Questions on testing etc.

[Fixated24]

Hi DR.

I appreciate this forum greatly, I'll try and get right to details.

I realize it probably just anxiety but your answers will help. I am 36 married, and kids. I searched info on testing but didn't find my question.

Had some drinks with a female acquaintance (approx) 40 yrs old. There was no sex that I can recall I did fell asleep/pass out, she did try fir sex at one point waking me up by straddling me, we were still both clothed this is last thing in my memory .

2 -  3 days later strange feelings in groin region.  Had slight irritation between urination, no noticeable discharge ( some small light/white stains in underwear sometimes).

Visited clinic 6 days later, had  NAAT gc urine test. Treated with 1G of Zithromax. Tests were neg as I expect.

Symptoms still exist, worried I may not remember that something happened.

Questions : 1. gave a mid stream urine test not knowing until later this was incorrect.  Would this affect results? I have seen studies that say it is still around 96% accurate.

2. Is discharge always noticeable or can it be slight.

I can see after reading my post that I am probably looking to closely at normal sensations due to anxiety and guilt but the symptoms feel real.

Thank you,

[Edward W Hook, MD]

When infections causes swollen lymph nodes they are typically tender.  

Lymph node swelling, as I said before, is a nonspecific process. If you have swollen lymph nodes, they may have been present for a long period of time and do not necessarily reflect current or ongoing infection.

You really need to relax and move forward from here.  EWH

[Fixated24]

Thanks Dr,

It really is a great thing you do here. This will be my last post.

In regards to the lymph nodes from the previous post, my concern wasn't HIV. Just more curious if something like trich could cause that.  I would expect with an infection that the nodes would be tender, but do not really know if that would be the case.

I will try to move on after your next post,

Thank you..

[Edward W Hook, MD]

1. Some NGU is not due to gonorrhea or chalmydia and is diagnosed based on detection of increased numbers of white blood cells in a urine specimen or a swab taken from the penis and stained.  

2.  There are many other illnesses which can cause lymph node swelling.  Swollen lymph nodes are a non-specific response to any number of stimuli including infections due to bacteria and viruses, allergic reactions and autoimmune disease.  Of all persons with swollen lymph nodes only a tiny proportion of them have HIV.  If you are concerned about swollen lymph nodes, the proper place to get evaluated is with a good internal medicine physician.

3.  No this is not a concern.

Take care. You really should not worry.   EWH

[Fixated24]

Thank you for such a fast response Doctor.

Just a couple more questions and I will be done.

1.I was test for Chla and gon, but this test wouldn't find other NGU correct? Doctor said tests would have found trich, but I don't know for sure other than chla and gon what was tested for.

2. It appears I have swollen lymph nodes at top of leg crease near groin.  They are not painful but are swollen and I can notice them at all times.

3. After ejaculation or urination tip of penis has been itchy and I notice split stream urine every day or two. Is there anything I should be concerned about?


Thanks Doctor

[Edward W Hook, MD]

Welcome to the Forum. I'll  be happy to comment on your questions although it appears that you have already answered your questions. The events you describe did not put you at risk for any STI and the absence of infection is now confirmed by your urine NAAT test.  Further, even if you were infected, the azithromycin you took would have cured virtually all infections as it is recommended therapy for chlamydia, for NGU and would cure 70% of gonorrhea if present.

It sounds to me as though your concerns are causing you to become hype aware of normal genital sensations.  

As for your specific questions:
Questions : 1. gave a mid stream urine test not knowing until later this was incorrect.  Would this affect results? I have seen studies that say it is still around 96% accurate.

Correct.  While the instructions are to collect a specimen as you begin to urinate, midstream specimens have been found to perform essentially as well.  Believe your test results.

2. Is discharge always noticeable or can it be slight.
STIs like gonorrhea or chlamydia can have mild symptoms or even be asymptomatic.  Even when they are however, the NAATs urine tests are highly accurate.  Once again, I urge you to believe you tests.

I hope this comment is helpful.  Please do not worry. There is no need. EWH