Dear Doctor

I must say that you are doing a wonderful service to humanity providing answers to embarrassing questions and a willing shoulder to cry on. Maybe you could help me as well.

I am an Indian Accountant (age 49yrs ) based in New Delhi. I did an overseas contract in the middle East between 2003 and 2004. During that time I happened to have sex(unprotected) with my housemaid (who was looking quite healthy and clean ) couple of times . A nightmarish experience followed within the next 2 weeks . symptoms were like , severe itching of genitals , with an occasional droplets of watery discharge, swollen glands in armpits,neck arms and calf muscles, severe painful cracks at the corners of the mouth , tightness in the facial muscles neck and armpits, severe inflammation of the lower gums, severe pain in all the joints and muscles .Every single joint of the body was affected resulting in severe depletion .

Also every bone of the body became shortened to a certain extent ,including the knuckles and toes resulting in kinking up at the joints. I also developed a backward stoop at the midriff. Even the muscular structure got transformed to soft flesh. After nearly one year when it was time to go home, I went through several tests . like HIV Elisa , HIV (PCR) ,VDRL,TPHA ,Chlamydia (enzyme Immunoassay :Elisa for IgG and IgA ) and Chlamydia (by indirect immunoflouerenscence : IF for IgM ) all of which were negative.

As soon as I returned home , I had sex with my wife (age 45 yrs) and very

soon she developed practically all the symptoms which I had experienced. When we both consulted a specialist, we were put on Tetracycline for 15 days ( 3x100mg per day) We felt slightly better. We consulted another doctor after 4 months .He put us on Azithromycin for 1 week ( 2x250mg per day ) we felt really better. When I went for another consultation because of penis irritation and occasional watery discharge continuing intermittently) I was told that , if it was a sort of bacterial infection , then the 2 courses of antibiotics would have definitely taken care of the problem. What remains is a fungal infection which would need to be treated from time to time by Fluconazole alongwith a cream to be applied to the penis on the inside.

My question to you is :

1. How would you diagnose the condition given the above symptoms

2. Could it be a herpes infection? Although we never had any blisters on

the genitals, we used to have an occasional pimple on the cheek a couple of times.

3. Is it possible that the above damage could have been caused solely by a

fungal infection ,say, candida albicans and made worse by a course of metronidazole (30days @ 2x100gper day ) taken as advised by my GP 6 monhs after the incident while I was overseas.

4. By way of damage control, now that we are feeling quite normal other

from my occasional watery discharge , is there a way of regaining the mascular structure and the healthy joints as before ?

Your advice would be greatly appreciated.

Regards

Hi,

thanks for your kind words and I am going to be straight with you. You are searching for an answer in the domain of biology and medicine. You think that a good medical explanation and related drugs may pacify you and solve the problem. You disregard the power of guilt and anxiety. You belittle the transformational effect on you body structure induced by emotional and social conflicts. You have taken all the medication and tests on the book and...yet you are still searching for an answer. I invite you to reflect for a moment on what is happening and why it is happening to you without rushing for an answer. May be what it being revealed in this email is an unconscious desire to finally take responsibility for one's own actions.

In good health,

Dr.Gian

Hello Dr. Gian, I am hoping you can point me in the right direction. About 3 weeks ago, I noticed a small red bump on the shaft of my penis, about .20 inch in diameter, with small white head. I thought it might me an infected hair folicle, and tried to squeeze it, which was painful. Very, very small amount of white fluid came out. This happened numerous times. It has morphed into what can best be described as a firm oval shaped red bump...looks sort of like an insect bite. It is not sore, but hurts & swells when squeezed hard. I have no obvious symptoms of any STD near as I can tell (no sores, discharge, or any other symptom near as I can tell from reding up on it on the i-net), and have been in a monogamous relationship for past 1 year, albeit we have unprotected sex. My girlfriend has been to her obgyn in this time, and been tested for STDs, with negative results. After doing some research, the only thing I could see that it might be is a wart derived from HPV. My question is this:

How do I go about getting this diagnosed, and could it be something other than what I think?. I have a PCP on my HMO plan, but am mortified to go to her with this. I am in Houston, TX.

Secondly, if it is a wart:

how do I get it removed?

will it return?

will it go away on its own or are there meds to take orally?

Please help!!

Hi,

First off I would not continue to do any more squeezing of this or other bumps and I would not be "mortified" to have my Doctor {don't worry - she is though skinned) take a culture of the bump. I would also ask to be tested for type 1&2 Herpes virus. In both cases, Herpes and HPV,  there are effective treatments available orally and locally and in both cases skin manifestation can return. Don't forget...you are in charge!

Be well

Dr. Gian