Diagnosed With Epididymitis. Prescribed With Metronidazole. Relieved From Pain. Is It Due To Trichomoniasis?

Posted on Mon, 4 Nov 2013

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Mon, 4 Nov 2013 Answered on

Wed, 27 Nov 2013 Last reviewed on

Question : Hello Doctor, I was diagnosed with Epididymitis 10 months back. I tested negative for chlamydia and gonorrhea. I still took the appropriate antibiotics for them and they were no help. I have also been prescribed Bactrim-DS, Clindamycin, Neurontin and they were also no help. After 9 months of epididymitis, I finally got prescribed metronidazole medication. After taking it my pain was gone within a week. So I was wondering if this is a case of chronic epididymitis and it has gone away or if it was because of Trichomoniasis.

Answered by Dr. Manuel C See IV (7 hours later)

Brief Answer: Not necessarily trichomoniasis. Detailed Answer: Dear XXXXXXX Good Day and thank you for being with healthcare magic! You may have suffered from chronic epidiymitis infected with multiple drug resistant organisms. Metronidazole is not only for trichomoniasis but also for atypical (unusual, uncommon) bacteria. Metronidazole would be a third or fourth line treatment choice for epidiymitis that has not resolved after treatment with first and second line drugs. Cultures of semen, Urine and prostatic massage fluid may help identify the organisms involved. That being said it may also be trichomoniasis but is fairly uncommon and I would still think of an atypical drug resistant bacteria. Generally prevention would entail drinking plenty of water since infection usually comes from the urine and the most effective defense of the body against bacteria is expelling the bacteria with the urine. Also frequent urination also decreases the colonization time of the bacteria thereby limiting infection. I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at: WWW.WWWW.WW I would gladly help you. Best wishes. Regards, Manuel C. See IV, M.D. DPBU

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Manuel C See IV (13 minutes later)

Hi, I got epididymitis 3 days after my sexual exposure. Does it favor that the cause is trichomoniasis or my past medication would have already taken care of it. Are there chance of recurrence, if it responded well to metronidazole? Thanks

Answered by Dr. Manuel C See IV (1 hour later)

Brief Answer: Recurrence would happen if exposed again. Detailed Answer: I believe your current infection is eradicated already with metronidazole. Recurrence can happen if re-exposure happens since there is no immunity that will develop after an infection. Recurrence can also happen if the organism is inadequately treated for example antibiotic duration is not completed. This is the reason why it is important to finish antibiotic duration even though symptoms disappeared to prevent occurence of drug resistant organisms. Also avoiding sexual exposure to high risk individuals and wearing condoms. STDs are a serious health risk and epididymitis is XXXXXXX one of the numerous diseases that can be acquired (e.g herpes, syphilis, HIV). Regards, Manuel C. See IV, M.D. DPBU

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Manuel C See IV (14 hours later)

Hi, What tests can I take to know, if there are any organisms present in the epididymis like urine culture. What is accuracy of them. Thanks

Answered by Dr. Manuel C See IV (8 hours later)

Brief Answer: No need for tests. Detailed Answer: Since your symptoms already resolved, there is no need for any other further examinations and just continue the prescribed metronidazole. Cultures will not grow anything at this point in time because the bacteria in your epididymis is already treated and possibly eradicated. Generally cultures are very accurate with proper collection of specimens.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Manuel C See IV (25 minutes later)

For the past 5 days, sometimes I feel itchy, irritation on scrotum. I don't know if its inside or outside the skin, but it doesn't feel like the epididymitis, I had before. So was wondering if the standard 2g metronidazole killed all of them or it is relapse. What is the success rate of the antibiotic for Trichomoniasis, and should I get another dose of the medication just to be on the safe side. Thanks

Answered by Dr. Manuel C See IV (23 hours later)

Brief Answer: 2g metronidazole is sufficient already. Detailed Answer: Good Day! I think the 2 gram dose of Metronidazole is sufficient to eradicate the Trichomonas and atypical bacterial organisms. The itching may be just skin irritation or sometimes the antibiotics taken tend to alter the normal bacterial flora in the body thereby altering the balance between the good and the bad bacteria. There is no need to take another dose of Antibiotics. Success rate is almost absolute as long as the organism is susceptible to the drug used which in your case i believe the metronidazole already eradicated your infection. Regards, Manuel C. See IV, M.D. DPBU

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Manuel C See IV (47 minutes later)

I have been reading that male infertility caused by epididymitis is common. So I was wondering if my 9 months of epididymitis might cause infertility. Is it necessary for me to take a test for it because of high probability or not. Thanks

Answered by Dr. Manuel C See IV (46 minutes later)

Brief Answer: Probably not cause infertility. Detailed Answer: Good Day! Infertility caused by epididymitis is usually caused by chronic complicated cases causing fibrosis of the epididymis and obstruction of sperm passage. I would think your epididymitis didn't cause infertility. If you want to check do a sperm analysis 3 months from now with 5 days sexual abstinence before having the sperm examination.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar