The views expressed by me are for educational purposes only and do not establish a doctor patient relationship.
I am Mysticdoc, experienced Internal Medicine Specialist.
I am here to help you with your concerns.
do you take any medication like prednisone?
I am on Remicaid
And an NSAID, Mobiv
But no steroids
Remicade can suppress your immune system.
this is possible as long as you are on remicade and even longer.
Hence, it is not due to the RA, but the medication can reduce the antibody response from your body.
What about test results from 6-7 months after possible exposure
At which point I was not on any sort of immunosuppressant
I only started the Remicade in May
in that case, your result should be more accurate.
As long as your white cell count is normal, this should be ok
The possible exposure would have been March 2012 and I got 2 rounds of comprehensive testing in November and January
I will call my PCP and see but she did blood work for me the other week and there was no mention of white blood cell count issues when she briefly reviewed them over the phone
I think that should be accurate.
But you're suggesting that this most recent round of testing may not be necessarily as conclusive given the immunosuppression
It's just that I've had chronic testicular pain and we cannot seem to narrow down a cause
Is it possible that something like HSV 1 or 2 could cause testicular pain? Tested negatively for it repeatedly but I read sometimes there can be a false negative. Likewise I have had probably 8 negative gonorrhea and chlymidia tests
Or perhaps soemthing like Trich or NGU, or HPV, that is currently not testable for men?
I mean the test before treatment should be more accurate
Right, which does make me fairly confident
and if your white cell count is normal currently, the tests should be accurate as well.
What about any of the STDs Ive mentioned, could they potentially cause chronic testicular pain?
I really think I'm getting worked up over STD and it's very likely NOT that but I'm curious to know
I did not get your last reply.
Correct, sometimes may not be detectable.
Antibiotic therapy can tried like doxycycline orally and ceftriaxone shot
Can any of the StDs I mentioned cause almost daily testicular pain?
it is the chronic inflammation that will cause it.
Chronic inflammation from what?
Can you be specific about which STDs from the list I mentioned would possibly cause chronic testicular pain (presimably from inflammation)
gonorrhea, chlamydia more commonly.
Also non std infection is possible.
Not HSV Or HPV?
chronic prostatitis is also common.
I actually haven't shown any flora in my urine cultures, which is weird
Chronic prostatitis, I will look into that
that is common with prostatitis.
in fact for prostatitis, a trial of antibiotic for 6 weeks is tried.
cipro is preferred.
Just to be clear -- are you suggesting this is not a viral infection?
no it is not.
Well clearly since it's antibiotics you sugget
But you odn't know of any viral infections that would cause chronic testicular pain I mean
viral infction does not cause it
That is good to know
I was kind of worried about HSV or HPV potentially being a cause for the testicular pain but from what you're saying that is very unlikely
no that should not be worrisome
It's strange because the urologist I saw immediately dismissed any prostate issues as a potential cause which given that I've had now multiple rounds of STD testing, urine cultures, etc that have always showed no viral or bacterial infection.. I mean, what else could it be?
Esp because the CPPS/CP thing seems to fit my symptoms and your info is aligning with that
I can't think of anything else.
Nothing else seems to make any sense
CPPS is the diagnosis when nothing else can be found.
You're being very helpful, by the way
I am going in for a 2nd ultrasound on the testicles
ok see if anything is detectable like cyst or inflammation.
At which point if it shows nothing in addition to the handful of engative viral/bacterial blood/urine testing I am basically down to CPPS at that point
What's a long-term outlook if it's some sort of chronic prostatitis
It seems very difficult to treat
usually improves over time.
there will be some flare ups.
I also wonder if I'm magnifying the symptoms psychologically
but gradually body resolves the issue
I will suggest you to go ahead with cipro for 6 weeks.
Is is possible for the CP to be related to my autoimmune conditon?
that is possible.
probably that may be the cause
I then wonder if the Remicade is only making it worse
By sort of not allowing my body to work past it
hard to say
but probably you have no other option.
To stop the Remicade you mean?
I will look into that
Thanks for your help