Resolved question:
Hi,
41 year old male here.
I live in a provincial area of a third world country and often have to do my homework when dealing with the doctors here so here I am.
I was experiencing some discomfort in my urethra for a week or so then one morning woke up to milky discharge. I went to the local clinic and did a urinalysis and gram stain. The results showed gram positive cocci. I was was prescribed doxycycline 100mg 2x a day for 7 days. I am now 3 days into the treatment and each morning there is still discharge. I think the discharge throughout the day is lessening (50% reduction) but still there.
So here I am wondering if I'm on the right medication. I can't find any recommendations for using doxycycline for gram positive cocci. Do you think the results I have experienced thus far are consistent with a successful treatment with doxycycline?
Submitted:
4 Days
Category:
Urologist
Hello,
Thank you for choosing DoctorSpring.
Your symptoms are suggestive of Urethritis (possible STD). Yes, you are on right treatment plan. There are two major causes for the white/milky discharge. Gonococci (Gonococcal Urethritis) or Chlamydia, the later being more likely with your current symptoms.
Doxycycline is a recommended treatment option for Chlamydia infection. The fact that there is response (even though not complete) suggests than the infection is responding to the antibiotics. You need to continue DOXY for 7 days. Only if symptoms persists even then you will need to go for repeat testing or empirical treatment for Gonorrhoea.
The gram stain report is either wrong or of a contaminated sample. Gram positive cocci are the common Staphylococcus and Streptococcus found in abundance everywhere (so easily a contaminant). These bacteria is unlikely to cause such symptoms. You can ignore this result for the time being.
Hope this clarifies.
Feel free to ask followups
Thank you
Thank you for your advice. In light of the possible bad gram stain I went ahead and had another one done, this time making sure a good amount of discharge was there. Attached is the result.
I also checked for fungus and that was negative.
Does this change any of your thinking on my condition?
Hello,
Yes this does change my opinion. Since the repeat tests also show G+ Cocci I would give weightage to the test. You will need to get a Culture done (Culture of the discharge or early morning urine sample) + antibiotic senstivity. This is only sure shot way of knowing what organism is this. i would not recommend changing or stopping Doxy now. Based on the culture report you can change the antibiotics.
Do update me with the culture results (it might take 3-4 days)
Hope this helps
Feel free to ask followups
Thank you
Thank you for your advice. In light of the possible bad gram stain I went ahead and had another one done, this time making sure a good amount of discharge was there. Attached is the result.
I also checked for fungus and that was negative.
Does this change any of your thinking on my condition?
Hello,
Yes this does change my opinion. Since the repeat tests also show G+ Cocci I would give weightage to the test. You will need to get a Culture done (Culture of the discharge or early morning urine sample) + antibiotic senstivity. This is only sure shot way of knowing what organism is this. i would not recommend changing or stopping Doxy now. Based on the culture report you can change the antibiotics.
Do update me with the culture results (it might take 3-4 days)
Hope this helps
Feel free to ask followups
Thank you
Thank you for your advice. In light of the possible bad gram stain I went ahead and had another one done, this time making sure a good amount of discharge was there. Attached is the result.
I also checked for fungus and that was negative.
Does this change any of your thinking on my condition?
Hello,
I am getting the same question again. May be some technical issues. Contact info@doctorspring.com if you need any assistance . Thank you