Post-Sexual Encounter Anxiety and Penile Symptoms
Case at a Glance
A 23-year-old male presents with penile itching and discoloration following protected sexual intercourse, expressing concern about potential sexually transmitted infections despite consistent condom use.
Patient's Story
The patient reports his first sexual encounter in 8 years, during which he used protection throughout. He initially used a condom that had expired 2 months prior, which was later replaced with a new one by his partner. The encounter was brief and incomplete. Within hours, he developed itching on the glans penis accompanied by bluish discoloration that has since subsided. He denies any unprotected contact and expresses significant anxiety about potential STI transmission.
Initial Assessment
Patient presents with acute onset penile pruritus and transient discoloration following protected sexual activity. Physical examination reveals mild erythema of the glans with no visible lesions, discharge, or swelling. Vital signs stable. Patient appears anxious and seeks reassurance regarding STI risk.
The Diagnostic Journey
Given the temporal relationship between symptoms and sexual activity, differential diagnosis includes contact dermatitis (possibly latex sensitivity), balanitis, or early manifestation of STI. The patient's anxiety about STI transmission despite consistent barrier protection suggests health anxiety component. Laboratory workup includes comprehensive STI screening panel as per guidelines.
Final Diagnosis
Contact dermatitis of the glans penis, likely secondary to latex sensitivity or mechanical irritation. Anxiety disorder with health-related concerns. STI screening results pending but low probability given consistent barrier protection.
Treatment Plan
Topical mild corticosteroid cream for symptomatic relief of dermatitis. Patient education regarding STI transmission risks and protection efficacy. Counseling for anxiety management and sexual health education. Follow-up for STI results in 1-2 weeks. Recommendation for hypoallergenic or non-latex condoms for future use.
Outcome and Follow-up
Symptoms resolved within 5 days with topical treatment. All STI screening results returned negative. Patient reported decreased anxiety following education and reassurance. Advised regarding routine STI screening intervals and proper condom use. Referred to counseling services for ongoing anxiety management.