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STDs (Expert Forum)
Could this be herpes
Answered by
University of Washington
Seattle - WA
This forum does not cover AIDS/HIV issues. This forum is for questions and support regarding STD issues such as: Chlamydia, Crabs (pubic lice scabies), Gonorrhea, Hepatitis (viral), Herpes, HPV, Molluscum Contagiosum, PID, Rectal Infections, Syphilis, Trichomonas, Warts, Yeast Infection.
IMPORTANT
This forum is limited to questions about STDs other than HIV/AIDS. For questions about HIV prevention, or if you have general questions about safe sex (e.g., condoms, how to protect yourself from HIV and STDs), please visit the HIV Prevention and Safe Sex Forum
Some of the most common types of questions concern the risk of HIV or STD after a particular sexual exposure, and about symptoms that might or might not be due to HIV. If your question is along these lines, please visit the HIV Prevention and Safe Sex Forum.
This forum is limited to questions about STDs other than HIV/AIDS. For questions about HIV prevention, or if you have general questions about safe sex (e.g., condoms, how to protect yourself from HIV and STDs), please visit the HIV Prevention and Safe Sex Forum
Some of the most common types of questions concern the risk of HIV or STD after a particular sexual exposure, and about symptoms that might or might not be due to HIV. If your question is along these lines, please visit the HIV Prevention and Safe Sex Forum.
Could this be herpes
by hopefully not, Aug 25, 2006 12:00AM
2 months ago I was having severe burning and itching while urinating. I went to my doctor and she automatically figured it was Chlamydia, so she went and ahead and prescribed me a 1000mg single dose of Zithromax and sent my urine off to the lab. My urine came back positive for chlamydia. Well over the 2 months since then I still have occasional burning and itching when urinating, it seems to be worse in the mornings. But it is not nearly as painful as when I was first diagnosed. So I went back to my doctor yesterday and told her the symptoms I was still having and now she is saying I have probably got herpes. She done a blood test but I won't know the results for a couple days. Now I am scared to death that I may have herpes, but I have never had an outbreak of sores or any lesions. She told me that does not matter, which I know some people never show symptoms, but is this slight burning and itching I am having really herpes, or is it possible that I never fully got over the Chlamydia and I am still experiencing that. Because like I said I have never fully been back to 100% since I was diagnosed, but now it seems to be getting worse.
Doctor's Answer
by H. Hunter Handsfield, M.D., Aug 25, 2006 12:00AM
, Aug 25, 2006 12:00AM
From your description, herpes sounds possible, but not very likely. Although your symptoms sound like they vary in severity, they have been there more or less the whole time for 2 months, which would be very unusual for herpes. And herpes in the urethra usually is more painful than you describe. Finally, you are right that herpes more likely would include external genital lesions. Completely asymptomatic genital herpes is common, but in men with symptoms, having symptoms only in the urethra is rare.
In at least 10-20% of people with nongonococcal urethritis (NGU), whether due to chlamydia or other things, the symptoms persist or come back. Also, there is a slight possibility your chlamydia wasn't cured; azithromycin (Zithromax) is good against chlamydia but not perfect. Trichomonas is a possibility as well. Gonorrhea is theoretically possible, but probably would have been picked up when chlamydia was diagnosed.
The standard approach to patients like you (as recommended by CDC and as we do in my STD clinic) is to first make sure that there is urethritis, easily done quickly by swab from a urine specimen; and also to re-test for gonorrhea and chlamydia. If persistent NGU is confirmed, you should be re-treated, usually with doxycycline, and perhaps also with a drug against trichomonas, just it case it is there.
Finally, I assume your sex partner(s) were examined and treated for chlamydia, and that you haven't had sex with anyone since your initial treatment. If the partner you caught chlamydia from hasn't been examined, that's important for her (or his) health--and the exam also might show something else that could explain your problem. And if you have had sex with that person or anyone else, that person needs to be reexamined now.
I hope this helps. Feel free to print out this response and take it with you when you go back to your doctor.
Best wishes-- HHH, MD
In at least 10-20% of people with nongonococcal urethritis (NGU), whether due to chlamydia or other things, the symptoms persist or come back. Also, there is a slight possibility your chlamydia wasn't cured; azithromycin (Zithromax) is good against chlamydia but not perfect. Trichomonas is a possibility as well. Gonorrhea is theoretically possible, but probably would have been picked up when chlamydia was diagnosed.
The standard approach to patients like you (as recommended by CDC and as we do in my STD clinic) is to first make sure that there is urethritis, easily done quickly by swab from a urine specimen; and also to re-test for gonorrhea and chlamydia. If persistent NGU is confirmed, you should be re-treated, usually with doxycycline, and perhaps also with a drug against trichomonas, just it case it is there.
Finally, I assume your sex partner(s) were examined and treated for chlamydia, and that you haven't had sex with anyone since your initial treatment. If the partner you caught chlamydia from hasn't been examined, that's important for her (or his) health--and the exam also might show something else that could explain your problem. And if you have had sex with that person or anyone else, that person needs to be reexamined now.
I hope this helps. Feel free to print out this response and take it with you when you go back to your doctor.
Best wishes-- HHH, MD
HHH, MD
You say "In at least 10-20% of people with nongonococcal urethritis (NGU), whether due to chlamydia or other things, the symptoms persist or come back."
For clarification, is it possible after initial exposure and successful treatment yielding a negative test result (say at 12 weeks) to have the symptoms come back (with no other possible exposures)??
HHH, MD