questions about chlamydia

[can'tstandanxiety]

hello doctor. quite upset about a recent positive result on chlamydia:

facts: i'm an heterosexual man. been on a monogamous relationship for 7 years now. my only sexual activity out of this relationship was a condom protected intercourse and non protected fellatio with a girl of unknown status the 25th may 2006. after that, unprotected vaginal and oral sex with my girlfriend just three or four times.

symptoms: only a soft discomfort on the inside the urethra (like humidity and cold feeling) that comes and goes, feeling i have to urinate without having real urine (also comes and goes) and a soft pain in the left groin from three months ago.

tests:
urine test (october): WBC normal and cultive normal. not a specific chlamydia test.
urine test (november): WBC normal and cultive normal. not a specific chlamydia test.
5th of january 2007: syphillis-negative, hepatitis A&B-negative, HIV-negative, gonorrhea-negative, BUT positive chlamydia (swab polymerasa chain test).

questions:
1) what are the chances i contracted chlamydia by the fellatio?
2) could my girlfriend or me carried it for years without knowing and have been passing it one to the other?
3) is the test for chlamydia reliable?
4) other ways of contracting chlamydia?
5) my doctor ordered me 100g of doxycilin twice daily for 7 days and said that my girlfriend should have ZITROMAX 1000mg in one take. don't know why treatments are different, maybe because he thought of a more easy one for my girlfriend. my girlfriend also has been taken ZITROMAX 500mg in three days (1500 mg in total) two times in the last two months for other infections (teeth and bronchitis). anyway, are these treaments 100% effective for eliminating chlamydia? can i be sure that after these we will be completely safe for having sex again?
6) assuming me and my girlfriend have been carrying chlamydia for 9 months (since my fellation exposure) is it possible that antibiotics are not 100% effective because chlamydia has turned resistance? is chlamydia more difficult to cure after such a long time?
7) can chlamydia get resistant to anibiotics?
8) the ZITROMAX 1000mg was powder. the instructions said i had to add 2 cups of water and dilute it. i put more water than that. may have it be less effective for that reason?
9) my girlfriend is taking ecchinacea tincture, which has alcohol in it, 1ml twice. does this interfere with ZITROMAX effectiveness?
10) should me and my girlfriend be re-tested in the future?
11) i've been on doxy for three days now and symptoms persist, although they have always been mild. how long takes the symptoms to go away?
12) my girlfriend works in a school with children. this is her first year so she is all the time having things like colds and flu. no fever. only one day low fever. she's been with cough for some months now. not a very heavy one but still couging a little bit in the morning and in the evening. is it possible that she has chlamydia pneumoniae and has passed it to me through oral sex?

[H. Hunter Handsfield, M.D.]

Chlamydia can be carried for a long time in women, but the longest ever documented is 4 years and that is rare.  Probably shorter in women.  So one possibility is that your girlfriend has had other partners and was infected recently.  I cannot judge the likelihood; you know her and your relationship, and I do not.  Second, a false positive test result is possible.  That is unlikely with PCR testing, but not unheard of.  (Of the various nucleic acid testing methods, false results are a bit more common with the PCR test (produced by Roche) than with others, like Aptima (Gen-Probe) or Probe-Tec (Beckton-Dickinson).  But the main problem with Roche PCR is in testing women; false results in men are uncommon.

1) Chlamydia has never been shown to be acquired by receiving oral sex, and certainly could not occur via condom-protected fellatio.

2) Carriage for 7 years is extremely unlikely.

3) Test reliability: see above.

4) Chlamydia is only transmitted sexually.

5-7) Both treatments are highly reliable and resistance to azithromycin or doxycycline is very rare, probably nonexistant.  Long duration of infection does not reduce treatment efficacy.

8) The Zithromax powder instructions say 2 ounces, not 2 cups.  But that won't affect efficacy, as long as you ingested the entire 1000 mg.

9) Echinacea or alcohol won't affect treatment efficacy.

10) It is recommended that people with chlamydia be retested in 3-4 months.  The purpose is to detect both rare cases of treatment failure and occasional cases of reinfection.

