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Gonorrhea in Thailand, persistant symptoms
Thanks in advance for any assistance. I contracted gonorrhea here in Thailand and was put on a one time dose of ciprofloxacin (500 MG) and a week of doxycycline (twice daily 100 MG). While I am only on day 6, I see little or no improvement in condition (still have constant discharge). I have read that many strains here in Thailand have high resistance, and the doctor that I saw was unsure what to perscribe when I said I was allergic to pennicillon. Should I be concerned at lack of improvement.
The two other factors that lead to my concern are: 1) I am a severe type 1 diabetic, which I know can make some infections a bit harder to deal with, and 2) I already have a swollen epididimous from an injury 5 months ago. Since gonorrhea can cause epididimitis, I am worried about a long recovery making my existing condition worse. Thank you for any information you can give me.
The two other factors that lead to my concern are: 1) I am a severe type 1 diabetic, which I know can make some infections a bit harder to deal with, and 2) I already have a swollen epididimous from an injury 5 months ago. Since gonorrhea can cause epididimitis, I am worried about a long recovery making my existing condition worse. Thank you for any information you can give me.
MEDICAL PROFESSIONAL
You are correct to be worried about resistant gonorrhea in Thailand. Throughout Asia many (most?) gonorrhea bacteria are entirely resistant to the fluoroquinolone antibiotics (cipro and others) and many are resistant to the tetracyclines (doxycycline).
I doubt your diabetes is playing a role here, especially if it is reasonably well controlled; and your prior testicular injury is unlikely to make you more susceptible to epididymitis.
Nevertheless, you need to be reexamined promptly. Depending on the certainty and severity of your penicillin allergy, you likely can be safely treated with whichever cephalosporins are handy in Thailand (e.g., cefixime or cefpodoxime orally, or ceftriaxone by injection). Although there is a small chance of cross-reactivity in penicillin-allergic persons, it is rare.
Good luck-- HHH, MD
I doubt your diabetes is playing a role here, especially if it is reasonably well controlled; and your prior testicular injury is unlikely to make you more susceptible to epididymitis.
Nevertheless, you need to be reexamined promptly. Depending on the certainty and severity of your penicillin allergy, you likely can be safely treated with whichever cephalosporins are handy in Thailand (e.g., cefixime or cefpodoxime orally, or ceftriaxone by injection). Although there is a small chance of cross-reactivity in penicillin-allergic persons, it is rare.
Good luck-- HHH, MD
Thank you very much for your help. I will give those a try, and pass your wisdom on to the doc here in Thailand. Have a good day
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