Gonorrhea and Chlamydia

[DR79]

Hi doctor...thank you for your time. I hope you can help me.

I had a one time, brief (30 sec-1 min)act of fellatio performed on me by a woman who is not my long term girlfriend. No ejaculation.

Afterwards, I became freaked that I could have gotten chalamydia or gonorrhea. I went to a doc who did not test me, but did prescribe 2 grams of zithromax for both me and my long term GF. (8 pills each) We both took the treatment (she did not know it was for STDs - that's another story). We waited the 7-10 days suggested before resuming sex. (Probably 8 days before we resumed).

After the zithromax, I have now had 2 swab tests that both came back negative for chlamydia and gonnorhea. (one test was 11 days after treatment, one was 40 days after).  The two tests were done almost a month apart, and in between the 2 tests, I had  unprotected sex with my long time GF once or twice. I would love to believe that we're both in the clear due to my 2 negative tests - but she has not been tested, and I can't tell her about this incident so she can be tested or my relationship will crumble. So my questions:

1. Is there any chance that the zithromax cured me, but not her...and that she could still be positive while my tests have shown me as negative? (I worry that she could be positive and not know it, and she will become sterile)

2. She is going for a gynocological exam (routine) soon. Would a normal exam and a pap test pick up any of these STDs, or any signs of trouble? She had an STD test before my incident (she was neg.) so she won't be getting another one, and I can't convince her to get another without arousing major suspicion.

4. Based on my 2 neg. tests after the 2g Zithromax treatment that we both received....is it safe to assume we are both in the clear? I would like to gain some closure on this that doesn't involve our relationship being ended.

I understand that this event has been handled incorrectly, and I am having a lot of trouble with the thought that my GF could be infected and it is silently affecting her health. Any reassurance you provide would be extremely helpful.

Thanks.

[H. Hunter Handsfield, M.D.]

The exposure you describe was low risk for gonorrhea and zero risk for chlamydia.  (Chlamydia transmission to the penis by oral sex has never been documented to occur; and chlamydia of the mouth or throat is rare.)  Further, you can be completely confident any gonorrhea you acquired would have been effectively treated by the drugs you were given.

1) Since you almost certainly didn't have anything to transmit to your regular partner, the question is irrelevant.  But in the off chance an infection was present, there is no reason to suspect it would have failed in either you or her.  (2.0 g azithromycin is overkill for chlamydia, and generally is effective against gonorrhea.)

2) Routine pap testing does not detect chlamydia, gonorrhea, etc.  However, many providers do those tests routinely when they do pap tests.  On the off chance she has a positive result, I would be 100% confident that it has nothing to do with the casual sexual encounter you describe.

3) You should forget all this and stop losing sleep over it.  Assuming you have no other risks you don't describe, the odds you have an infection you gave your partner are less than the chance you'll win the next lottery.

Now about this business about arranging treatment for your partner without telling her about an STD risk.... What planet is she from?  What planet are you from?  If she has an IQ over 50, you can be sure she at least suspectsThis happens a lot, that is males with STD finding excuses to   That was a really dumb idea.

Good luck, though--  HHH, MD

[bigdaddy1992]

hi littlepond5, i mhave a couple of thoughts until the doc can answer you. Firstly you dont know you had anything to begin with, did you have symptoms? Also males nearly always have a painful discharge with Gonnoreah so i think you can safely discount that anyway. The 2g of zithromax you took was double the normal dose used for chlamydia so that was overkill for treatment even if you had it ( which probably you didn't ). You waited the required time before resuming sex so after the dose you took i think the doc will say theres no way you or your gf could have it anyway. Dont know what it's like where you live but in the uk when women have smear tests chlamydia is one of the things they test for but theres more chance of a plane crashing into your house than either of you having it with your treatment and tests. Hope it helps until the doc can tell you more thoroughly.

[bigdaddy1992]

just re-read your post, if you only had oral given to you then chlamydia does not get transmitted this way so you def didn't have it to start with.

[Imdumb]

If all you had was insertive oral, you did not get chlamydia anyway.  You don't get chlamydoa from insertive oral. Sometime (rarely) gonnorea is spread by receiveing oral, but you would have had obvious symptioms of discharge and painful urination.

Bottom line is you never had anything, so any treatment is not relevent.  If this ever happens again, insist on a test before any meds are taken.  It is not responsible medicine to treat without a test, IMHO.

You should forget it and move on.

[DR79]

Thanks for the input. I received the zithromax about 6 days after the incident...a little too soon for symptoms to occur?? I had no symptoms up till that point...

Additionally, my GF hasn't had any real symtoms...an occasional stomach pain here and there, one bout of nasaua (that could have been explained by drinking too much) but other than that...nothing. Certainly nothing that would make her say, "hey...this feels wrong" or anything like that. She's the one I'm really worried about.

[DR79]

Doctor...a follow up if I may...

1. is it usual procedure for possible chamydia/gonnorrhea exposure to have a "test of cure" after being prescribed and treated with 2gs of Zithromax? Or would the usual advice just be take the pills, don't have sex for a week, and then you'll be ok? My GF takes birth control pills (Mircette)...would that have effected the Zithromax at all, causing it to fail?

2. Do you see any reason for me to push my girlfriend to be tested? I don't want to arouse more suspicion, but have to be sure she's ok...I love her.

Thank you.

[H. Hunter Handsfield, M.D.]

No, test of cure is not generally recommended after treatment.  It especially is not recommended when no infection was diagnosed in the first place.  There is no need for your girfriend to be test.

There is an editing glitch in my closing comment in my origina response.  The last paragraph is supposed to read  "Now about this business about arranging treatment for your partner without telling her about an STD risk.... What planet is she from? What planet are you from?  If she has an IQ over 50, you can be sure she at least suspects that you were concerned about STD. That was a really dumb idea."

HHH, MD

[DR79]

Sorry doc...last post...would her Mircette birth control have effected the Zithromax, causing it to fail?

[who_is_this]

No.