11) I don't understand why you were treated with both azithro and doxy.  In any case, it typically takes several days for symptoms to clear up entirely.  However, it's possible your symptoms were not due to the chlamydia--i.e. that you had asymptomatic chlamydia plus something else.

12) There is no way C. pneumoniae is causing your problem.  Anyway, C. pneumoniae wouldn't have shown up on the PCR test.

Good luck--  HHH, MD

[HHH,MD]

Second sentence is supposed to say "Probably shorter in men".

[can'tstandanxiety]

thanks a lot doctor for all your very helpful answers. please let me ask only three more questions. only three more:

1. fellatio was unprotected. any chance i contracted chlamydia through it? is it as rare as carrying chlamydia for 7 years? because my doctor said i contracted it through this fellatio without any doubt. he said it was quite common. can he be that misinformed? i think this is one of the best STD clinics.... i think my girlfriend hasn't had any other partners,... but the likehood, from what i can conclude from your words, is that she's been with another partner in the last few months.  anyway, i really don't mind. we are in love, and that's it.

2. you say that it's possible my symptoms are not due to the chlamydia--i.e. that i have asymptomatic chlamydia plus something else. this really frightens me... what can this be?? can it be harmful to my girlfriend? can it be as a result of the unprotected fellatio in may?

3. you say there is no way C. pneumoniae is causing my problem. but, can it be the ther way round? i.e. that i carried chlamydia and passed it to my girlfriend that would be the reason of her continous coughing? or it sure has nothing to do?

thank you a lot again in advance and sorry for my english...

[H. Hunter Handsfield, M.D.]

1) Sorry, I thought the oral was protected.  Still, there are no data to suggest frequent chlamydia acquisition by fellatio.  Nobody can say for sure it doesn't happen, but among men (either straight or gay) in STD clinics, chlamydia is rarely found in the urethras of men whose only exposures were receiving oral; and chlamydia is uncommon in the throat of sexually active people.  Many folks believe in oral transmission without awareness of the data, often because they just assume the situation is the same as for gonorrhea.

None of this proves that receiving oral cannot result in chlamydia, but it surely is uncommon.  Further, carriage of chlamydia in the urethra for 9 months appears to be rare.  Most men undergo spontaneous cure much sooner than that.  Since you "think" your partner has not had other partners (not exactly a ringing endorsement of her fidelity), that seems a more likely possibility than either the oral sex episode or a false positive test.  The odds are you never are going to know for sure which of these explanations is the truth; certainly I cannot decide and am not going to try.

3) C. pneumoniae has nothing to do with any of this, any more than any other respiratory infection.  If your partner's cough concerns her, she should see her provider about it.

HHH, MD

2) If not chlamydia, it's nothing harmful.M  aybe NGU due to an otherwise harmless bacteria in your partner's vagina or mouth.  Or nothing sexually transmitted at all; such symptoms often remain mysterious.  I cannot speculate, but this has been discussed frequently on this forum.  You might search the threads for more information; use search terms "NGU", "nongonococcal urethritis", "oral sex", "fellatio", and "STD symptoms".

[JK07]

i clearly got myself chlamydia form of the many collage girls,,
and i sort of found this out when..
well i was putting 'scholl' on a verruca i was getting rid of at the time and i put some of this gel  on my nob where there was a couple of these chlamydia hump/lump things and it must have burnt them as this verruca gel has salicylic acid (11.25% w/v), camphor (2.8% w/v)//// well it stung a lil  (hurt like a b!tch but anyways as my m8 says "chin up")

anywho if you try this what you should hope for is that it burns away the lump and leaves a lil scare thats smooth and  you carnt rlly see its a scare ///

it might take a couple of time to get ride of a bigger lump,, some times it doesnt do much all

(tip it stings more in areas where you might like a lady to please you (the end and under part or ya toy))


Remember this is something that i found out by chance and works to an extent (but if ya running out of options it is worth given ago before you completely come to a conclusion that a girl will not ever going down on you ever again,,)

i also have a question to who ever knows,,

what is inside a chlamydia lump / hump / spot and why do they form ??

..there purpose in life is really unnecessary to humans..

[JK07]

sorry i would edit this ^^
but the forum is not all that good and doesn't let you edit your posts,,
if ya really need ill re'post this
my grammar is the worst haha