Ph of doxycycline

Photo 1 and 2 is how my skin was before and 3 is how it is now.
I've been battling rosacea type 2 for five years now, and living in Korea has been a blessing in terms of affordable dermatological care. I've tried countless skincare products that promised relief, only to find myself stuck in a never-ending cycle of flare-ups and disappointment. From soolantra to doxycycline, sulfur soap to salicylic acid, azelaic acid to retinol, elidel cream, rejuran healer, skin botox, lasers, red light therapy I've tried them all.
What finally worked for me was stripping back to the basics. Following my dermatologist's advice, I stopped using all products and focused on simplicity. I took doxycycline for a week, and my dermatologist advised against using any products that was oily. Despite my initial apprehension (my skin was so dry and irritated) I switched to lightweight, non-oily products.
After much research, I settled on Korean products: Aestura Ato barrier A-Cica 365 Blemish calming serum, Aestura Atobarrier 365 Hydro Soothing Cream became my go-to moisturizer, complemented by Etude Soonjung pH 6.5 Whip Cleanser. These products proved to be a game-changer in restoring my skin's barrier function.
Previously I was using larosche posay b5 baume which worked wonders when I had type 1 but with type 2 it broke me out in papules and papules.
Months later, my skin is glowing and healthier than ever. Minimal flare-ups during the initial adjustment period have now subsided, and I've even stopped taking doxycycline altogether. With a healthy skin barrier, I've reintroduced retinol into my routine, Innisfree Cica Moisture Recovery Serum, both of which have worked wonders for me.
I wanted to share my journey here in case anyone else is struggling with rosacea and could benefit from the products that have helped me reclaim my skin's health. Don't lose hope—sometimes, simplicity is the key to finding relief.

I just finished taking doxycycline and i’m pretty sure it gave me a yeast infection or BV. I have, itchiness odor, i’m not sure about the discharge bc im on my period, and when i was using my toy it hurt. I’m assuming it’s a yeast infection so will boric acid love wellness get rid of it? I’ve used it before after my period and sex to balance my ph but never for a yeast infection so i’m not sure

Hello Im M21. I last had intercourse on 3/13 with a woman I met online(this was at 3am). Unprotected like an idiot. She also gave oral but I didn't. Right after I left her place driving back home I felt an itch where my pubes are. Later on that same day I started feeling tingling and itchiness in my urethra, I thought it would clear up after some sleep because it was on and off. The next day at work is when I started to think I caught something because I had crazy testicle pain, nausea, and bladder pain along with the tingling and itch. Also some needle like pain on my penis(felt like it was inside) that would come and go. It wasnt until 3/15 that I went to the ER at 1am. Told the doctor my symptoms and the diagnosis was urethritis. He gave doxycycline to take for 10 days 2 times a day and also did a urine test for chlamydia and gonorrhea. Im not sure how early you can test for chlamydia but both came out neg. Also my urinalysis results were normal until I saw my urobilinogen was abnormal and pH was in the 8.5 range which was considered high. Then on 3/17 I woke up and it felt like something popped in my urethra? Or maybe my tip was sticking together and came apart because it was sticking a lot more but I looked in my urethra and saw a red area almost like rash. I went back to the ER and this time the doctor tested me for HIV/Syphilis by blood which was non reactive. He gave me moxifloxacin to take with the doxycycline and said if that doesn't work I would need to see an urologist. I asked him could herpes be the reason and he told me its possible but he doesn't think so because herpes cause blisters and would hurt a lot. Half way into the medication I started to see a little bit of improvement and after I finished it I felt a lot better. No tingling. Hardly any itch. Less testicle pain. Bladder pain was lessen. But it wasnt completely gone. So on 4/11 I had an appointment as a follow up with my primary doctor and I told him about it all, he come to the conclusion that it might be something fungal and that it might be jock itch. I also asked him about herpes and he also said I would know if it herpes because it hurts ALOT. Im now applying miconazole in the meantime but can't tell a difference other than the mild irritation I get from the cream. Im not trying to say they are both wrong, I want to believe them but it still worries me. Im going to PP on the 30th to get tested just to be sure.
Also like to note I have no pain when I pee and I have no burning sensation. The itch is really mild and happens on and off, no tingling, testicle pain also off and on but last happened on the 15th, bladder pain comes and goes and also been awhile. The red area in my urethra gets bumpy only when Im erect otherwise its just flat, I have no clue if that has to do with anything with herpes. Other than that I feel decent but it's still there sort of. Pic 1https://ibb.co/kmJVHc2 Pic 2 https://ibb.co/1zHgSv0 Pic 3 https://ibb.co/0BLnWFL Pic 4 https://ibb.co/mt1d9D2 Pic 5 https://ibb.co/4YMCmFJ
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WARNING !!! THIS IS DISGUSTING
38F. Last few months I've been having insane pain and discharge after my period/during ovulation. There's water, and there's gak aka oobleck. It's yellow-green and it smells like antifreeze/pus. Swollen lymph nodes in the hip crease. I've been to the doctor the last two months and they say it's no big deal. I'm going again literally RIGHT NOW because it is NOT normal for me at all
Please tell me anything you know about this? I have NO SEX LIFE of any kind even toys for almost a year. I don't douche. It just started happening. Possibly it started after a month of prog-only pill I was trying (quit because it made me feel awful).. hmm
ETA: doc said there's no strong evidence of any particular type of infection but I've got white blood cells and visual cervicitis. said the discharge looks normal. I said I will watch and wait and possibly pick up a week of doxycycline if I'm worsening. pH slightly elevated. It hurts so much, like my entire abdomen is infected. sigh

after many times of trying to look for unknown cause of pale green discharge and being put into several medications (metronidazole-neopenotran suppositories + doxycycline), i finally got my lab test results and no sti was found (negative for trich, gono and chlam)! only high number of epithelial/pus cells + positive for fungal elements.
with this, i’m currently taking antibiotics which are clotrimazole suppositories for yeast (2x/day for 3 days) and oral metronidazole for bv (3x/day for 7 days). i’ve finished the clotrimazole course and i’ll finish the oral metronidazole in 2 days, along with my menstrual flow (currently on period).
i just wanna ask if i can go back to being intimate with my partner a week after? i’m afraid my discharge would persist just like how it did with my first 2 antibiotic course although this time i’m pretty confident i’m feeling really well! (not on period for first 3 days of clotrimazole/oral metro and no green discharge and pelvic pain found)
also can i get some suggestions just in case, how do i start maintaining my ph balance off the off side? do you just use boric acid suppositories? or probiotic suppositories/oral? i’m afraid no OB around my area takes them seriously and they’d just really put you into antibiotics.
thank you!

I need help. I've been dealing with the gbs for almost a year. I've been misdiagnosed a few times and was given treatement for bv and yeast. And doxycycline. Then finally cephalexin twice after the diagnosis. Originally it was in a urine sample when I didn't do a clean catch. The one oher thing is that I have an overgrowth of lactobacillus crispatus but NO other good bacteria down there. My ph is normal. But oh my God does it burn! I can't have sex. I have a white discharge that they said comes with the overgrowth. I've tried sitz baths to bring down the crispatus over growth. My latest gyn gave me a suppository anti biotic that didn't cure it. And now she gave me topical steroid to treat the inflammation even though i cannot use it internally which is where it burns. She had me to go a pelvic floor therapist for the pain. Next she said we'll try Clindamycin. But I need help. I can't deal with this anymore. What works?! I just want to live my life like normal again.

