develop any painful urination or burning micturition it will indicate an UTI and then antibiotic will be recommended. As of now it is not required and it doesn't seem likely that you will be needing it.
It seems more like an allergic inflammatory reaction as of now, in absence of any other symptoms which can point towards an active infection.
Hence please apply the ointment and get back to me in a couple of days time in the follow up.
Wish you a speedy recovery,
Regards.
Patient replied :
I just visited a local doctor about an hour ago. He visually inspected me and noted everything looks normal, without even redness and certainly no lesions. He said my symptoms were rather baffling as it doesn't readily point to any common condition. Nevertheless, he ordered a battery ot tests to check for everything and I should have the results in a couple of days, to rule out possibilities and narrow it down. In the meantime, I will use the Clotrimazole.
A couple of other things to add: I took a shower a few days ago at a friend's house and used her shower gel (Satsuma Shower Gel) to clean my penis. It could have caused irritation or allergic reaction, since the label said "not for facial use"
Another thing was last weekend I went camping and slept in the van with windows open. There were many mosquitos and bugs, one of which could have bitten me at an unfortunate location.
How likely are the two possibilities that I added?
Hello.
Thank you for the follow up.
As i told you even in my earlier reply, the balanitis you developed seems more likely to be an allergy. Both the possibilities you have given can cause the symptoms that you described. More so for the shower gel because penis is very sensitive and most of the shower gels and soaps are irritants.
Continue with the clotrimazole regardless. If your local doctor has ruled out possibility of fungal infection completely, then it may not be required. Since i can't examine i can't comment on that. However topical hydrocortisone and Tab. Claritin as i mentioned earlier will be helpful in your case.
Hope this was helpful.
Regards.
Patient replied :
I bought one of those home test strips for urinary tract infection and noticed that I had trace amounts of leukocytes, but negative on the nitrites. I will test again tomorrow. What does the presence of leukocytes in the urine mean (especially in the absence of nitrites)?
My penis and leg/foot are burning like crazy.
I bought a non-soap cleanser such as Cetaphil to wash the penis before applying the Clotrimazole.
Hello.
Thank you for the follow up.
Leukocytes in urine can indicate UTI.
Since it has evidences of infection, it is better to initiate treatment with Tab. Norfloxacin 400 mg for 7 days.
Before that it will be better if you can give your urine sample for urine routine and culture. It will guide in confirming the organism and what antibiotics are suited for the organism. It normally takes 48-72 hours for the reports to come. Hence you can start with Norfloxacin since it is the first choice antibiotic for most UTIs, after you have given the sample for urine routine and culture. Also continue with clotrimazole. In case you develop burning micturition, you can take cranberry juice 2-3 glasses a day. It is very effective in reducing the burning micturition.
Wish you a speedy recovery,
Regards.