Q: I am a 25 years old male suffering from pain and inflammation in urethra at the tip of penis. This pain worsens after ejaculation. The doctor did VDRL test, urine examination, urine culture and sensitivity test. The VDRL reported non-reactive, 8-10 pus cells and 3-4 epithelial cells in urine, urine culture reported as E. coli and sensitivity determined as norfloxacin (Resistant), cefixime (++), augmentin (++), amikacin (+++), Netlimycin (+++). The doctor prescribed me Cefixime (200 mg) and Augmentin (625 mg) for seven days but I got no relief. Then Amikacin injection (500 mg) twice a day was been given to me for five days. But it increased the pain and inflammation and hence I stopped injecting it. The doctor repeated the above-mentioned tests. According to the report, there were 6-8 pus cells in my urine. The urine culture and sensitivity tests showed the same results. What do my results indicate? Do I have an E. coli infection? Can it be treated?

A:E. coli found in your urine seems to be a distracter since any acute infection should respond to the barrage of antibiotics you have already taken. Some times, urine may be false positive for infection, especially if the sample has not been properly collected, or delivered long after collection. The primary diseases that need to be excluded are sexually transmitted diseases (STDs). STDs panel includes tests for Herpes and Chlamydia, apart from VDRL. After exclusion of STDs, and active urine infection (by repeating a freshly voided mid stream urine sample for culture, collected and delivered in lab), imaging of urinary tact may be required to exclude any foreign body like stones. Chronic prostatitis is a diagnosis of exclusion, which may cause such symptoms, and may have to be treated with long low dose antibiotics as decided by your physician.