Hi all, I (25F, sexually active, BC is copper IUD) am looking for some advice/support. For the last 5 months or so I’ve had recurrent yeast infections after almost every time after I had sex with the same guy. I’ve been suppressing them with diflucan/monistat/boric acid/coconut oil. You name it I’ve probably tried it. And around 20 days ago I got fishy discharge after my period ended. I got tested quickly for BV, yeast, STIs and ureaplasma/mycoplasma. BV and yeast came back positive a couple days later. However, in those days I used boric acid and the fishy discharge was gone so I never started the Flagyl that was prescribed. Doc also said to hold off on the Flagyl if I was feeling normal. I also had no visible yeast symptoms.
Lo and behold my ureaplasma urine test results just came today (which is wow, so late) and it’s positive too. Also just took diflucan yesterday for a yeast infection that I felt starting. I’m at a loss at what to do. Of course I’m gonna take the doxycycline that was prescribed for UP. I’m holding onto this sliver of hope that maybe the ureaplasma was the culprit of the yeast and BV problems. My vaginal flora and pH are probably just a huge mess rn.
Is there anyone here that had their problems go away after treating the UP?
Also looking for advice on what to do during those 7 days of doxy which will definitely further mess up my flora. Any advice is appreciated by this desparate, tired and fed up lady 🙋‍♀️

So I've been a chronic BV sufferer since 2014, from 2014- 2017 it consisted of multiple trips to doctors who didn't help along with me trying alllllll of the home remedies suggested. After April 2017, I finally got rid of the fishy smell with a 7 day course of oral metronidazole. But few months after that, it was back and so begun the endless cycle. Multiple antibiotics over the years with no results. I became abstinent in 2021. I also was like I'm done, I'm not trying anymore around that time as well. I did multiple tests which showed everything as negative. I used boric acid to try and keep the odour at bay. In January of this year, I got a really bad odour which I made up my mind to just go to the gynaecologist. I was treated with 14 days of metronidazole tablets, 7 days of doxycycline, 1 tablet of Azithromycin (cant remember the dose). Concurrently with 7 days of Boric acid. I then went on to use 5 days of metro gel after all this. I remember a user posting her advice after years of BV too. Along with this rigorous treatment, I threw away all of my underwear and bought 100% cotton underwear. I wear these during the day at work. At nights and weekends when I'm not working I go commando. I used love wellness probiotic suppositories immediately after the metro gel for 5 days, but not every night as it BURNS. I also take 4 300 billion CFU oral probiotics for women- I now alternate it every other day as it causes me to bloat really bad. Last week, I had an allergic reaction to a soap I used to wash the labia which threw my pH off but I used a vaginal suppositories and it was back to normal. I'm only 3 months in, I'm praying this is permanent. The damage 10 years of BV has done to my mental health is irreversible. So I'm keeping my fingers crossed.

Jan 1st I 32F started antibiotics for a UTI (three day course). Immediately started burning and itching vulva with watery discharge. Swab came back positive for low yeast amounts. Since then:
Clindomyacin 7 days Fluconazle tabs 1 week plus a week of clotrimazole suppositories.
Two months in and no change - started doxycycline after Juno said slightly elevated a ureaplasma. Started Metro gel as Juno also indicated prevotella bacteria (slight amount).
Metro gel helped some (took the edge off maybe). Still there ten days later.
Took another round of fluconazle after metro gel as I was worried about yeast.
At this point almost four months and no break in symptoms aside from watery discharge has gone away.
Coconut oil makes worse Boric acid (3 days) made worse Hydrocortisone cream and zinc cream make worse. Probiotic suppository (vagibiom) made worse Been taking for a month: 2x AZO probiotics, Candex by inner health probiotic. Vitamin D, C, magnesium and iron. -changed toilet paper, washing powder and do not wash area. - not on BC ever and have not had sec with partner for over a month. He is now treating himself with Doxy too.
Symptoms: Burning bag opening Itching and burning labia inner and outer including pubis. No smell or discharge. Ph 5-5.5 Period made it worse Itching and burning worse at night and when I wake in the morning. Vag look very red but no visible dry areas of legions etc. I had laser hai removal 10 years ago so have no hair aside from four months of slight regrowth on labia due to fear of shaving and making worse.
I have a specialist appt end of may but that’s so far away.

!!! trigger warning for readers/viewers - mentions mental health complications
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Hi all,
I'm desperately looking for answers as to why I'm still battling urinary urgency after my chlamydia treatment from a month ago.
I won't burden you with the 4 month long story details, but I'll give you a bullet point timeline of this 4 month long nightmare along with some other minute notes and details:
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MY SYMPTOM BREAKDOWN
- DECEMBER 2023

• started feeling urinary urgency and pain when urinating, felt exactly like a UTI
• noticed a lot of random spotting, in the middle of my menstrual cycle (I have the hormonal IUD Mirena, and am on year 4 of that IUD - assumed it was just irregular spotting due to the IUD)
• thought it was a UTI, so got treated with an antibiotic for UTI via Telehealth (first antibiotic)
• symptoms seemed to be knocked down a bit, but symptoms were not eradicated

- JANUARY 2024

• still struggled with urgency and pain when urinating
• experienced rectal bleeding for the first time in my life, only once and a small amount, yet still concerning
• continued with random spotting in the middle of my menstrual cycle
• figured maybe I had a different bacterial culture, was treated via Telehealth with a different antibiotic for a UTI (second antibiotic)
• again, symptoms seemed to be knocked down a level, but symptoms were not eradicated

- FEBRUARY 2024

• symptoms elevated drastically, urgency and frequency was constant, and pain was almost unbearable - I spent countless hours crying at the bottom of a warm shower trying to find relief
• visited my local Planned Parenthood for a urine culture and to have STD/STI testing, full panel, blood and urine, and paid extra for a trichomoniasis test as well
• urine culture came back with no traces of bacteria for UTI, but had to wait a week for my STD/STI testing to come back
• doctor prescribed an antibiotic for trich in the meantime to see if it would help alleviate symptoms, a seven day course, two tablets a day (third antibiotic)
• within that week, my STD results came in with a positive test for chlamydia (February 20th), all other STD/STI tests came back negative
• finished the antibiotic round that was prescribed to me for trich, to be immediately followed by doxycycline for chlamydia, the seven day course, two tablets a day (fourth round of antibiotics in three months)
• completed 1 round of Fluconazole within the month of February to combat the raging yeast infection that resulted due to the antibiotic for trich, and followed up with 2 more rounds (in March) to rule out the slim chance that yeast could be irritating my urethra
• cut out all known bladder irritants such as coffee, alcohol, tea, fizzy drinks, spicy foods, etc.

- PRESENT DAY, MARCH 2024

• it has been over a month since I received my positive result for chlamydia, and have since tested negative
• urgency symptoms are the only symptom to stubbornly remain, but now only present right after I urinate and last for about 45 minutes to 2 hours, then disappear until I urinate again.
• completed urinary tract crisis intervention supplements, insane amounts of D-Mannose and other supplements to support a healthy urinary tract and flush out any pesky leftover bacteria in the urinary tract (that was crazy, I had to take 20 pills a day for 3 days)
• my periods have been normal, starting on time and lasting about as long as I expect them to
• I have found a primary physician who has completed the following tests:
  • standard UTI test - negative result
  • microscopic UTI urinalysis test - no bacterial growth was found
  • pelvic exam - searching for symptoms of PID, no pain was discovered during the exam
  • chlamydia test - result came back negative
• Primary physician to complete the following tests in the next month:
  • detailed urinary/vaginal test (MicroGenDX qPCR + NGS DNA Diagnostic - tests over 50,000 potential pathogens) with the help of a biofilm defense supplement to potentially detect triggers for interstitial cystitis
  • full bloodwork panel to detect any cancerous possibilities
  • potential pelvic floor physical therapy as a last ditch effort

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PARTNER'S SYMPTOM BREAKDOWN
For those whom are curious, here are the symptoms my partner (male) dealt with 3-4 weeks after his sexual encounter that I believe he contracted his infection from:

• proclaimed asymptomatic in the urinary/genital regions, as far as he's told me - however, I do recall him making frequent trips to the restroom and being annoyed at how much he had to pee when we would hang out. I do also recall a moment of him complaining about a burning sensation, but blamed it on potentially coming in contact with my ordinary use of boric acid suppositories for healthy pH balance - I ritually use these after sex. (I'll give him the benefit of the doubt there, I'm sure with improper timing that could be irritating to his skin/urethra.)
• came down with what he described to me as a lower respiratory infection which he exclaimed was bronchitis (symptoms such as itchy eyes and throat, sore throat, fever and an unrelenting cough that lasted longer than a month) and was treated with azithromycin. (A typical antibiotic used in treating chlamydia, and sometimes used to treat C. pneumoniae - he was treated with a similar dosage, if not identical to that of an antibiotic round which would be prescribed for a chlamydial infection.) He was treated for this 'lower respiratory infection' around 3 weeks after we slept together (he did take his time getting evaluated and treated), which was about 6-8 weeks after his encounter with his previous partner - before my symptoms elevated to an unbearable level, and before I considered an STI for my symptoms.
• he was not tested for chlamydia until mine came back positive, as he didn't believe that an STI was a possibility - his test result came back negative. I think it's important to note that he was tested for chlamydia multiple weeks after he was treated with azithromycin, which would have been enough time to eradicate a possible chlamydial infection. However, because I tested positive, he was treated with doxycycline at this point as well. Basically, he was accidentally treated for chlamydia before either of us knew it had been contracted. (My gut microbiome is very bitter about this. Haha.)
• please keep in mind, this is all information that I've gathered using my own context clues and research, as he hasn't been very willing to be upfront, honest, or even aware of his symptoms with me. He tells me his previous partner has been tested 4 times since their encounter because she has had some additional risky encounters since the sexual encounter they shared (according to him, she had a blackout night after alcohol intoxication and shared a sexual encounter with someone who was positive for herpes). She made it difficult for him to receive her test results, (emotional strain/manipulation) and he has withheld the detailed information she shared with him about her test results (also emotional strain and fear, I'm sure) but said her test results came back negative. I have a lingering feeling that I shouldn't blindly trust him or her at this point. He still stands firm on the idea that this infection did not come from him, so he has been hard to work with in this aspect. He has suggested some pretty outrageous ideas - such as suggesting I possibly could have got a UTI from being around my dog. I can't believe I have to explain this - but I sleep in the nude at times, like many people, and my dog tends to sneak up and sleep at the foot of the bed. He suggests that bacteria from his coat/shedding could be causing me UTI/chlamydial infection in my genital region. BIG TIME LOL. I've explained to him that STD's and UTI's don't work that way. Though this seems and feels incredibly unfair, inconsiderate, and downright insulting to me and my dog (again, LOL), I want to reiterate - I'm only seeking answers for my symptoms. But information on the timing of his symptoms may be beneficial to finding out just what it is that is going on with me, and why I'm still suffering.

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SUBNOTES
This has been my first experience with an STI in my life. I am 30 years old, female, relatively healthy, healthy BMI, relatively active. I have not dealt with urinary complications prior to this 4 month long season, outside of the occasional UTI (maybe one a year, MAYBE). I am fairly certain I know which partner I contracted the STI from (mentioned above), as I had not been sexually intimate with another partner since a year ago. I understand that symptoms don't always present immediately, but I have been highly symptomatic all of my life with any infection that I've come down with. Within 3-4 weeks of sleeping with my most recent partner is when I began experiencing these symptoms. I personally believe that I hadn't had chlamydia for longer than 3-4 months. My pelvic exams seem to back up this theory. I do vape regularly, but am quitting on the first of April out of sheer desperation to regain a healthy pelvic floo bladde kidneys.

• It might be useful to know that as a child I suffered from Juvenile Rheumatoid Arthritis, an autoimmune disease that was treated with Methotrexate (a known chemotherapy and abortion pill) for about 7-9 years of my childhood. I seemingly grew out of this, as I do not suffer with inflammation of my joints as an adult. Throwing this in there in case there could be an autoimmune possibility/pelvic floor issue that someone may have any insight to.

!!! Above mentioned TRIGGER WARNING: I am concerned and incredibly desperate to figure out the cause of my continued urgency after emptying of my bladder, every single time. I have also suffered greatly in terms of mental health, and I think the eradication/depletion of my gut microbiome/bacteria has not helped with this matter. It has gotten to the point where I've nearly admitted myself into a mental health hospital to keep me from doing something that I can't take back.
Here are/were some of my theories:

• after 4 rounds of antibiotics back to back, my gut microbiome has been obliterated. It's possible that it's taking my body longer to bounce back than usual, even though the studied and noted symptom eradication after doxycycline is within 2-4 weeks after completion. It has been around 8 weeks for me now, and I'm still suffering.
• a kidney/bladder infection was a theory that I had until I got my two urine cultures back with absolutely zero growth found, so I'm ruling that out.
• I also thought there may be a possibility that I'm dealing with PID, however with my assumed timeline and a thorough pelvic examination which resulted in no finding of any pelvic pain and/or tenderness - I am close to ruling this one out as well.
• it could be possible that I'm dealing with a pelvic floor muscle group disorder. I have read that women who have UTI's can result in a hypertonic pelvic floor after 1-2 UTI's which typically last about a week or two. With the pain and tension I dealt with for 2 months straight, I think it's possible that my pelvic floor muscles may have taken a beating and are having a hard time recalibrating to a relaxed state, resulting in the feeling of urgency/frequency.
  • I think it's important to note that I have not dealt with incontinence. There have been no leaks, even though I've for sure THOUGHT I was going to leak, there have been none. I have had control for the most part. After urinating now, when I feel the urgency come on, with certain steps or jumps/skips/hops, I feel like I'm going to have leakage, but I don't.

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CONCLUSION
I currently show no bacterial growth in terms of my urinary tract/ kidneys/ or chlamydial infections.
I am struggling with urgency only after I urinate, for about 45 minutes to 2 hours, and then symptoms seem to disappear until I urinate again. This is incredibly difficult to navigate, as I am a volume bartender, standing and moving for two to three 12 hour shifts a week.
I am continuing further and more detailed testing out of desperation to find answers/ treatment.
I am quitting vaping at the first of this month to help alleviate inflammation/ bladder irritants.
I am feeling as if my struggles are leaning more on a functional level than a bacterial/infection level, but I'm more than willing to do everything possible in order to rule out and eventually find the culprit.
I have spent around $900 trying to figure this situation out and regain my healthy and happy body, and the bills keep piling up. I have received no financial help from my (above mentioned) partner. I have scoured the internet for any information that matches my situation. I've nearly sold myself on the idea that I might have bladder cancer. I am scared, concerned, and honestly a little bit traumatized The amount of pills I've taken in the last 4 months is depressing. I will do whatever it takes, but I'm really struggling to stay hopeful. And I pinky promise, I will never touch a bare penis again until I am in a committed relationship and have test results in hand. I learned the hard way.
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Any information, possible theories, suggestions or whatever you may be able to offer me would be so incredibly appreciated. I've been suffering for 4 months, and it's straining my mental health on a scary level. I never had urinary issues like this before my positive chlamydia result, and I'm really struggling to make a comeback, even though I'm showing no traces of bacterial growth. Please help however you can. Thank you so much in advance, and I'm so looking forward to your ideas/suggestions.

Symptoms first started for me around the start of December with a fever, diahhrea and aches, which lasted for around 5 days. This was a week after I took antibiotics alongside my girlfriend (I didn’t need them, just a precaution) I developed stinging urination, redness at tip, frequent urination, like a clear liquid in urethra, redness foreskin, penis glans/sore/slightly itchy, testicle ache etc… on that 5th day of the other symptoms above. So I went to the doctors and was prescribed nitrofurantoin thinking it may be urethritis. I took these, the problem persisted and I ended up going to the clinic on day 7 of my antibiotics. They tested me for STIs and gave me a swab of the urethra. They looked under a microscope and found a couple of small yeast cells, which suggested I had a yeast infection, probably from the 2 loads of antibiotics. STI negative.
So, I then went away, applied clotrimazole and took a one-off fluconazole pill. I used the cream for around a week and a half but saw no real progress, if anything it looked better right after I’d had a shower compared to cream. I went back to the doctors as it hadn’t really worked and they had a look and thought it probably was yeast so prescribed me 4 weeks of fluconazole 50mg once per day, so I started taking these. As well as reading lots of other forums like this online, ended up buying plenty of different creams and moisturisers/body washes to use but nothing seemed to work. I was getting a bit desperate and just wanted it to go, every time I would be active/masturbate the skin would kind of flare up and look redder, plus a redness in the scrotum too.
I went to see a urologist who had a look and thought my skin looked pretty normal and said to just leave it alone for 4 weeks and see what happens.
I knew deep down that it didn’t feel quite right, so I kind of disregarded his advice and went back to the doctors 1 week into my fluconazole and got some doxycycline prescribed, of which I took alongside my fluconazole as I believe it could be ureaplasma which my girlfriend had a month before.
So, I finished my doxycycline, and things were maybe a bit better but not fixed at all. I then went back to the doctors and asked for swab or bacteria culture test as I had been reading online about people with E Faecalis and how their symptoms seemed similar to mine.
They couldn’t offer a bacteria culture test but they gave me a standard swab test from behind the front desk which I took home with me and swabbed my foreskin and the tip with, and brought it back the next day for them to send to the labs.
This came back positive for a bacteria called enterococcus, they didn’t specify what type but said it was enterococcus. Under this bracket is Enteroccocus Faecalis which is what I mentioned above.
They prescribed me Fusidic Acid cream to use for a week, which basically is an antibiotic cream which prevents bacteria from spreading.
After I finished that the redness had gone down a little bit but wasn’t perfect.
To add, I had slightly little cuts on my foreskin and one on my penis glans which were quite painful prior to this and during this time.
Now 3 weeks later I’m the best I’ve ever felt, my cuts are gone and my skin is looking as natural as it’s been, my wee doesn’t sting anymore and everything seems to be virtually normal.
WHAT DO I THINK CAUSED ALL THIS?
Well, I believe at different points I had a yeast infection (from antibiotics), Enteroccocus (bacteria) and Balantis (from either of them/creams etc…)
WHAT DO I THINK WORKED?
LEAVE YOUR DICK ALONE! Literally the 3 weeks after my Fusidic acid I literally left it alone and just only ever pulled the foreskin back to wash it lightly in the shower. Just forget about it and get on with your day!
BUY 100% cotton boxers. These are so soft that it helps with your soreness/any cuts and friction.
In the last 3 weeks I tried to wash like every 2 days with just water in a shower, no soap and stuff. Your skin has the power to heal itself, but if your constantly washing it you’re just irritating it. Even go 3-4 days without washing if you need to. Your skin needs a bit of a reset.
Go and do a swab test to try and find out what’s causing your issues.
Whenever you have a piss, spend the next 2 minutes gently dabbing the top of your penis to make sure it’s dry and no more piss will come out.
I’ve been taking turmeric curcumin capsules daily, I have no idea if it’s helped but it’s meant to be good for your gut and is antibacterial/antifungal. I also took a probiotic/prebiotic but not sure if that had an affect, though your gut does play a big part in it.
I’ve been eating healthy, making sure I don’t go over on sugar etc…
I found that at times my dick looked a bit wrinkly/cracked/dry/heat rash on the penis glans, but what worked best and has now made it look better was just leaving it alone and not putting moisturiser on it, the skin can heal itself, it just takes weeks, maybe months. In my case, I refrained from sex/masturbation for around a month. Your skin needs time to heal.
My frequent urination lasted around a month and only recently cured itself when I just stopped worrying about it and left it alone! I think frequent urination and painful urination can be caused by having cuts etc…
WHAT NOT TO DO!
DO NOT keep on pulling your foreskin back and looking at it, the best I looked was when I completely forgot about it and just left it alone and just got on with my days.
DO NOT overwash your penis. I washed it maybe 2 times a day thinking it would help, but it’ll do the opposite and just fuck up your skin PH.
Same goes for the creams, don’t go using random stuff and trialing on your skin as it’ll disrupt the natural biome and your PH.
DO NOT use showers gels that are fragranced etc… try use non bio washing machine tablets and just water for showers or non fragrance if you do want to use stuff to wash with.
Don’t be an idiot like me and use loads of antibiotics as it’ll just mess things up unless you 100% know your cause!
I received oral twice this weekend for the first time in a month and my skin hasn’t flared up, so it looks like just being patient and letting the skin just have a bit of a reset and rest has worked!

Symptoms first started for me around the start of December with a fever, diahhrea and aches, which lasted for around 5 days. This was a week after I took antibiotics alongside my girlfriend (I didn’t need them, just a precaution) I developed stinging urination, redness at tip, frequent urination, like a clear liquid in urethra, redness foreskin, penis glans/sore/slightly itchy, testicle ache etc… on that 5th day of the other symptoms above. So I went to the doctors and was prescribed nitrofurantoin thinking it may be urethritis. I took these, the problem persisted and I ended up going to the clinic on day 7 of my antibiotics. They tested me for STIs and gave me a swab of the urethra. They looked under a microscope and found a couple of small yeast cells, which suggested I had a yeast infection, probably from the 2 loads of antibiotics. STI negative.
So, I then went away, applied clotrimazole and took a one-off fluconazole pill. I used the cream for around a week and a half but saw no real progress, if anything it looked better right after I’d had a shower compared to cream. I went back to the doctors as it hadn’t really worked and they had a look and thought it probably was yeast so prescribed me 4 weeks of fluconazole 50mg once per day, so I started taking these. As well as reading lots of other forums like this online, ended up buying plenty of different creams and moisturisers/body washes to use but nothing seemed to work. I was getting a bit desperate and just wanted it to go, every time I would be active/masturbate the skin would kind of flare up and look redder, plus a redness in the scrotum too.
I went to see a urologist who had a look and thought my skin looked pretty normal and said to just leave it alone for 4 weeks and see what happens.
I knew deep down that it didn’t feel quite right, so I kind of disregarded his advice and went back to the doctors 1 week into my fluconazole and got some doxycycline prescribed, of which I took alongside my fluconazole as I believe it could be ureaplasma which my girlfriend had a month before.
So, I finished my doxycycline, and things were maybe a bit better but not fixed at all. I then went back to the doctors and asked for swab or bacteria culture test as I had been reading online about people with E Faecalis and how their symptoms seemed similar to mine.
They couldn’t offer a bacteria culture test but they gave me a standard swab test from behind the front desk which I took home with me and swabbed my foreskin and the tip with, and brought it back the next day for them to send to the labs.
This came back positive for a bacteria called enterococcus, they didn’t specify what type but said it was enterococcus. Under this bracket is Enteroccocus Faecalis which is what I mentioned above.
They prescribed me Fusidic Acid cream to use for a week, which basically is an antibiotic cream which prevents bacteria from spreading.
After I finished that the redness had gone down a little bit but wasn’t perfect.
To add, I had slightly little cuts on my foreskin and one on my penis glans which were quite painful prior to this and during this time.
Now 3 weeks later I’m the best I’ve ever felt, my cuts are gone and my skin is looking as natural as it’s been, my wee doesn’t sting anymore and everything seems to be virtually normal.
WHAT DO I THINK CAUSED ALL THIS?
Well, I believe at different points I had a yeast infection (from antibiotics), Enteroccocus (bacteria) and Balantis (from either of them/creams etc…)
WHAT DO I THINK WORKED?
LEAVE YOUR DICK ALONE! Literally the 3 weeks after my Fusidic acid I literally left it alone and just only ever pulled the foreskin back to wash it lightly in the shower. Just forget about it and get on with your day!
BUY 100% cotton boxers. These are so soft that it helps with your soreness/any cuts and friction.
In the last 3 weeks I tried to wash like every 2 days with just water in a shower, no soap and stuff. Your skin has the power to heal itself, but if your constantly washing it you’re just irritating it. Even go 3-4 days without washing if you need to. Your skin needs a bit of a reset.
Go and do a swab test to try and find out what’s causing your issues.
Whenever you have a piss, spend the next 2 minutes gently dabbing the top of your penis to make sure it’s dry and no more piss will come out.
I’ve been taking turmeric curcumin capsules daily, I have no idea if it’s helped but it’s meant to be good for your gut and is antibacterial/antifungal. I also took a probiotic/prebiotic but not sure if that had an affect, though your gut does play a big part in it.
I’ve been eating healthy, making sure I don’t go over on sugar etc…
I found that at times my dick looked a bit wrinkly/cracked/dry/heat rash on the penis glans, but what worked best and has now made it look better was just leaving it alone and not putting moisturiser on it, the skin can heal itself, it just takes weeks, maybe months. In my case, I refrained from sex/masturbation for around a month. Your skin needs time to heal.
My frequent urination lasted around a month and only recently cured itself when I just stopped worrying about it and left it alone! I think frequent urination and painful urination can be caused by having cuts etc…
WHAT NOT TO DO!
DO NOT keep on pulling your foreskin back and looking at it, the best I looked was when I completely forgot about it and just left it alone and just got on with my days.
DO NOT overwash your penis. I washed it maybe 2 times a day thinking it would help, but it’ll do the opposite and just fuck up your skin PH.
Same goes for the creams, don’t go using random stuff and trialing on your skin as it’ll disrupt the natural biome and your PH.
DO NOT use showers gels that are fragranced etc… try use non bio washing machine tablets and just water for showers or non fragrance if you do want to use stuff to wash with.
Don’t be an idiot like me and use loads of antibiotics as it’ll just mess things up unless you 100% know your cause!
I received oral twice this weekend for the first time in a month and my skin hasn’t flared up, so it looks like just being patient and letting the skin just have a bit of a reset and rest has worked!

So I haven’t posted here in ages, tried to avoid the ureaplasma subreddits for a long time as I was getting obsessed and thought a break might help me calm down. While it may have saved me some time for other things, this break did nothing to make me feel better physically, and only marginally helped my obsession. I’m back because I need to share my story with people who will understand. I’ll try to keep the update as brief as possible.
My symptoms started in October 2022, didn’t get a positive test for ureaplasma until March 2023 and it was a struggle. I convinced my doctor to give me a prescription for two weeks of doxycycline followed by the recommended dose of azithromycin. Before this I had already had lots of other courses of antibiotics to treat other things (chlamydia, bv, group b strep uti). I even tried a few days of cipro (I didn’t know at the time this was not the recommended fluroquone), but had to stop after experiencing terrible side effects. My symptoms never really improved, even while on antibiotics. Since then, I have not even been able to get a proper pcr retest for various reasons. It’s not easy in Canada! Even though there is now a lab that offers the pcr testing, nobody seems to know about it, and my doctor’s office claimed they were not able to get the required swabs from the lab. I did a Juno test in July 2023 and no ureaplasma was detected, but I had no good lacto bacteria, and very high levels of group b strep and prevotella. I don’t trust the no ureaplasma results though, but since I had heard of lingering symptoms, I was hoping that’s all it was. But nearly a year later, I’m pretty sure I still have it. After months of waiting I finally got to see a gynaecologist, but she disregarded my concerns about ureaplasma and also my Juno bio results, claiming that these bacteria were normal and I just needed to replenish the good flora. She’s tested me a few time for other stis and bv and yeast and utis which all come back negative (I got the ureaplasma along with chlamydia, which was successfully treated). But testing in Canada sucks, and I obviously have problems if i have no good bacteria in my biome, plus a consistently high ph.
She’s given me estrogen cream, with no change, and now she’s just prescribed me a steroid cream which I am not going to take as I don’t want my immune system suppressed. I am terrified it won’t relieve my symptoms, will only make them worse. I’ve been using boric acid and vaginal suppositories fairly regularly, as they have a minimally soothing effect. I was really trying to build up my biome again, but it’s not working because I have so much bad bacteria that’s taken over, and I can’t get her to believe that. I’m so at a loss. It’s not like I can easily find a gynaecologist to see. She is already the second one I’ve seen (the first was even more dismissive), and I would have to wait months for an appointment.
My main symptom is almost constant urethral/vaginal irritation and burning. It gets way worse after masturbation/sex. I’ve limited both, and have barely had any sex (protected of course) since this all started, but sadly this has not lessened my high sex drive as much as I kind of wish it did, because I know I am selfishly putting others at risk. But I have no long term partner, and living without physical touch forever is not something I can deal with. I’m already depressed enough. And it’s not like I can properly date with this condition. I can’t imagine anyone wanting to stay with me after knowing what I’m going through. I also have so much watery discharge, while at the same time feeling super dry, and my urine smells really bad. Along with the vaginal symptoms I also have intermittent pelvic and bladder pain. I developed arthritis just a month after my vaginal symptoms started, way too young (I’m 46), and I can’t get anyone to believe that’s connected, although I’m sure it is.
I can’t live like this forever, but I really don’t know what else too do. I feel so dejected. I think my next step will be to try more long term antibiotics (most likely ordered online as I doubt a doctor will prescribe them), but I want to get a positive test first, which has proved way too difficult up to this point, and I’m so tired of fighting for the smallest thing.
Anyhow, sorry for whining and rambling on, but thank you to those who have read to this point. I am so heartbroken to know that there are so many others who are suffering as much and even worse than I am with this truly terrible and misunderstood bacteria. I wish I could turn back time and not have unprotected sex with the person I am sure gave this to me, but sadly that is as impossible as curing this seems to be 😔

I (38) was diagnosed with cervicitis today at PP due to discharge combined with WBCs on my swab and self-reported symptoms. Swab was negative for BV and yeast, and they sent out for chlamydia and gonorrhea. They noted I also had WBCs in my urine but no UTI. Gave me a 7 day course of Doxycycline 2x/day. I'm not sure how or why I have it; literally nothing has changed. The only thing I can think is that maybe a wayward poop fleck found its way in, or maybe there was/is another issue present 🤷🏻‍♀️
I'm also wondering if cervicitis has been part of my problem this whole time?
Back on 12/24, I woke up with what felt like UTI symptoms. I did an AZO test and it said positive for leukocytes and nitrates. At UC, they said I was positive for some leukocytes but negative for nitrates. The UC doctor didn't even do a pelvic exam or swabs; just a urine dip. She gave me an Rx for Macrobid and a Diflucan and sent me on my way.
After the Macrobid course, the painful bladder pressure, tingling when urinating, and urge to pee literally just after going went away, but I noticed I was still having some issues in the following days. I knew from a prior instance that yeast infections can cause vulva and urethra irritation and make you feel like you have to pee, and you don't always have to have cottage cheesey discharge—and I did just finish a weeklong antibiotic course—so I took the one Diflucan and followed up with Monistat 3, and I had about three weeks of little-to-no symptoms that I noticed.
However, these last two weeks I've been increasingly symptomatic again. I have been dealing with: (what feels like) bladder pressure, urge to urinate more frequently, an uncomfortably full feeling in my pelvis, vulva and urethra irritation, and a LOT of patchy white and even yellowish discharge. At one point I did a PH test and it turned straight up teal-blue (5-5.5). I've been sitting in the 4.0-5.0'ish range since.
Either way, I guess we'll see if the diagnosis is correct and the antibiotics work. I'm extremely tired of feeling this way. Any suggestions? Thoughts? As soon as my period starts and levels off, I'm going back to PP for my annual & pap.

