STDs Expert Forum
Recurring STD
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The STD Forum is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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Recurring STD

Hello Doctors

I have posted before so I am not trying to do it under a different scenario or anything like that ( I have found the website excellent to use).

I had mutual masturbation, with a CSW in Mexico, she offered protected sex but i did not want that..... There was alot of fluid on her hands and mine plus she straddled me and was rubbing her vagina and I think fluids may have drippied on my penis (no oral, anal, vaginal contact or penetration). About 1-2 weeks or so later i started getting a numbing sharp pain inside my penis and a reddish irritated area at the tip. I self treated myself (1gram Azithromycin)  it went away for a week or so then it came back , so I eventually went to the doctor a few weeks later and tested positive for Chlamydia. The doctor precscribed me 1 gram a day of the same Azithromycin for 6 days, well i have just finished it (2 days ago) and besides feeling like crap the symptoms seem to be coming back; esepcially the red area at the tip. About 6.5 - 7 weeks after the event i had the young lady in question tested, she tested negative for HIV, VDRL, Herpes1 & 2 (elisa) but positive for Chlamidia. I have two questions;

1) Would this high dose have killed any Gonnerhrea also? what could it be? the slight sharp pains and reddness. I will get tested in 3 weeks to confirm of course.

2) Does this seem like a low risk for HIV also

I have worked my self into a bit of a tizzy over this as it was my first time at a place like that and my first time with an STD. I apreciate any thoughts you may have.

239123_tn?1267651214
Welcome to the forum.

I scanned your discussion with Dr. Gonzalez-Garcia on the international forum.  I'm actually skeptical you had chlamydia.  First, the exposure described was essentially zero risk; there's a theoretical possibility of acquiring chlamydia from that event, as Dr. G-G said, but I certainly have never seen a case that was not acquired by unprotected vaginal or anal penetration.  In addition, a positive blood test for chlamydia only indicates an infection sometime in your life, not necessarily a current or new one; and further, those tests cross-react with nonsexually transmitted chlamyidal infections, like those that occasionally cause bronchitis.  Your negative nucleic acid amplification test (NAAT, of which PCR is one kind) is far more reliable and indicates you were not infected.  As for your symptoms near the time of diagnosis, they are not at all suggestive of a chlamydial infection or any other STD.

On the other hand, you did subsequently learn that the woman involved in your exposure also had a positive chlamydia test.  Assuming her test was a NAAT and not a blood test, then probably she was infected.  (If it was a blood test, the same comments as above apply to her as well as you.)  Given the quasi-exposure plus your blood test result, it was not unreasonable for you to be treated with azithromycin as a precaution.  

To your specific questions:

1) Gonorrhea testing is almost always done simultaneously with chlamydia NAAT, and you would have been informed if it were positive. In addition, it is very uncommon to acquire gonorrhea without obvious symptoms (pus dripping from the penis).  So you can be quite confident you didn't have gonorrhea.  If you did, the azithromycin dose you had would be around 90% reliable in eradicating the infection.

2) I agree with Dr. G-G:  there was no risk of HIV from the events described.  But since you have been worried enough to ask about it twice (both forums), I advise you to be tested.  Anxious persons usually are more reassured by negative HIV test results than by experts' assurance that the risk of transmission was low.

In summary, there is no cause for a "tizzy" -- and I am quite confident you have had no STD of any kind.

Best wishes--  HHH, MD
6 Comments
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Doctor it is funny you say that because I have been at a total loss as to what is going on, that is why i have been so stressed and anxiuos, and yes guilty of asking twice.....

The first blood test i had was positive for IGg which means I had it once before, correct? (it must have been as a teenager , I don't remeber having problems....). Then I had another first catch urine test in the USA NAAT which was negative, but both tests were within a week of having antibiotics. So i waited on this last blood test (2 weeks without antibiotics) and it was positive for Igm 4.00, they were just blood tests, no NAAT. But I was in some pain (no dischage, just pain intermittent and really sharp)

The PCR DNA urethra swab was done one day after taking azithromycin, could it have been effected by that so soon? The lab tech here seemed to think not but.......

I realize I sound a bit anxious, which I am. But it was just all very confusing to me. The fact that I had the girl do 2 test for HIV ans STD's probably confirm your supicion of my anxities, but I am just at a loss.

So i will not repost anything to this thread after your response as there are more serious cases for you to attend. But i guess I am just at a total loss as to what is going on. Thanks again Doc, I appreciate your help.
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239123_tn?1267651214
As I said, your positive blood test doesn't necessarily mean you had a sexually aquired chlamydial infection as a teen or any other time; it could have reflected a respiratory infection due to other chlamydia types.  In general, IgM testing is even less reliable than IgG testing.  And chlamydia doesn't cause the sorts of symptoms you describe, like intermittent genital pain.

The NAAT tests take at least a few days, sometimes a couple of weeks, to become negative after treatment of chlamydia.  Your negative result a day after taking azithromycin was reliable.

For those reasons, this additional information doesn't change my opinions or advice.  
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4786399_tn?1359206516

Dr HHH

First of all I hope your doing well and thank you for all of your hard work on Medhelp, it really is a great service.

I am at the 11 week mark after the above mentioned incident and I wanted to share some information and if you had a second maybe get one or two lines of feedback.

I recently had the lymph nodes in my neck swell up (big, it looks like a marble on the right hand side), the doctor asked me about my sex life and whether I have been tested for HIV..........  I said yes at the 8 week mark or so, he suggested I do it again, I did and it was negative (11 weeks after as mentioned above). I am starting to get concerned again and I am wondering if there could be a chance still of infection? I tested negative for Mono but my neutrophil was slightly elevated 64% and my hemogloben was a little low. I live in Mexico and I wonder if the testing here is of an earlier variety and if that would have an effect on the timeframe to register antibodies.

It can be a lonely situation going through this down here so any feedback would be appreciated.

Regards,

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239123_tn?1267651214
Thanks for the thanks about the forum.  We are happy to help.

All the HIV tests done in every country in the world are entirely reliable 11 weeks after the last exposure.  Your test results prove you don't have HIV and it isn't the cause of your symptoms.
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4786399_tn?1359206516


Thanks again Dr HHH!

You probably dont realize how much you, the other doctors and forum contributors have helped me over the past 11 weeks, I felt like I almost went into a deep depression but the information and support I recieved here helped me get through it.

On another note I have really recieved somewhat of an eduacation about HIV and even though it is not great to be given a positive result, it is not the end of the world as we know it. There are great support systems and medications and I have to believe that with continued research the ability to make this disease even more manageable will prevail.

Thanks again and please keep helping as it makes a huge difference in peoples lives, for the better.

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University of Washington
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