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STDs (Expert Forum)
Cause for concern
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.
Cause for concern
by stupiddawg, Jan 28, 2007 12:00AM
Hello,
Recently I made the stupid mistake of having relations with a prostitute and had unprotected oral sex. After a few days, I had pain during urination and discharge. My PCP performed a STD test with swap and blood and gave me 2 500mg Levaquin pills as well as a seven day supply of doxy. Needless to say, the test can back positive for gonorreah. Blood tests were negative. At the last day of the doxy dossage, I still noticed a little discharge in my shorts. However, the pain during urination and the swelling/redness around the tip of my penis subsided. My doctor presrcibed me a 10 day dose of 500mg Levaquin as a precaution. I am on my fifth day of the dosage and it appears the discharge is worse than after the doxy dossage. It also shows up when the urethra is milked and when I have an errection. My understanding is the original dosage should have cured the gonorrhea. Is there a possibility of another type of infection? Will the Levaquin clear it up? I am scheduling a follow up with my PCP, but was looking for another opinion.
Thank you.
Recently I made the stupid mistake of having relations with a prostitute and had unprotected oral sex. After a few days, I had pain during urination and discharge. My PCP performed a STD test with swap and blood and gave me 2 500mg Levaquin pills as well as a seven day supply of doxy. Needless to say, the test can back positive for gonorreah. Blood tests were negative. At the last day of the doxy dossage, I still noticed a little discharge in my shorts. However, the pain during urination and the swelling/redness around the tip of my penis subsided. My doctor presrcibed me a 10 day dose of 500mg Levaquin as a precaution. I am on my fifth day of the dosage and it appears the discharge is worse than after the doxy dossage. It also shows up when the urethra is milked and when I have an errection. My understanding is the original dosage should have cured the gonorrhea. Is there a possibility of another type of infection? Will the Levaquin clear it up? I am scheduling a follow up with my PCP, but was looking for another opinion.
Thank you.
Doctor's Answer
by H. Hunter Handsfield, M.D., Jan 28, 2007 12:00AM
, Jan 28, 2007 12:00AM
Gonorrhea symptoms should start to improve within a couple days and usually pretty much clear up within a week. Gonorrhea resistant to the fluoroquinolone antibioitics, including levofloxacin (Levaquin) is increasingly common in the US. It is especially a problem in gay men (was your prostitute partner a male, by chance?), but is increasing everywhere. And many gonococci also are resistant to doxycycline. So the most important thing is to make sure you don't have persistent gonorrhea. (If you're not in the US, and especially if you are in Asia, you can definitely assume fluoroquinolone-resistant gonorrhea.)
If that's not the explanation, I'm at a loss. Co-infection with chlamydia is a consideration, but not in this case. Chlamydia is rare by oral sex, and in any case always responds to doxycycline and/or a fluoroquinolone like Levaquin. Another theoretical possibility is trichomonas, but that isn't acquired by oral sex. Most oral bacteria that might cause co-infection should have responded well to levo and/or doxy.
So all I can suggest is follow-up with your PCP as planned, making sure s/he checks for antibiotic-resistant gonorrhea. If that's what it is, you should be treated with ceftriaxone by injection. Otherwise, s/he probably will want to do a urine culture and perhaps check you out for less common infections, like yeast. But I don't have any other bright ideas.
Good luck-- HHH, MD
If that's not the explanation, I'm at a loss. Co-infection with chlamydia is a consideration, but not in this case. Chlamydia is rare by oral sex, and in any case always responds to doxycycline and/or a fluoroquinolone like Levaquin. Another theoretical possibility is trichomonas, but that isn't acquired by oral sex. Most oral bacteria that might cause co-infection should have responded well to levo and/or doxy.
So all I can suggest is follow-up with your PCP as planned, making sure s/he checks for antibiotic-resistant gonorrhea. If that's what it is, you should be treated with ceftriaxone by injection. Otherwise, s/he probably will want to do a urine culture and perhaps check you out for less common infections, like yeast. But I don't have any other bright ideas.
Good luck-- HHH, MD
Thanks so much for your responce.