Chlamydia Treatment

Sir, I have been experiencing penile discharge for a couple of months now.  When I first noticed it, I took a 1 gram dose of ZITHROMAX and it did not clear up.  Three weeks later I went and saw the doctor and they did a swab test, urine test, and blood test; the results for chlamydia and gonorrhea were negative.  They also treated me symptomatically at the time of the above said visit for both mentioned STD’s.  I still have a small discharge when I wake up and “milk” it and it appears to be clear and kind of watery.  I have been really concerned with this and I'm constantly checking myself (milking) and noticing a small amount of clear fluid, not even enough to come out, at the tip of my penis.  This does not happen every time I check, but often enough to concern me.  My partner had a blood test done the other day and she was never called back, which means to me her white cell blood count didn't concern the lab.

So my question is this: Does ZITHROMAX always clear up this kind of infection or are there strands that are immune to this treatment?

Thank you for your time in this matter.

[H. Hunter Handsfield, M.D.]

Based on your symptoms, it seems clear you had urethritis.  Most cases are due to nongonococcal urethritis (NGU).  About one third of those are due to chlamydia, and several other bacteria cause the rest, but often no particular cause can be found.  Gonorrhea is another common cause of urethriitis.  It is a shame you were treated before being tested for gonorrhea and chlamydia.  That was a mistake, by you if you treated yourself without medical advice, or by the provider who gave you the azithromycin.  At this point, you will never know the cause.

However, most likely little harm was done by treating without a firm diagnosis.  Azithromycin is almost 100% effective against chlamydia and also the treatment of choice for other cases of NGU.  It's not a top choice for gonorrhea, but usually is effective anyway.

The blood test your partner had cannot diagnose any of these infections. That probably was a test for syphilis and/or HIV, not for gonorrhea or chlamydia.  However, she might also have had a standard culture or DNA test for those infections.  Even if not tested, or even if her test results come back negative, your partner must be treated just as you were.  If not, she could have serious complications (e.g. pelvic inflammatory disease, i.e. fallopian tube infection), and you or other partners could be reinfectred.  Make sure she has been treated before you have sex with her agin.

Your improved symptoms suggests your treatment was effective.  Regardless of the original cause of urethritis, mild symptoms often persist for a couple of weeks then gradually improve over time.  You need to stop examining yourself and definitely stop milking your penis, which can prolong the symptoms and even can cause discharge.  If your symptoms continue 1-2 weeks after keeping your hands off, return to your health care provider to be re-checked, just to be safe.

I hope this helps.  Best wishes--  HHH, MD

[anonymousman1]

Dr.  Thank you for the help, very much appreciated and your insight was paramount to my being a little easier about this.  My partner was tested with 1 gram of ZITHROMAX at the same time I was and we obstained from sex for 1 week.  I will do as you said and seek attention if the symptoms persist.

Thanks again for your help.

[H. Hunter Handsfield, M.D.]

Glad to be of assistance -- and it's nice when forum advice is accepted at face value.  It doesn't always happen.  Take care.

[H. Hunter Handsfield, M.D.]

Follow-up questions belong in the same thread, not as new threads. Only a limited number of new questions can be accommodated each day, and superflous ones block others with their own new questions.  Your new thread will be deleted.

You asked: "I lift weights and did squats the other day, but hadn't done them in some time.  I noticed shortly after that lift that I had testicular pain that radiated to my abdommen.  This pain last approximately 12 seconds when it comes on, and it comes on a few times a day...mostly when I'm sitting down.

"I heard that chlamydia may not be cured for up to a year even if antibiotics were taken for the infection.  I've had symptoms and took 1 gram of ZITHROMAX in one serving, then 250 mg 12 hrs later and another 250mg 12 hrs after that.  I started to notice this tesitcular pain two days ago (approx 1.5 wks after treatment), but hadn't noticed it with my first onset of symptoms (penile discharge--mild) 2-3 weeks ago.

So my question would be this:  Can symptoms show up gradually ie. penile disharge for a week, then testicual pain, then abnominal pain etcetera?  Or do you think this may be related to my weight lifting?"

Reply:  You are over-analyzing the situation. The simple, obvious explanation almost always is correct.  Your pain isn't related to chlamydia.  The weight work is a far more likely explanation.  You have had more than the usual or necessary dose of azithromycin to cure chlamytia.  And you aren't going to develop the first symptoms of epididymitis or other complications after starting treatment. Finally, treatment failure is rare and it certainly is not true that chlamydia often persists a year (or for any other period) after treatment.

That will have to end this thread, and also any new ones on the same topic.