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Question:
I was diagnosed with epididymitis on the right testicle a little more than 4 months ago. I was given 1 week of levaquin to treat the problem and the swelling went away. About 3 or 4 weeks later it seemed like i still had discomfort on my right side but no swelling. So i was then given 3 weeks of levaquin. I was drinking alcohol very heavely during that time(8-12 drinks a day). I then developed bad stomach problems and was diagnosed with irrital bowel syndrome almost 1 month ago. I did not finish the last couple of doses of levaquin during the time with my stomach problems. More than a month ago i started to have this somewhat pulsing feeling on the left side of my testicle. I then went to see a doctor that gave me 2 weeks of levaquin which i only took 5 doses. I did this because I went to see a different urologist at the University of Virginia and he put me on doxycyline and flagyl for 2 weeks. I took it for a week and the symptoms worsened on the left side. So he switched it to cipro and i was on that for 4 days. I then went to see a Infectious Disease expert at UVA and he put me on 4 weeks of levaquin. 3 or so days into this regimen the right side of my testicle reswelled. I had not had any problem with the right side since a couple months before that. I could tell it was my epidydimis that was swollen. So i went back to him and he said that it could be swollen because the bacteria was breaking up and going away. By the way he said it is probably chlamydia that i have contracted. I contracted it 4 months ago when i had unsafe sex with a girl. He said as long as the symptoms don't worsen then i shouldn't be worried. they haven't worsened. I've been on the levaquin for 2and half weeks now and the left side still has a small pulsing feeling sometime and the right epidydimys is still swollen. My question for you finally is am i taking the right anitbiotics and doses? I've read a lot lately on chlamydia and most websites have said that it is usually treated with doxycyline or azithromycin. I've stopped drinking for the last 2 months and that is no problem now. I'm really tired of dealing with this and worrying bout it and i'm looking for help in anyway. Thank you so much
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Answer:
by Larry Siegel: ()
Hello and thanks for taking the time to write in to Sexual Health.com. I can certainly understand your concerns, both about the infection and the treatment. It is quite possible that your epididymitis is due to a chlamydial infection. However, since not all epididymitis cases are caused by the chlamydia bacillus, I personally think it was irresponsible for your doctor to have gone ahead with treatment without testing you for the infection. I also must take issue with the statement that the epididymal swelling is a result of "the bacteria breaking up and going away."
Treatment for chlamydia usually involves 2 classes of antibiotics: -mycins (erythro-, azithro-, clinda-) and -cyclines (mino-, doxy-, tetra-). Sometimes, amoxycillin will also be prescribed. In general, I don't believe the quinones (Cipro, Levaquin) are the first line medications.
There are 2 main factors I see that might be prolonging your infection: first, you may not have been started on the most effective antibiotic and, second, you did not take a full course on more than one ocassion (including drinking heavily while taking them). Many bacteria can easily develop a resistence to the drugs when insufficient amounts are present to kill them. This can result in a relief of symptoms and a subsequent flare-up that is more difficult to treat, especially if using the same drug that the resistence was built against. I would suggest talking with your doctor about switching to a different antibiotic.
More importantly, though, I would suggest having a test to definitively show that it is chlamydia in the first place. It makes a big difference in treatment to determine exactly what bacterium it is.
I'm glad to hear that you've changed your drinking behavior, especially considering you have this UG infection and IBS. This can only be to your benefit.
I realize I can't give you any specific medical advice or diagnosis in this type of forum (not to mention that I'm not a MD) but I hope this has been of some help to you. I wish you much luck and success in resolving this once and for all.
Take care and be well.
Larry SiegelReviewed by: Patricia Fawver Ph.D. in Sexology
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