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very very confused
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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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very very confused

Hello Doctors and excuse my poor English
I am a very confused male from Eastern Europe
2 years ago I had sex with a woman without a condom and 3 month later I developed reactive arthritis(RA). It seems that I had a chlamydial infection since I did the antibodies and they were very high. I did not have any genital symptoms but when the reactive arthritis occured I had swollen knees and a lot of pain. I was given 100 mg Doxycyline for 10 days and a month later I was given Azithromycine 1 g orally a single dose. I hope the treatment was correct.
Since then I have been performing only protected vaginal sex but on a few occasions I engaged in performing cunnilingus....
1 month ago I started having a minor pain in my ankles but no swelling. I thought that I was going to have another reactive arthritis. I did some blood tests like ESR, CRP which were normal then. I don't know how they are now. The pain is not there and appears occasionaly but it is minor and no swelling. I have done the antibodies( Ig A) again and they were not normal..they were a little bit high ( the value is 16 and they should be under 9)..
Now the questions:
1. What are the chances for me to contract chlamydia from cunnilingus?
2. What is the meaning of these antibodies that are still a bit high?
a) Does it mean that the infection is still in my body?
b) Does it mean that the treatment was not done properly?
c) Does it mean that I got again chlamydia from cunnilingus assuming they were probably normal before the cunnilingus exposures ?
d)Does it mean that the infection has gone but the antibodies are there for life?
3.I have read that when the Ig A antibodies are high this means that an active infection is present. Is this true?
4. Should I do another round of antibiotics( Azitro or Doxy?)-Which one should I choose?
5.Should I perform the DNA Chlamydia test from urine? If I do this test and is positive than I should start the treatment?
Best wishes. Waiting for our answer.
239123_tn?1267651214
Welcome to the forum. Thanks for your question.

I'm sorry to hear about your past trouble with reactive arthritis. Given the blood test result, I suspect chlamydia indeed was the trigger.  However, I doubt you your reactive arthritis is the problem now or that you have a new chlamydial infection. To your specific questions:

1) Oral sex is safe sex for chlamydia, which uncommonly infects the oral cavity and is rarely if ever acquired by cunnilingus.

2) You're currently positive blood test means none of these things. Once positive, the test is positive for life. This is why blood tests are not usually used to diagnose chlamydia at all; a positive result cannot tell whether an infection is currently active. The strongly positively when you had RA, but the current result means nothing.

3) IgA is no more helpful. It also can remain positive for life and does not necessarily mean a recent infection.  This is another reason that chlamydia blood tests are not used to diagnose the infection in the most developed countries. (These tests are not even available in my STD clinic.)

4) Based on the information provided, no additional doxycycline or any antibiotic treatment is needed at this time.  Antibiotics actually do not help RA anyway; they clear up the triggering infection, such as chlamydia, but the joint inflammation clears up on its own or with anti-inflammatory drugs.

5) I see no need for chlamydia testing at this time.  Of course, if your new ankle pain continuess or if other arthritis symptoms develop, see your doctor about it.

I hope this has been helpful. Best wishes-- HHH, MD

7 Comments
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Avatar_m_tn
thanks so much doctor
so I should not perform DNA chlamydia Test from urine?
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239123_tn?1267651214
See answer no. 5.  I haven't changed my mind; from the standpoint of your past infection, reactive arthritis, ankle soreness, etc there is no need for chlamydia testing.

If since your RA you have been sexually active other than with a mutually monogamous partner, then you should have routine STD testing (chlamydia, gonorrhea, syphilis, HIV) from time to time, like once a year.  But this advice has nothing to do with your past RA and the presumed chlamydial infection that triggered it.
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Avatar_m_tn
Thanks so much
One last question
How soon after a possible genital chlamydia exposure can I test for DNA in urine to get a conclusive test ?
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239123_tn?1267651214
2 days.
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Avatar_m_tn
I will do this test(DNA Chlamydia in urine) on monday and I will let you know the result as soon as I can
Can pharyngeal chlamydia( aquired from cunnilingus) cause RA?
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239123_tn?1267651214
As already discussed, people probably never get chlamydia by performing cunnilingus, even if the woman is infected.  It is unknown whether pharyngeal chlamydia could trigger RA, but I suppose it could.  However, you have provided no evidence that you still have RA.  My advice remains the same: see a doctor about your ankle pain, then follow his or her advice if s/he recommends chlamydia testing. But don't test yourself without medical guidance.

That will end this thread.  There is no need to post any negative test results.  
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