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Chlamydia confusion
I had my GB removed 2 months ago and had a stent due to bile leakage, removed 2 weeks ago. Two days ago I awoke at 5 am vomiting, mostly bile. By 10 that evening I called GI and he said go to ER. Could be a virus but wanted my blood checked since the leak. Said I was dehydrated anyway. ER ran labs and CT scan and said it was gastroenteritis. I also had a catheter and bladder infection while in hospital for stent and told ER doc that I still felt a little irritation but no discharge. He said my urine was clear and the irritation could be yeast since I was on a high amount of antibiotics. He did a pelvic and said it looked fine. After being on anti-nausea drip and fluids, I was released from ER. My husband and I were home about 1 hour and the ER doctor called and said my swab came back positive for chlamydia and that I must have PID instead of gastroenteritis! My husband swears he has not strayed and he has no signs of any infection. The doc called in a script for each of us but my husband wanted to see his GP. We went yesterday and we both left urine samples. It will take about 3 days to get results. GP was able to download all test results from ER and said he found it odd that my urine did not have puss. About two years ago I kept getting bladder infections and was finally put on flagyl for bacteria infection. Could this be the same thing this time? My doctor at the time just said it was bacterial, not STD. I have read the blogs and get different answers on whether chlamydia is dormant for a time? Yesterday our GP said he would rather get the results before jumping to conclusions. The ER doctor told me he was looking for an STD. He actually plays golf with my husband. When he called back he said there is no dormant period, you have it and either your got it our your husband gave it to you and it was in the last 3 weeks. The next two days will be hell waiting for results. Could this be bacterial instead? What else could be going on?
MEDICAL PROFESSIONAL
I'm glad things are working out OK. Best wishes.
Thank you for all of your help. I went to my gyno for my annual on June 18. He was shocked that I had a raging yeast infection that the ER doctor missed. Also, he felt that I did not have PID, rather the symptoms were probably related to the gall bladder bile leak. I just received the test results from the urine sample that my husband and I gave on Monday at our GP and they are both negative for chlamydia! I guess I was one of the rare false positives. I am to follow up with my gastro regarding the other symptoms. Thanks again for your advice. My GP has sent out letters to all concerned doctors letting them know that I am not infected. Thanks.
MEDICAL PROFESSIONAL
Chlamydia testing is recommended as a matter of routine in the right demographic categories, especially sexually active men and women in their teens or twenties; doing it often is the mark of a responsible doctor. However, most ER docs don't do chlamydia testing as routinely done by ObGs, office-based doctors, and others. Therefore, this makes me wonder whether something in your behavior or questions triggered the test. (If a patient asks "Are you testing for STDs?", it's usually a bright red flag that testing is a good idea.)
Chlamydia and UTI (bladder infection) can cause very similar symptoms. But as I said in my original reply, your doc is the only one who can answer this question. It depends a bit on other tests that were done, i.e. whether s/he knew for sure you had a UTI or only suspcted one. But cipro would have suppressed chlamydia (not recommended as cure, but it has substantial activity against the germ). Therefore, as I said above, it is likely you acquired your infection sometime after you last took Cipro or other antibiotics.
Chlamydia and UTI (bladder infection) can cause very similar symptoms. But as I said in my original reply, your doc is the only one who can answer this question. It depends a bit on other tests that were done, i.e. whether s/he knew for sure you had a UTI or only suspcted one. But cipro would have suppressed chlamydia (not recommended as cure, but it has substantial activity against the germ). Therefore, as I said above, it is likely you acquired your infection sometime after you last took Cipro or other antibiotics.
Thanks. My husband is still insisting that there was a mistake. We will just have to wait for the results. My first bladder infection was April 7 but I did not finish all of the meds because of the GB removal. Then I returned with symptoms on May 19 and was given cipro. Could this have been chlamydia then and just diagnosed as bladder infection? Also, could he have been giving it to me several times over the last couple of months after the cipro worked? Also, when I said the ER doctor told me he was looking for an STD, I meant that he never said that he was looking. Sorry for the confusion. That is why I was so shocked when he called. Apparently he specifically asked for this test to be run on my sample?
