Chlamydia question on transmission.

[bradgdl]

Dear Doctor,
Thank you for this great service!
My wife just went to her ginecologist because she had iches, and pain in her abdominal and vaginal area with some form of yeast infection. The doctor diagnosed her with Chlamydia. I am confused in how we or she could aquired this disease, I do not show any type of discomfort or symptoms.
The doctor told her this was a 99% sexual disease and that the 1% could of been aquired by sitting in a toilet or using some other persons infected clothes.
She was unfaithfull to me about 1 year ago and I will never know if she protected herself or not.  We separted for a 3 month period because of this. I would say she did have relationships with the same man or maybe someone else.    
I have had several vaginal encounters but all have been using a condom, but I have had unprotected Oral sex about 3 times in the last year when we separated, but never finished and were pretty short.  Here are my questions:

1. Could she have acquired Chlamydia through any other form of contact other than sexual?
2. The doctor gave her a injection and some medicines for this. Should I be taking medicines also? she only gave her medicines.
3.we have been together six years and never had any signs of any type of std's. I have taken a vdrl and hiv test 2 months ago and everything came out negative. Can This disease lay asleep for some time?
4.could I have cought and transmitted this disease from my several all protected encounters with a condom and 3 unprotected oral sex encounters?
Thank you for all your help.  

[H. Hunter Handsfield, M.D.]

First, I cannot tell from your question whether your wife has had a positive lab test for chlamydia, or if her ObG is just assuming it based on her symptoms and exam.  For the rest of this response, though, I'm assuming she had a positive test and definitely is infected.

Her doc is wrong about 1% coming from toilets, shared clothing, etc.  Every genital chlamydial infection was acquired by sex with an infected person.  Period.  However, some infections can persist for months.  A year is on the long side, but it can happen.  (About 10% of untreated women with chlamydia still have positive tests if tested a year later.)  And men can be infected without symptoms, so you could have it from one of your outside partnerships.  It's unlikely unless there was a condom screw-up, but still possible.

So the answers to your questions are:  1) No, only sexual. 2) Yes, you definitely need to be treated.  Before treated, you also should tested for chlamydia.  (If your test is negative, you could still have been infected, but your immune system cleared it up.)  3) The duration of chlamydia carriage in men has not been studied, but the best guess is that it rarely persists for more than a few months.  4) Oral sex is not believed to be a significant risk for chlamydia. If there was any genital contact before you put the condom on, that's the more likely source.

Bottom line:  I cannot say whether your wife was infected a year ago (or more recently, if she had other relationships you don't know about); or whether you caught it more recently and infected her.  You're never going to know and it doesn't matter, and I strongly recommend you not get into the blame game.  You're sharing an infection, both of you have been at risk, and that's it.  Now the only important thing is for both of you to be properly treated.

Oops, one other bottom line: You need to inform the women you had sex with in the past few months (even if you are positive about proper condom use) and advise them to get tested and perhaps treated.

Good luck-- HHH, MD

[bradgdl]

Dear Doctor,
Thank you for your prompt reply, and all your answers.   I spoke with my wife and she told me that her ginecologist just told her she had Chlamydia without even doing her a test. Can this be correct, can you tell if you have this disease just by observing?

On the other hand, I did use the condom in a correct way and there was no direct touching in our genital areas, just the unprotected oral sex.

Please let me know what i should do?

Thank you...

[sparkeler]

I don't think a doctor can say with 100% accuracy whehter or not your wife has chlamydia without doing a test. However, doctors can tell when something doesn't look right.  I know if they suspect one has a bacterial std or infection they will test them as well as treat them then & there.  I'm surprised they didn't do a test, that was irresponsible on their part.

[H. Hunter Handsfield, M.D.]

Sparkeler is right.  I'll bet your wife's doc did not tell her she had chlamydia for sure; more likely he speculated about chlamydia as possibility and your wife misunderstood.  (If he really did say chlamydia was definite, that was highly irresponsible.  Nobody can tell without doing a test, and lots of other infections can cause the sorts of symptoms your wife had.  And if he suspected chlamydia but didn't test for it, that also is irresponsible.  But give him the benefit of the doubt until/unless you know all the facts.)  If your wife wasn't tested, it's probably too late, assuming she is now taking antibiotics.  But you can be tested--and given your and your wife's sexual history, that's still a good idea.

[bradgdl]

DEAR DOCTOR,
THANK YOU FOR YOUR RESPONSE.   I TOOK MY WIFE YESTERDAY TO ANOTHER GINECOLOGIST AND HE LOOKED AT HER AND GAVE HER SOME ADITIONAL TREATMENT TO WHAT SHE WAS TAKING.  HE AND ALSO TOOK A Q-TIP AND TOLD HER TO GET A TEST MADE FOR SOME TYPE OF BACTERIA.  HE SAID HE WILL SEE HOW SHE RESPONDS TO TREATMENT BECAUSE SHE IS FEELING A LITTLE BIT BETTER AFTER ONE DAY OF TREATMENT, HE ALSO SAID THAT HE BELIEVES IT IS A BACTERIAL INFECTION, EVEN AMOEBAS , BUT THAT HE WILL HAVE TO WAIT A FEW DAYS TO SEE HOW SHE RESPONDS, AND YOU ARE CORRECT RIGHT NOW BECAUSE ALL THE TREATMENT SHE CAN NOT BE TESTED. SHE STARTED TAKING WITH THE FIRST DOCTOR A SHOT OF PENECILIN, AND AMOXICILIN, AND A FUNGAL CREAM. WE WILL GET TESTED ONCE SHE FINISHES HER TREATMENT.THANK YOU DOC.. BEST REGARDS..  
ALSO, THANK YOU SPARKELER FOR YOUR POST.  I KNOW THE DOCTOR WAS NOT VERY ETHICAL TELLING HER SHE HAD CHLAMYDIA WITHOUT A POSITIVE TEST.   I JUST HOPE EVERYTHING TURNS OUT OK.