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Chlamydia?
Hi Doctor,
For the past 5 days I’ve had:
1.frequent urination: sometimes takes time to come out (like constipation) and other times feels like I havent completely emptied and there can be leakage.
2.haven’t noticed discharge but a couple of times I felt a small amount of sticky substance when I poked around the urethra. I don’t find my penis or underwear wet when I wake.
3.about 2 wk ago I would occasionally (3 or 4 times) get a stinging pain at the tip (like someone stabbing it with a needle) for a few seconds (unrelated to urination). Different from the sensation you get from chlorine, soap, etc.
4.Early morning today (Monday) after going to pee a very small amount and feeling the “stick substance” (without being able to see anything come out), I felt this strange burning sensation on the glans but again different from what you get when something irritates the urethra.
History as follows:
Oct 4: protected oral with escort plus ejaculating inside the condom while grinding (she had her underwear on the whole time).
Oct 7: protected sex with wife
Oct 15: 1.5 g of Zithromax all in one go
Nov 3: tested for STDs (incl Chlam IgM/IgG and HIV duo). All negative (all were blood tests).
Resumed unprotected sex with my wife. Last was appx Nov 23.
Dec 1 to Dec 15: course of amoxicillin (2 g per day) + chlarythromycin (1 g per day) + pantoprazole pfor H. Pylori. Later, stinging sensation appears few times.
Dec 12 or so: frequent urination begins
Dec 15: noticed crust in urethra. Saw urologist. Urine results normal but for WBC of 2-4. Chlam IgG (blood test) exactly borderline 1:320. I’ve asked for Chlam IgM (blood) and Chlam Ag (urine) tests but the results will take a few days.
Based on the borderline IgG + WBC, the urologist concluded that I had an “incompletely-treated Chlamydia infection.” Do you agree with him? Is it possible that the symptoms are from 10 days of antibiotics?
For the past 5 days I’ve had:
1.frequent urination: sometimes takes time to come out (like constipation) and other times feels like I havent completely emptied and there can be leakage.
2.haven’t noticed discharge but a couple of times I felt a small amount of sticky substance when I poked around the urethra. I don’t find my penis or underwear wet when I wake.
3.about 2 wk ago I would occasionally (3 or 4 times) get a stinging pain at the tip (like someone stabbing it with a needle) for a few seconds (unrelated to urination). Different from the sensation you get from chlorine, soap, etc.
4.Early morning today (Monday) after going to pee a very small amount and feeling the “stick substance” (without being able to see anything come out), I felt this strange burning sensation on the glans but again different from what you get when something irritates the urethra.
History as follows:
Oct 4: protected oral with escort plus ejaculating inside the condom while grinding (she had her underwear on the whole time).
Oct 7: protected sex with wife
Oct 15: 1.5 g of Zithromax all in one go
Nov 3: tested for STDs (incl Chlam IgM/IgG and HIV duo). All negative (all were blood tests).
Resumed unprotected sex with my wife. Last was appx Nov 23.
Dec 1 to Dec 15: course of amoxicillin (2 g per day) + chlarythromycin (1 g per day) + pantoprazole pfor H. Pylori. Later, stinging sensation appears few times.
Dec 12 or so: frequent urination begins
Dec 15: noticed crust in urethra. Saw urologist. Urine results normal but for WBC of 2-4. Chlam IgG (blood test) exactly borderline 1:320. I’ve asked for Chlam IgM (blood) and Chlam Ag (urine) tests but the results will take a few days.
Based on the borderline IgG + WBC, the urologist concluded that I had an “incompletely-treated Chlamydia infection.” Do you agree with him? Is it possible that the symptoms are from 10 days of antibiotics?
MEDICAL PROFESSIONAL
"if it is chlamydia then it can't be that one encounter that caused it. Correct?" CORRECT. The other information doesn't change my opinion or advice.
That will have to end this thread. I won't have any further comments or advice. Best wishes.
That will have to end this thread. I won't have any further comments or advice. Best wishes.
Thanks again, Doctor, for your thoughtful response. You're basically saying the symptoms and tests may very well point to chlamydia, but if it is chlamydia then it can't be that one encounter that caused it. Correct? Unfortunately, it's an antigen test that I'm waiting for as the DNA tests are not available in this country. I'm also waiting on a second IgG. Both the Ag and the new IgG are from a different lab than the one that did the borderline IgG. This same (new) lab just told me a few moments ago that I was negative on the IgM test (1.8 against a borderline of 9.0). I don't know if it changes anything but just thought I'd mention it.
MEDICAL PROFESSIONAL
Only 2-4 WBC in urine is very trivially elevated -- maybe not abnormal at all. In any case, chlamydia is a less common cause of elevated urine WBC than NGU and other possibilities such as prostatitis.
If I correctly understand, you're waiting on the result of a urine test for chlamydia. (You say Ag, meaning antigen -- but I would hope it's actually a test for chlamydial DNA.) That will tell the story. But my bet is that it will be negative, and I stand by my previous opinion and advice. Based on the non-marital sexual exposure you have described (condom-protected oral sex), you couldn't have caught chlamydia. If that's the explanation for your symptoms, then you'd probably have to look to different sexual exposures (perhaps many months ago?) as the source; or to consider whether your wife might have acquired the infection from another partner.
Has your wife been tested? If not, that might make sense; you should discuss it with your urologist. If there is any doubt about your wife's infection status, of course she needs to be treated.
In summary, my guess is that this isn't chlamydia and never was -- but I can't rule it out based on the information provided. But most likely you'll never know for sure. Even though I have not agreed with your urologist about all aspects of this situation, I would advise you to follow his advice about management and possible follow-up tests.
