Gonorrhea, Antibiotics, Questions and Anxiety!!

[AnxiousInTX]

Dr. I had a urine test done Thursday to test for C/G and am waiting for results.  I am a gay male who received a ** about 2 weeks ago.  This is a chronology of the events is as follows:

- 2 weeks ago, someone performed oral sex on me
- about 3-4 days later I started taking 100mg of Doxy 2x/day for unrelated (acne) issue
- in next day or so I started to feel some discomfort (ache) under my testicles & a general burning sensation on head and shaft of my penis
- some dribbling after urinating (like bladder isn't quite empty).
- Last Thursday I went to the dr and asked him to check for me - that I thought I had I might have a UTI, as I said earlier he ran a test for C/G among other things.  it had been about two weeks since the oral sex and about a week since started taking the Doxy
- On Thursday I was given a shot of something and told to continue doxy for 10 days, which is not a problem since i am on it for 3 months anyway
- Today is Sunday and I am still experiencing the same symptoms and at same level - never had thick discharge (some clear liquid leaking) and still don't and still have similar level of... "discomfort".

I know I just need to sit tight and wait for tests but wanted to ask a few questions, if you don't mind, just to prepare myself for Tuesday.

1- how likely is contracting gonorrhea from receiving oral sex
2- Did the fact that I was taking doxy for a week before the test going to mess up the test?  (I have seen some people say doxy does nothing to gonorrhea and others say effective just not drug of choice)
3- When should I start feeling better?  I just got shot on Thursday but have been on Doxy for close or over 1.5 weeks?
4- Does the fact that symptoms seem same and that discharge was never like pictures that I saw online suggest something else might be going on?

Thank you for taking time to answer... I have been consumed with questions, so just decided to get them all down in one place.  I appreciate your time.

[Edward W Hook, MD]

Thanks for the follow-up.   Glad I could help. EWH

[AnxiousInTX]

Dr, I want to follow-up on our thread.   Apologies for not  updating sooner, but as you predicted my chlamydia and gonorrhea results did, in fact, come back negative!  Thank you for your reassurance and expertise during what was a couple weeks of real anxiousness.  

[Edward W Hook, MD]

Your test results reaffirm what I have told you.  The absence of WBCs and negative cultures indicate that you were not infected.  EWH

[AnxiousInTX]

Thank you! Partial urine results came back today both WBC and cultures were negative. Waiting for specific G/C results tomorrow or next day.

Do WBCs or culture results give any indications?

I will be sure to post results once I know. In meantime, thank you again for your time and in advance for your answers.

[Edward W Hook, MD]

If you were taking doxycycline at the time of exposure it might well prevent infection, but, if you were infected, your test would be positive.

I would not be worried about STIs if I were you.  EWH

[AnxiousInTX]

Thanks Dr Hook,

As I mentioned, I did get checked for chlamydia and gonorrhea, I am waiting for results on Thursday.... I am not concerned in the least about HIV.

So the doxycycline would not have any potential impact on my pending test results?

So,on treatment might symptoms would not be getting worse, correct?  Would the "other causes" you mentioned be STI/Ds or do I need to cast the net broader or even more specifically with a specialist?  My last comment, promise. Thanks again

[Edward W Hook, MD]

1.  gonorrhea and chlamydia are more common than HIV, that is why I suggest you get checked for them., .  Actually however, I made a mistatement and meant to say NGU, not chlamydia.  Chlamydia is extraordinarily rare following receipt of oral sex.  

2.  Doxycycline s recommended therapy for both NGU and chlamydia and cures much but not all gonorrhea.

If your symptoms are getting worse, then this is not one of the STIs I mentioned.  You need to look for other causes.  these would be unusual symptoms for prostatitis as well.  EWH

[AnxiousInTX]

Thank you, Dr. I hope you don't mind if I ask a couple questions of clarification...

question1
When you say, "When they occur, gonorrhea and chlamydia are no most common infections that occur", do you mean that they are "not" or that they are "the" most common?

question 2
When you said that "The doxycycline you are taking is recommended therapy for gonorrhea and I suspect the shot you got was ceftriaxone, the recommended therapy for gonorrhea." Did you mean that both treat gonorrhea or were you intending to say that one treats chlamydia?

Do additional questions if you don't mind.

- is it possible that (if I were infected by either of the above), my symptoms would be getting worse, I am now feeling like I am having some discharge even though I haven't been able to see something with the exception of a small floating "puddle" that I saw this afternoon floating in the toilet bowl (it looked a bit like ejaculate)?

- Would you mind elaborating a bit on what the potential impact of the doxycycline I was taking might have been on testing if I HAD been infected?

- Random question.... could this be prostatitis?  I am on T replacement therapy....

I appreciate you indulging this and I will try to limit this thread to these questions.  

[Edward W Hook, MD]

Welcome to the Forum.  I'll be glad to comment.  STIs following receipt of oral sex are not particularly common.  When they occur, gonorrhea and chlamydia are no most common infections that occur.  The doxycycline you are taking is recommended therapy for gonorrhea and I suspect the shot you got was ceftriaxone, the recommended therapy for gonorrhea.  Both are highly active and if you did get an STI, these would cure the infections.  

STIs do not cause urinary dribbling and to have testicular discomfort without an obvious discharge is most unusual.  On the other hand, these same symptoms are a common sign of anxiety, particularly in person's whose attention is focused on the possibility of having gotten an STI.

I am confident your tests will be negative.  My advice is to not worry further about the exposure you describe.  I hope my comments will help you to do this.  EWH

[AnxiousInTX]

PS I also posted in STD community, as I was unsure as to whether or not you were answering questions over the weekend.  Hope that does not create a problem for the forum