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STDs  (Expert Forum)
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chlamydia/gonorrhea testing and transmission
Answered by
H. Hunter Handsfield, M.D. -
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.
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MedHelp Member's Question

chlamydia/gonorrhea testing and transmission

by genesys, May 22, 2005 12:00AM
doc, thanks for the help in advance. my questions are in all caps to help you go back and find and answer them...



i was given doxyxicline without being tested for std's to alleviate a mild burning/stinging sensation in the head of my penis just before and just after i'd urinate. the symptom showed up about 4 days after a sexual encounter with a stranger. the stinging is gone now after 4 days of treatment (still have 6 more days left)



although i never had any dicharge during the 10-12 days of mild stinging, i want to go back and get tested to see if i had any std's other than the possible chlamydia, such as gonorrhea or herpes. BUT HOW MANY DAYS SHOULD I WAIT, AFTER I'VE FINISHED TAKING THE DOXY, TO GO AND GET AN ACCURATE TEST DONE FOR  GONORRHEA, HERPES, ETC.? WHILE ON THE DOXY, CAN I GO  GET TESTED FOR THE OTHER INFECTIONS SO I CAN BEGIN IMMEDIATE TREATMENT FOR THEM?



i've read that doxy is good for chlamydia, and that it may clear up gonorrhea. also, that chalmydia and gonorrhea can both cause painful urination, IF I DO/DID HAVE GONORRHEA, IS THERE ANY WAY TO TELL FROM THE SYMPTOMS AND THE TIMING OF THEIR ONSET THAT MIGHT DIFFERENTIATE THEM FROM THE POSSIBLE CHLAMYDIA? AND IS IT POSSIBLE THE DOXY WILL TAKE CARE OF BOTH POSSIBLE INFECTIONS?



also, i had red, bloodshot eyes one morning. not sure if they were irritated from looking at the tv and computer screen a lot, lack of sleep or if it was conjunctivitis. HOW BAD DOESN CONJUNCTIVITIS GET? DOES IT CLEAR UP ON ITS OWN? IS IT USUALLY REOCCURING? i haven't had any redness in my eyes since...
Doctor's Answer

by H. Hunter Handsfield, M.D., May 22, 2005 12:00AM
I wish I could help, but once treated, your tests for gonorrhea and chlamydial infection will be negative.  Unlike some STDs (herpes, HIV, syphilis), there is no test that can accurately diagnose past infection with gonorrhea or chlamydia.  Now that you're already on doxycycline, there is no way to know whether or not you had one of these infections.  The short incubation period (4 days) suggest gonorrhea more than chlamydia; but on the other hand, most gonorrhea would cause more prominent symptoms than you describe (more pain, overt discharge).  Doxy is virtually 100% reliable for chlamydia and ~90% reliable for gonorrhea.  So be alert for resurgent symptoms after you finish therapy, but if that doesn't happen, you can be confident the treatment was effective (if you had either gonorrhea or chlamydia).



The conjunctivitis probably is coincidental.  Most cases are due to viruses and resolve spontaneously after 1-2 weeks.  However, it is conveivably that you acquired adenovirus type 19, which sometimes causes simultaneous conjunctivitis and urethritis.



Good luck-- HHH, MD
Member Comments (14)

by barneyc, May 22, 2005 12:00AM
To: HHH
I have a question that is somewhat related to this post. I am a man and on March 2, I received unprotected oral sex from a woman for about 30 seconds and did not ejaculate. She had no visible sores, etc... I had no symptoms, but I was worried and on April 4, I was tested at an STD clinic for HIV, gonorrhea, chlymidia and syphilis. All the tests came back negative, but the clinic said the testing company could not issue a definitive report on the urethal swab because the swab was past its expiration date. I had no further symptoms, but this past week I began to experience some discomfort with my penis. There has been no discharge or sores, but I have a very slight burning sensation before and after I urinate, no pain at all during urination. I also feel as though I have to urinate more frequently. I have a feeling that this may just be a UTI, but wanted to see what you thought. I also wanted to know if I should take a prescription of amoxicillian that I have left over from a sinus infection in April. The doctor gave me the amox, but then had to give to give me a stronger drug - Avelox. He told me to keep the Amoxicilian in case I got another illness later. Would amoxicilian treat gonn, chylm. and a UTI? Do you have any idea what might be happening to me? Also, can I be comfortable with my Oraquick Rapid HIV test results that were obtained 33 days after my brief exposure?

by gab5, May 22, 2005 12:00AM
you asked 90% of his question back in April.  The doctor is probably going to tell you to go to the doctor and get checked for a UTI.  That based on your exposure the 33 day Oraquick is fine.  Good luck.

by H. Hunter Handsfield, M.D., May 22, 2005 12:00AM
To: barneyc
gab5 is right.  I have no more to offer you.  I will just add that moxofloxacin (Avelox) won't add anything (it isn't any "stronger" than other antibiotics); and the proper advice for unused antibiotic (your amoxicillin) is to discard it.  Saving it for self-treatment for future infections is irresponsible; it's bad medicine at a personal level, and at a population level that sort of approach just contributes to the spread of antibiotic-resitant bacteria.



HHH, MD

by genesys, May 22, 2005 12:00AM
thanks doc. since yesterday afternoon my testical sack has kind of felt "warm" down there...like a feverish feeling you might get in your head when you get a flu or something. it's mild. and seems to come and go. and the skin may be more redish than usualli don't know if it's caused by my anxiety, is a normal reaction in the healing process or if it's a new symptom of something other than chlamydia or gonorrhea.



if i had gotten herpes...may 1st what would symptoms would've showed up by now typically?

by genesys, May 23, 2005 12:00AM
sat down and really did the math. it was probably more like 5 or 6 days before i had a slight "itch" or slight inflammation inside my penis from base to tip,  and the stinging followed 1-2 days after. so on the 6th or 7th day, definitely the 8th day the stinging had started.



should i call and ask the doc to prescribe cipro or something that works better against gonorrhea? or trust in the doxy?



and, what about getting tested for HIV, herpes, syphilis based on symptoms and exposure? would the doxy make those tests come out falsely negative as well? i know it won't cure them, but will it affect the outcome of the tests?



oh, and i was wondering. if i was exposed to (had sex with a) partner that has chlamydia and gonorrhea, is it possible for me to catch only chlamydia or only gonorrhea?



my new partner



thanks again.

by H. Hunter Handsfield, M.D., May 23, 2005 12:00AM
You can be exposed to multiple infections and acquire some but not all.  You don't also need cipro.  It wouldn't hurt, just not necessary; if your symptoms respond to doxy and con't return, you can be 100% confident you didn't also acquire gonorrhea.  Doxycycline also will prevent syphilis; there is no point in testing for that infection.  It will have no effect against herpes or HIV, but the risks for them are too low to worry about.



HHH, MD

by genesys, May 23, 2005 12:00AM
doc you never answered my question about testicle sack swelling and i have some swelling by the sphincter now at times it seems. the testes themselves don't seem swollen, just the amount of fluid or whatever is in the sack. the pain in the head of my penis before and after urinating is gone. but what's with this new twist? could it be something else?

by dar28, May 24, 2005 12:00AM
Genesys, well this may not be the answer, but everyone seems to be willing to add their own little piece to the puzzle, so I thought I'd add mine.  I had a similar encounter with a girl that I didn't know (and whom I now regret).  I ended up being VERY tired the next day, tingling sensation in the penis, no discharge, etc, etc...  I went to the doctor, he gave me the Cipro and Doxy and called it a day...  I also had that conjunctivitis.  Only mine was VERY bad; debilitatingly so...  I got up in the morning and my eyes