If I correctly understand, you're waiting on the result of a urine test for chlamydia. (You say Ag, meaning antigen -- but I would hope it's actually a test for chlamydial DNA.) That will tell the story. But my bet is that it will be negative, and I stand by my previous opinion and advice. Based on the non-marital sexual exposure you have described (condom-protected oral sex), you couldn't have caught chlamydia. If that's the explanation for your symptoms, then you'd probably have to look to different sexual exposures (perhaps many months ago?) as the source; or to consider whether your wife might have acquired the infection from another partner.
Has your wife been tested? If not, that might make sense; you should discuss it with your urologist. If there is any doubt about your wife's infection status, of course she needs to be treated.
In summary, my guess is that this isn't chlamydia and never was -- but I can't rule it out based on the information provided. But most likely you'll never know for sure. Even though I have not agreed with your urologist about all aspects of this situation, I would advise you to follow his advice about management and possible follow-up tests.
Thank you Doctor for your reply and for taking time to read the other posts. I agree that anxiety is playing a big part here, but I'm not sure the frequent urination is primarily due to anxiety. It came about at a time when I was quite relaxed mentally and focusing on my job and it took me till the end of the day to notice that I was getting up from my desk more often than usual. I also think it would have subsided by now (which it hasn't). I had a similar episode a couple of years ago when I loaded up on creatine so my hunch (or hope) is that it's just the heavy course of antibiotics I was on for 2 wks (your thoughts are welcome on that of course).
Not to slice and dice about it but just to clarify the urologist's reasoning: he thinks I transmitted it to my wife on Oct7 and got it back from her in late Nov (making the intervening Zithro irrelevant). I'm not saying he's right and I don't want to waste your time discussing the efficacy of latex.
What concerns me more is the WBC of 2-4. He acknowledged that the IgG was not reliable on its own, but coupled with the WBC he felt Chlamydia was the only plausible explanation. (fyi he looked at an Usound of my lower abdomen and kidneys.) Any thoughts on what the WBC could mean? Thanks again for your patience.
Not to slice and dice about it but just to clarify the urologist's reasoning: he thinks I transmitted it to my wife on Oct7 and got it back from her in late Nov (making the intervening Zithro irrelevant). I'm not saying he's right and I don't want to waste your time discussing the efficacy of latex.
What concerns me more is the WBC of 2-4. He acknowledged that the IgG was not reliable on its own, but coupled with the WBC he felt Chlamydia was the only plausible explanation. (fyi he looked at an Usound of my lower abdomen and kidneys.) Any thoughts on what the WBC could mean? Thanks again for your patience.
MEDICAL PROFESSIONAL
I saw this before I replied above. It doesn't change my opinion or advice.
MEDICAL PROFESSIONAL
WElcome to the forum. Thanks for your question. I have also looked at your threads on the community forums.
For a number of reasons, there is no chance you have chlamydia. I disagree strongly with your urologist. Here are the reasons.
The chlamydia blood tests are useless. Although used in some parts of the world, notably parts of Europe, they are never used in the US to diagnose current chlamydial infections because the results are not reliable. Your borderline positive result only indicates you may have had a chlamydial infection at some time in your life. And maybe not sexually transmitted chlamydia; the blood tests can also be positive due to certain non-STD chlamydia-like infections of the respiratory tract.
Further, as discussed on the community forums, you could not have acquired chlamydia (or any other STD) from the exposures described. You had condom protected sex -- and NO STD can pass through intact latex! And even without a condom, oral sex almost never transmits chlamydia. And your symptoms are not typical for chlamydia. In most infected men, the only symptom is discharge of mucus or pus from the urethra (penis); uncomfortable or frequent urination or pain in the penis are not usually due to chlamydia. Finally, if you had had chlamydia, the azithromycin (Zithrommax) that you took would have cured it.
For those reasons, I do not agree with your urologist's diagnosis. Among other things, chlamydia always would respond well to the dose of azithromycin that you took. My belief is that all your symptoms are nothing more than the physical manifestations of anxiety over a sexual choice that you regret -- and not to any infection.
At this point, my advice is to stop all worry, do not have any furhter tests or treatment, and continue unprotected sex with your wife.
Best wishes-- HHH, MD
For a number of reasons, there is no chance you have chlamydia. I disagree strongly with your urologist. Here are the reasons.
The chlamydia blood tests are useless. Although used in some parts of the world, notably parts of Europe, they are never used in the US to diagnose current chlamydial infections because the results are not reliable. Your borderline positive result only indicates you may have had a chlamydial infection at some time in your life. And maybe not sexually transmitted chlamydia; the blood tests can also be positive due to certain non-STD chlamydia-like infections of the respiratory tract.
Further, as discussed on the community forums, you could not have acquired chlamydia (or any other STD) from the exposures described. You had condom protected sex -- and NO STD can pass through intact latex! And even without a condom, oral sex almost never transmits chlamydia. And your symptoms are not typical for chlamydia. In most infected men, the only symptom is discharge of mucus or pus from the urethra (penis); uncomfortable or frequent urination or pain in the penis are not usually due to chlamydia. Finally, if you had had chlamydia, the azithromycin (Zithrommax) that you took would have cured it.
For those reasons, I do not agree with your urologist's diagnosis. Among other things, chlamydia always would respond well to the dose of azithromycin that you took. My belief is that all your symptoms are nothing more than the physical manifestations of anxiety over a sexual choice that you regret -- and not to any infection.
At this point, my advice is to stop all worry, do not have any furhter tests or treatment, and continue unprotected sex with your wife.
Best wishes-- HHH, MD
I should have also mentioned that the stinging sensation stopped about a week ago (before the frequent urination began).
You are reading content posted in the STDs Forum
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