Hello, I’m a 36 yo male, from the U.K., now living in New Zealand (currently 80kg, 187 cm, no known allergies). White British, no rec drugs, less than 1 unit alcohol a week. Came down with this mystery illness 6 years ago. No health issues prior, was very fit and healthy, BP was about 115 / 75 (regular running, mountain biking, swimming). Travelled extensively prior to illness (30+ countries).
Onset of illness
While in the U.K., In November 2017 I noticed that my stools were consistently loose, not more frequent, just loose. December through early January 2018 I had a couple episodes of tachycardia, didn’t last longer than 5 minutes each time, thought nothing of it.
Late January went to Malaysia, during breakfast of 3rd day had sudden shortness of breath and lost consciousness. Figured it was probably heatstroke, so planned to rest for a few days. After 36 hours of rest still felt ill, easily exhausted, tachycardia, GI symptoms (crampy abdo pain and diarrhoea), asked to see hotel Dr who sent me to hospital as had elevated HR / BP. Full screen of tests at hospital showed hyponatraemia and thyroid dysfunction, BP varying from 175 - 150 / 100 – 90, HR varying from 60 – 160, but no other abnormalities. Had echocardiogram and ECG - normal. Felt I had fever but temp normal. After 4 days at hospital thyroid function / sodium returned to normal, Dr said now fine and discharged, though HR / BP still high and I felt exhausted, breathlessness worse on exertion and generally ill. Decided to cancel rest of trip and return to U.K.
Continued testing and partial recovery
In the U.K., I had 24 hour ECG (normal), was referred to tropical diseases unit (all tests negative) and also had numerous tests ran through my regular Dr (STDs, general bloodwork, D dimer). One night had a single circular shaped welt on my bicep (can post picture if required) that faded after 3 hours or so (Dr thought may be parasite but all bloods negative and never happened again so dismissed). Only test that was consistently above normal was liver ALT (around 100), so Drs figured I had some sort of post viral chronic fatigue syndrome.
Symptoms were extreme exhaustion (couldn’t walk longer than 100 m without needing to sit and rest, exhausted after showering), SOB after eating with tingly arms and legs, intolerance to lots of foods, confusion, brain fog, enlarged lymph nodes, palpitations and raised HR and BP (but generally less than 150 / 90). During this time, noticed that a few veins in hands and feet had become slightly more prominent and sometimes felt prickly / itchy, also felt easy to pinch my circulation, e.g., sitting would put pressure on the veins in the back of my legs which led to discomfort. Also my skin would not rebound as quickly when pressed. Changed diet to lower carb / no sugar / reduced gluten, and over period of 6 months tried to slowly do more exercise. Managed to get to about 50 % of prior energy capacity. Paid for private bloodtest with Armin labs (Germany) for lyme disease which was positive (can post results if required), but result not accredited by health service in U.K., and U.K. lyme test was negative – so overall inconclusive.
Move to New Zealand
In August 2018 moved to N.Z., and completed a PhD, which I managed around my fatigue / health. Would get episodes with flare ups of symptoms which sometimes included SOB. Decided to investigate through N.Z. health system. Had numerous bloods and abdominal ultrasound, all normal, but still raised ALT, enlarged lymph nodes, fatigue, brain fog, sensitivity to hot and cold temps (hot makes me more confused and prone to mentally drifting / increases fatigue and dizziness). In 2021 was referred to infectious disease Dr who said likely post viral fatigue of some sort. I noticed veins in hands and feet had increased in prominence again, raised with infectious disease Dr who said looked normal.
2 years ago switched to keto diet which reduced symptoms and made health more consistent, but still reduced energy / easy to overdo things / brain fog / inability to regulate body temp as efficiently. Managed to start exercising through weights and swimming (low impact).
Current symptoms
Over the last 12 months veins in hands and feet have become even more pronounced. Mentioned it to a Dr in August when getting a routine check who said they looked large but normal. As was not causing pain I figured I’d just be veiny and that’s okay. Then at the end of October all my symptoms worsened:
• Veins much larger, itchy, hot, engorged, painful.
• Exhaustion / confusion / weakness, limited capacity to work (20 hours a week maximum).
• Hot feeling in chest / forearms / toes, particularly in the evening.
• Can’t brush teeth without veins becoming overly ‘full’ when bending arm (trapping circulation?), likewise arm position when typing can lead to veins becoming large and ‘full’ until I shake them above my head, but then returns immediately.
• Veins in feet overly engorged, cannot cook / clean / shave / stand still with comfort in evenings and have to keep legs elevated most of the day.
• Dull ache in veins in hands, feet, legs, groin, neck, and more pronounced if lifting something heavy e.g., food shopping for a few minutes will lead to ache / discomfort in those veins / arteries for hours afterwards (note end of October I was doing 25 kg dumbbell curls so isn’t a strength issue – haven’t lifted any weights since weird vascular problems worsened at and of Oct / early Nov).
• Wet feeling in leg.
• Feeling of pressure in arms / lower legs
• Feels easy to pinch a vein / stop circulation just by having arm or leg in certain position.
• Veins in shins now also pronounced, and those in forearms.
• Veins retract when cold (e.g., when I’m in A.C.) or limb held upwards.
• Sometimes tightness / congested feeling in the chest when sleeping.
Saw my Dr who said definite vascular issue occurring, referred me to rheumatologist and vascular surgeon (had to wait 3 months to see them). All tests normal with rheumatologist. Vascular surgeon said potentially a couple of things going on and referred me for MRA (awaiting appointment). Mentioned secondary erythromelalgia and to watch out for trigger foods, stress, and temp and to keep my body as cool as I can.
Confusion points:

• My sister has also developed a similar vascular issue.
• Have tried antibiotics twice over the years (doxycycline) and both times noticed improvement in fatigue / overall symptoms (no improvement in vascular symptoms though).
• Using anti lyme herbs e.g., buhner protocol also helped alleviate some symptoms.
• Had consult with lyme specialist (Zhang clinic New York) who said has never come across vascular issues. Likewise, Buhner book on lyme does not mention vascular issues (apart from through Rickettsia).
• Cannot take vitamin C as feel ill afterwards / have reaction – flu but without the temp.
• Worsening of symptoms at end of October coincided with starting probiotics. Changed brands after a month but no change, only when stopped did some symptoms lift, but vascular issues still worsening.
• Have also noticed general fatigue / symptoms are worse after eating yoghurt with probiotics so have stopped eating all probiotics.

Current issue
I feel like my life is slowly being reduced further and my vascular problems / veins are visibly worsening every couple of weeks (see linked photos below). None of the Drs I have seen can figure out what’s going on (also recently saw a general practitioner at the hospital who said couldn’t give me a diagnosis but would keep my case open and await the MRA results).
Because I’m not having a serious episode / clot / stroke, there’s a lack of urgency, but I don’t want to wait for something like that to happen so am asking Drs of Reddit, please help me figure out what the hell is going on. I don’t want to be left with a severely damaged vascular system and permanently reduced lifestyle due to a reactive rather than proactive approach from the health system.

