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Chlamydia confusion
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The STD Forum is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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Chlamydia confusion

I have had annual STI screenings for the last three years - and all tests have come up clear - until two weeks ago, when a (urine) test for Chlamydia came up positive.  All other tests negative (Syph, Gon, Hep ABC, HIV, HSV1+2).  I have had only one regular female partner in all this time (who has made no complaint of vaginal discomfort), though i have also received perhaps half a dozen hand jobs at a massage parlor over the last twelve months.  On one occasion, the masseuse started to lick my scrotum, but i stopped her.  My penis did not enter her mouth.  I find it almost impossible to believe that my regular partner would 'cheat' on me - but from reading your posts, it seems it is equally impossible for me to have caught chlamydia from masturbation or this brief 'oral' exposure (if you could even call it that).  Prior to testing I had dull aching in my testicles, the need to urinate more often and slight 'dribbling' (clear fluid) from my penis.  Since testing, I was treated with 1mg Azithromycin - but, now ten days since that dose (and no further sexual contact), still feel the same symptoms with no relief.  It's a confusing set of circumstances - could I ask your thoughts?
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Welcome to the forum.

Chlamydia is quite uncommon in men your age (in your mid-30s, if I correctly recall from your profile), so the possibilty of a false positive test needs to be considered.  However, the chlamydia tests, especially the kind done on urine, are highly reliable; false results are very rare.  But if the laboratory used an atypical test, the result could be wrong.  I suggest you confirm with the doctor or clinic where the tests were ordered -- or with the laboratory, if you went directly to a lab (e.g. online) -- and confirm the exact test that was done.  I can then comment more reliably on the possibility of a false positive lab test.

In the meantime, you should assume the result is accurate.  I agree that there was no risk from the massage; that's simply not a credible source of a new chlamydial infection.  Therefore, it is most likely your regular partner is infected and is the source of your infection.  Alternatively, you might have been infected for many months; if your regular partnership is less than a year in duration, you might have had it before that relationship began.

In the meantime, your regular partner must be treated, and preferably should be tested for chlamydia as well.  Chlamydia complications are common in women and the risk rises rapidly with increasing duration of infection, so you should not delay, even though the test result is uncertain.  Speak with her today.  Perhaps you will learn she has had other partners after all.  But please do not assume that; raise the issue with delicacy and tact and see what she says.  If your sexual history is accurate, you can reassure her that you have had no other sexual exposures (the massage event doesn't count).

Let me know how it all shakes out.  In the meantime, I hope this helps.

HHH, MD
4 Comments
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239123_tn?1267651214
I forgot one other thing:  You're in Perth, Australia, right?  Collectively, your country's sexual health centres are the world's best network of public STD/HIV clinics.  While I have not had the opportunity to see the Perth SHC, you could count on world-class personalized advice and clinical evaluation.  Even if your STD testing wasn't done there, they will be happy to evaluate your situation.  Should their advice or opinions differ from mine, most likely they are correct!
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Thank you doctor - your comments help to clarify things in my mind. I have had no other sexual contact with anyone other than my current partner (of 3+ years) for more than two years, and thus three cycles on my annual, testing regime. I understand the urgency of having the difficult conversation with her, and will do so.

Would you mind commenting on the part if my initial post regarding my treatment and the continuing symptoms? Do I need to be 're-treated' or differently treated - or just wait? I gather from reading other posts that 'proof of cure' testing is not usually warranted. Could this indicate I have a longer term infection?

Thank you for the vote of confidence in the health services in my home town. I will arrange a visit.

Kind regards.
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239123_tn?1267651214
With this additional information, I am still more suspicious your positive chlamydia test was false.  And eve if accurate, I'm inclined to believe your symtpms are unrelated, and not surprised they have persisted after treatment.  I doubt additional treatment is needed.  But I will be interested to hear what they say after you have been seen at the Perth SHC.
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