MEDICAL PROFESSIONAL
There really are two issues here; this forum can deal with one but not the other. The first is the cause of your abdominal symptoms, and I cannot answer whether any of them could have been due to undiagnosed chlamydia. Certainly the gall bladder problems were not due to chlamydia. Your lower genital tract infection problems 2 years ago might have been, but the antibiotics used for such infections often would treat chlamyida even if undiagnosed. Conceivably chlamydia contributed to the more recent painful abdominal problem, i.e. perhaps you had PID instead of gastroenteritis. But that is something only your doctors can determine.
The second issue is interpreting your positive chlamydia test and when you might have been infected. With modern chlamydia tests, false positive results are rare. No lab test is perfect, so it is possible the result is wrong -- but most likely it is accurate. How long have you been infected? Impossible to know for certain. Chlamydia is commonly carried by women for 1-2 years and sometimes even 4 years or longer. However, if you had any antibiotics during that time -- for example, around the time of your gall bladder surgery or during the symptoms leading up to it -- then you can be pretty sure you were infected after you finished the last round of antibiotic treatment. And your doctor apparently agrees with this, when he says he believes you were infected in the past few weeks.
Is your husband infected? I have to say I suspect he is; and if so, it is likely he acquired it recently, i.e. might have had other sex partners. In my experience as an STD professional, in most situations like yours, this is the explanation -- more commonly than the woman carrying chlamydia forl years on end. However, you know your husband and I do not; I can make no judgment of whether or not this possibility makes sense in terms of your relationship.
It is interesting that ER doctor involved in your care is a golfing partner with your husband. It raises an interesting ethical issue. On the one hand, anything said between a doctor and his patient can be considered confidential. On the other, doctors also have an ethical obligation to the sex partners of people with known or suspected STD. And on top of all that is the issue whether their relationship is as friends, patient-doctor, or both -- and which principles apply.
If your husband's chlamydia test is positive, that will help sort this out. But be prepared for the possibility that your husband's test will be negative, even if had chlamydia. Chlamydia clears up on its own, without antibiotics, often within only a few weeks, especially in men. There is a good chance you're going to need to sort this out with some straightforward (but caring) conversations, regardless of the test results.
I hope this helps. Best wishes--- HHH, MD
The second issue is interpreting your positive chlamydia test and when you might have been infected. With modern chlamydia tests, false positive results are rare. No lab test is perfect, so it is possible the result is wrong -- but most likely it is accurate. How long have you been infected? Impossible to know for certain. Chlamydia is commonly carried by women for 1-2 years and sometimes even 4 years or longer. However, if you had any antibiotics during that time -- for example, around the time of your gall bladder surgery or during the symptoms leading up to it -- then you can be pretty sure you were infected after you finished the last round of antibiotic treatment. And your doctor apparently agrees with this, when he says he believes you were infected in the past few weeks.
Is your husband infected? I have to say I suspect he is; and if so, it is likely he acquired it recently, i.e. might have had other sex partners. In my experience as an STD professional, in most situations like yours, this is the explanation -- more commonly than the woman carrying chlamydia forl years on end. However, you know your husband and I do not; I can make no judgment of whether or not this possibility makes sense in terms of your relationship.
It is interesting that ER doctor involved in your care is a golfing partner with your husband. It raises an interesting ethical issue. On the one hand, anything said between a doctor and his patient can be considered confidential. On the other, doctors also have an ethical obligation to the sex partners of people with known or suspected STD. And on top of all that is the issue whether their relationship is as friends, patient-doctor, or both -- and which principles apply.
If your husband's chlamydia test is positive, that will help sort this out. But be prepared for the possibility that your husband's test will be negative, even if had chlamydia. Chlamydia clears up on its own, without antibiotics, often within only a few weeks, especially in men. There is a good chance you're going to need to sort this out with some straightforward (but caring) conversations, regardless of the test results.
I hope this helps. Best wishes--- HHH, MD
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