Hello,
I was wondering if anyone could provide insight on what course of action to take for an ureaplasma parvum diagnosis.
Back story:
For two years, I have been experiencing lingering issues of odor. No other symptoms at this point. The odor is chemical-like and thus very strong. I believe it is coming from my urine. All STD test have been negative. I have gotten well over 5 check ups within this 2 year period and have never had a reoccurrence of BV nor a Yeast infection. In the absence of the one time occurrence of BV and the yeast infection, my ph-balance has been tested and ruled normal by my OBGYN.
Recently, I further advocated for the Ureaplasma PCR test after being denied about a year ago. And the only strain that I tested positive for was “ureaplasma parvum.” I also tested positive for UP through a urine test.
In my area, Dr’s are not very educated on ureaplasma so they brush it off and advise that medicine like “Doxycycline” should not be taken. They also say that they doubt ureaplasma parvum is the reason for the odor because “odor isn’t usually a symptom for this particular strain.”
DID ANYONE ELSE HAVE AN ISSUE WITH ODOR (possibly from urine) with their ureaplasma parvum (UP) diagnosis or ureaplasma in general?
If anyone would be willing to help me go about this and give advice/share experiences especially with regard to the ureaplasma parvum strain, I would be very appreciative! Thank you!

Hello,
I was wondering if anyone could provide insight on what course of action to take for an ureaplasma parvum diagnosis and rather my symptom of odor is due to UP (although my Dr says it isn’t).
Back story:
For two years, I have been experiencing issues with odor. No other symptoms. The odor is chemical-like and thus very strong. The first year, I was diagnosed with BV. The next year, I was diagnosed with a yeast infection. Both have been successfully cured. All STD test have been negative. I have gotten well over 5 check ups within this 2 year period and have never had a reoccurrence of BV nor a Yeast infection. In the absence of the one time occurrence of BV and the yeast infection, my ph-balance has been tested and ruled normal by my OBGYN.
Recently, I further advocated for the Ureaplasma PCR test after being denied about a year ago. And the only strain that I tested positive for was “ureaplasma parvum.” I also tested positive for UP through a urine test.
In my location, Dr’s are not very educated on ureaplasma so they brush it off and advise that medicine like “Doxycycline” should not be taken. They have also told me that they doubt ureaplasma parvum is the reason for the odor because “odor isn’t usually a symptom for this particular strain.”
Also, despite the Dr’s that I have spoken to use of discouraging language in regard to using medicine to try to remedy the issue, the claim that it isn’t necessary for my partner to get treatment as well (my partner has no symptoms btw).
Lastly, I want to say that I have never had issues with foul odor before (which is how I knew something was wrong), don’t use scented products, I wear cotton underwear, not sexually active…etc.
Is there a link between UP and urine odor (chemically smell)?
If anyone would be willing to help me go about this and give advice/share experiences especially with regard to the ureaplasma parvum strain, I would be very appreciative! Thank you!

Hi, I had to take a course of doxycycline for one week two months ago and suddenly started getting white thick paste like discharge and it also stained like a water mark on my underwear. I normally have sticky clear discharge or none at all so this is not my normal. I assumed it was yeast, I did a self swab and came out negative for yeast,bv, trich. I also did std panel and was negative. took diflucan and still had symptoms. Retested through a wet smear and was negative. Doctors said it was normal but its not normal for me. I have no other symptoms. No smell, itching or pain. I had protected sex with my boyfriend three weeks ago and went back to gyno came back positive for bv and yeast. I took metro oral for 7 days and antifungal cream with applicator for 7 days. It was very messy so it was hard to tell if I was improving. I just finished treatment Monday and my discharge has improved but my underwear is still getting a little watery discharge and now a little white paste discharge. It looks similar to what I had but also what it looked like from the antifungal medication. I am so confused as to why I had the discharge during antibiotics but came out negative twice until the third time I tested(by a gyno after protected sex) normally my bf and I do not use condoms ever. Secondly, can this be residual of medication? Or is it normal for discharge from infection take awhile to normalize? I have has bv and yeast before but surprisingly I never have symptoms or if I do it is never discharge so this is new to me. I am not on birth control, and started taking probiotics two weeks ago. My doctors are not very understanding as I have anxiety. I have had STDs in the past so I am paranoid and worried this is not normal. I requested a test for myco and ureaplasma since I have been reading on that and want to consider although I have no other symptoms that would incline it can be but I want to make sure. Idk if my pH is just a mess because of the antibiotics and just needs time to readjust or if this is an infection I just want to feel normal again. My vagina also feels generally more wet than usual but when I look it looks normal and only see some discharge. Thank you 😕

Part 3
Part 2
Part 1
Welcome back! Once again I am updating progress to Part 3 with a new thread, to try and keep the information fresh.
Our latest installment confirmed the diagnosis of Q Fever (Coxiella burnetii) in our young Australian gentleman. He is currently deteriorating in ICU despite improvement in his clinical features of sepsis - he now has anuric renal failure, profound hyperbilirubinaemia, declining cognitive status, and appears to be bleeding while thrombocytopoenic.
I'm going to amalgamate the gamut of interventions and investigations requested by commenters from the previous Part 3 post, as they were many. We will end this thread with further clinical progress, before concluding in a final Part 4 with an overview and outcome, as well as some education around Q Fever.
Immediate management
Step 1 must be haemostatic resuscitation. Melaena is ongoing, our most recent Hb was 64 despite 2 units of PRBCs. Platelets were 40-ish and INR 1.5. It is reasonable to throw things empirically at this gentleman, but TEG/Rotem-guided resuscitation is also appropriate. You decide to give 3 units of blood, 2 pools of platelets, IV vitamin K empirically over the next 90 minutes, and your thromboelastogram afterwards is surprisingly not too sad - no further products are needed at this stage. More blood is available and thought likely to be required.
Step 2 must address the cause. A transfusion-resistant Hb suggests active bleeding, and active bleeding more often than not requires procedural intervention of some kind. A discussion with gastro yields a tentative plan to scope the patient (between appreciatively curious non-verbal acknowledgements of the intrigue of the case, you detect a certain wariness to become involved). They agree to do this tomorrow morning (it is still PM of Day 4 in ICU). To facilitate this, as quite rightly suggested by some, it is supremely sensible to secure the airway and intubate.
Step 3 therefore must be temporisation and optimisation. Although no stonkingly high, the urea of 40 is very acute, and it is reasonable to attribute some of the encephalopathy and bleeding tendency to this. You chuck a vascath in the groin (see below) and get some dialysis-du-jour up and running. Anticoagulation is probably not necessary - I would run the first filter without, but citrate would be a very sensible choice either way. There is no need to broaden antibiotic coverage - Coxiella is blessedly sensitive to doxycycline in its acute phase.
His haemodynamics become very unpredictable, with the onset of peripheral oedema complicating your fluid management. Nevertheless, with dialysis initiated, this is less of a worry. You crank the noradrenaline and soon have to add vasopressin (terlipressin would also be reasonable). Distributive shock predominates, but you suspect some septic cardiomyopathy in addition.
Lastly, a PPI infusion makes everyone feel much better. You hold off Octreotide at this stage, as there is no evidence of cirrhosis or portal hypertension in the investigations to date.
The discussion re: aHUS is a valid one and one that was held at the real case. The renal and haem team both agree that sepsis alone is enough to cause this clinical picture. Review of the films suggests, while schistocytes are present, they are not in numbers consistent with proper TMA. Sepsis, hyperthermia and splenomegaly are blamed, and the wallet is not opened for eculizumab.
Further investigations/examinations
Let's start with a bit of an examination. Our patient is yellow, GCS 12-13, with tender hepatosplenomegaly, asterixis and dry mucous membranes. His invasive monitoring continues to show a wide pulse pressure with systolic and diastolic hypotension (supported by your squeezy potions). He is on HFNO2 at 30L/min at 30% oxygen, sort of just because - some nurses thought the humidification would help. His chest is clear, though, and all you hear of note is an unsurprising flow murmur. There is half a centimeter of pitting oedema to his ankles. There are 2-3 spider naevi on his chest, but no other features of a more chronic process. There are no stigmata of IE. The entire room smells of melaena.
His complement levels are normal. ADAMTS-13 is negative. He does not have cold or warm agglutinins. He has 5% reticulocytes and a raised haptoglobin, with LDH 600. His D-dimer is moderately elevated and your senior colleague slaps you. His entire coag panel is otherwise mildly deranged, with a slightly low fibrinogen, slightly prolonged APTT and echis time. His albumin is 29 (and heavily supplemented at this stage). Coombs test is negative.
His ABG shows a pH 7.42 with a lactate of 3-4 (pre-dialysis), pCO2 26 (mmHg with apologies), pO2 85 and HCO3 16. His chloride is 115, K+ 5 and Na+ 144.
TTE (TOE is not yet deemed worth the risk) shows a globally hypokinetic LV with an estimated EF ~40-45%, no significant valvular pathology and an RV which appears to be quite happy. There is a 3-4mm global pericardial effusion.
CVL/Vascath insertion
There is no one way to approach this, but here is what I did.
I gave DDAVP and a pool of platelets as I prepped the site. I was less worried by the INR of 1.5. the right femoral site already harboured the CVL, so I prepped the left femoral. My thinking re: site is that most bleeding from instrumentation occurs from the vessel puncture site, and is therefore most easily and safely compressible in the leg. If you end up rogering the vessel distally and causing a retroperitoneal haematoma, well, that would only have been a haemothorax if you'd gone for the neck. Both of those risks are low, though.
In my coagulopathic patients, I do not use a scalpel prior to dilation - it will bleed for hours, ruin the dressings (and therefore sterility), and most importantly the nurses will nag me to do something about it. Even for a vascath, it is perfectly possible to slowly dilate a tract without an incision, taking extra care not to kink your guidewire. There's a decent argument to be made that a scalpel is never worth bothering with... but I'm lazy.
Progress
Having negotiated to scope electively in the morning, you fight fires into the evening - the nurses inform you that the patient is now on 40% oxygen... 50% oxygen... meanwhile you have had to commence adrenaline as your third vasoactive agent to maintain a perfusing MAP. He is now GCS 11 and his head lolls on his chest, bobbing with significant respiratory effort. "Fuck this," you tell the nurse, "we are intubating him".
You get some control, ventilate him quite hard on 60% oxygen, and get some imaging to reveal new bilateral interstitial infiltrates with small pleural effusions. Having survived induction, his haemodynamics stabilise, though he remains in need of triple agents. RRT ticks along and you cautiously take 50ml off per hour, in the hopes of reassuring the morning team they can try harder. His ABG normalises somewhat with good ventilation and RRT. At the very least, his fevers have settled.
In the morning, he is transfusion-dependent, and still has melaena. Gastro agree to scope him in ICU, and raise an 'I told you so' eyebrow as they reveal only generalised erosive gastritis. They spray some adrenaline around half-heartedly, but nothing much is achieved. They advise to continue supporting his bleeding medically, but continue slow NG feeding.
His sepsis appears to be controlled, you think, but he has stumbled his way into an unfortunate host of secondary insults.
This is now the whole clinical picture.
What do you think has happened?

In Sept I got oral sex and contracted Gonnorea. That was all healed and resolved in 5 days. It was prob the worst BJ ever and extremely tight and ultimately pointless and I left her house right away. It was obviously friction burn as it appeared a week later as I kept over touching myself and pulling skin down (I'm circumcized).
60 days of dry masterbation while thinking it was only friction burn sometimes and other times a mild form of balanits. I used to soak penis in baking soda as Dr said by doing that with a steroid should fix it. I think I over did the soaking and possibly destroyed my skin pH levels.
Dermatologist said to stop masterbation immediately! I did and over the next 19days things began to SIGNIFICANTLY improve. Like 90pct better. Over these 19 days I let smegma build up (not knowing what smegma was at the time). O thought it was healing or beginning to scab so I let it sit. Around day 15 of 19 I felt burning sensation on shaft and glans felt unusually electrically tender (sensation of licking a battery). Once I discovered what smegma was I washed immediately off.
On day 20 I masterbated since life was just about back to normal and then ALL HELL BROKE LOOSE!!!!!!!!!!! Entire shaft and glans literally caught on fire like a BBQ pit when u drop match in the coals.
Uncertain if fungal/bacterial but my life has been HELL SINCE. 9 days later I had a weak urine stream. Weaker and weaker and after a prostate exam confirmed Prostatitis. Since 12/1 unable to drink alcohol, caffeine or anything spicy or prostate will flare-up within 28hrs. In order to leave the house I have to wrap penis in gauze but after couple hrs the shaft will begin to burn.
Im black, 37 5'10 210lbs, in impeccable shape, training for track meets, softball, flag football, bench press +385lbs. Never had a single health issue until this nightmare.
For weeks I thought it was the one night stand but almost certain it has nothing to do with her now. Especially the way the weeks unfolded.
Bcuz I'm black EVERYTHING looks normal, no redness, no rashes, no bumps no NOTHING. So every Urologist, Dermatologist and Dr kept saying it's just friction burn and you'll be ok in 2 weeks.
I've taken Doxycycline, Alfuzosin, Meloxicam for prostate. Clotrimazole, Hydrocortisone, Econazole Nitrate, Nystatin powder and cream, Tacrolimus, terrasil, Eumaid, Penaten, over the last 60 days. I know that's alot but when I read details between Balanits and RSS I think I have RSS now.
3 days ago I rubbed my scrotum alot and it extremely flamed up, now it's spread to my anus. I just want a gf and a life.
I try to stay off Reddit and Discord as they can be depressing but it's more helpful info and ppl that can relate here. I'm sorry Dr's have no clue about any of this unless they actually had it. Venting!!!
Nothing but prayers at this point forward.

Hello everyone! I (28F) am desperate and at my wits end with my hormonal acne. I have been battling with my acne from the age of 17. At the start of of it I went on oral contraceptive and doxycycline to reduce the acne which worked but the prolonged antibiotic ruined my stomach. After the doxycycline I was prescribed tretinoin but this did not help one bit so I continued with doxycycline every few months in conjunction with my oral contraceptives.
By the age of 23, I had enough and decided to go on accutane to see if that would work. I was on accutane for a total of 9 months but decided to stop 3 months shy of my completion date because the side effects were too much to handle. I had some breakouts immediately after so the derm prescribed me RetinA 2X per week which caused by skin to get so dry it felt like it was about to crack.
Approximately 6 months ago I felt it was the best choice for my health to stop staking oral contraceptives and since then my skin has been a nightmare. I have consulted with a dermatologist and was prescribed 100mg of spirnalctone, winlevi (topical) , and actzone (topical). My current breakouts are around my cheeks, chin, and jawline consisting of comedones, blackheads, and papules. My skin type seems to be on the dry and sensitive side. I’ve basically given up on skin care products because all they seem to do is irritate my skin. Any advice/help with products or treatments will be greatly appreciated!
The products I have tried are: - cervae hydrating cleaners (cream and foam) - cervae salicylic acid cleanser - cervae night moisturizer - Cosrx low pH good morning gel cleanser - Cosrx snail all in one moisturizer - Laneige water sleep mask - azure retinol and hyaluronic acid night cream - ordinary hyaluronic acid - ordinary niacinamide - ordinary rosehip oil - first aid beauty pure skin face cleanser - pure aloe vera as a mask - ice rolling - high frequency wand - tea tree hydrating gel masks
Current routine: - AM/PM: cleanse face with versed cleaning balm and moisturizer (I have limited what I use because nothing has helped)
TLDR: I have struggled with hormonal acne most of my life and would like suggestions on products or treatments that have helped others.