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Avatar universal

what's going on - confused

Hi Doc, please bear with me as I describe the whole thing. First of all, I had STD screening last December and everything was normal. That was before I started dating this guy for 1.5 months. We had unprotected sex from time to time. Sometime in mid-March, we had intercourse and the next day he started having some strange symptoms (discharge, itching on his penis) so he went to the doctor. The doctor was pretty sure that it was Chlamydia and gave him antibiotics. I got scared so I went and got tested as well (Chlamydia/ghonnorea). The strange thing is, both our test results came back negative, and the antibiotics seemed to have worked for him. Also, about a week before he told me about this, I was showing some symptoms myself as well, namely, frequent/painful urination, vaginal irritation/itching. But since I get UTI often, I thought that it was just another case of UTI. When I went for the tests, the doctor also tested for UTI and yeast infection, but both were negative. Nevertheless, the doctor gave me antibiotics for UTI anyway. After I took the antibiotics, some of the symptoms went away (no more frequent urination), but some of the itching/irritation/burning still persist. I went back to the doctor to ask her what could've been the cause. She examined me, and said she didn't see any lesion so it shouldn't be herpes, but told me that I have vaginosis (she either looked with a microscope or tested the ph - I forgot. I told her that I was spotting and she said one of the test methods might not work). She gave me Cleocin for treatment. That was about 10 days ago and I didn't use Cleocin until yesterday. Before I started on Cleocin, I went to a county clinics for HIV testing, and while I was there, I decided to do another STD screening. The test results were negative on vaginitis (yeast, BV, and trich)! I am now very confused, and worried. I was relieved when she told me that I had vaginosis, but now new tests showed that they were negative. Chlamydia/ghonnorea results will come back in a week, but I am very anxious now. I am now seeing a different guy and have been intimate with him since a week ago (unprotected for couple minutes - that was when I believed what I had was only vaginosis). I am worried that I might've had something and given it to him (his last tests were last December, and I am the only person he's been with since). Let me summarize my questions:

1. Why did my doctor say I have vaginosis but the later test (two weeks later) showed otherwise? I had intercourse the day before the 2nd test... could that have interfered the test results? If so, how accurate would the 2nd chlamydia test be?

2. I just started using Cleocin yesterday. The symptoms are still there... the treatment lasts 3 days. But am I supposed to feel better after one day? I was hoping that the symptoms will go away after this so I'd have more reason to believe that it was vaginosis

3. What else could cause the persistent vaginal itching?

Thanks!
9 Responses
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239123 tn?1267647614
MEDICAL PROFESSIONAL
I very much doubt your HSV-1 infection has anything whatsoever to do with the problems you described.  The greatest likelihood is that you had an oral HSV-1 infections somewhere along the line, probably as a child.  Half the population is HSV-1 positive, so you're typical.  Your partner is right; he probably is not the source of your infection.

If you develop more typical symptoms of herpes (e.g., a blister, pimple-like lesion, open sore, etc of the vaginal opening, labia, or anal area), see a health care provider within 24 hours to check out the very slim possibility that you have recurrent genital herpes due to HSV-1.  But it's a really long shot, and in the meantime I would totally disregard it as a factor in your health or sex life.

HHH, MD
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Avatar universal
Hi Doc,

  Just an update... My Herpes results came back and I am HSV-1 positive (but negative on HSV-2). Although I've been doing some reading on this in the past few days, I am still somewhat disturbed by the news. I've never had a cold sore before. Can I assume that HSV-1 is what caused my symptoms (urethra itching/burning when urinating), and that I probably have an outbreak in my urethra? The blood test was done in mid-April, and the first time my current boyfriend and I kissed was about a month ago. Is that too soon for the antibodies to appear? i.e. Can I safely say that I didn't get it from him? My last partner is upset with me because he's not very well informed about HSV-1 and refuses to accept the probability that he might have given it to me (since he never had any symptoms). Thanks for your help!
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79258 tn?1190630410
Wow, I'm surprised. On the other hand, he was pretty viciously attacked on the men's health board, so that probably influenced his actions. Too bad.
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239123 tn?1267647614
MEDICAL PROFESSIONAL
Bunghole posted some badly inappropriate comments on other forums that got him banned by MedHelp.  Surprising (and too bad), based on his useful contributions in the short time he participated in this forum.

HHH, MD
Helpful - 0
79258 tn?1190630410
Hey, what happened to bunghole? I liked his posts. I hope he didn't get run off by the obnoxious responses to his question on the men's health board. Some of the posters on the other boards are *unbelievably* judgmental and moralistic - and completely misinformed. Yet another reason why I like this board so much :-)
Helpful - 0
239123 tn?1267647614
MEDICAL PROFESSIONAL
Your situation is too complex for me or any online source to give definitive answers, especially when you have already seen at least 2 health care providers (both of whom seem to have pretty good expertise in STDs) and at least 3-4 different diagnoses have been mentioned. Most likely your partner started out with nongonococcal urethritis (NGU); about 30% of NGU is caused by chlamydia, but the specific cause usually is unknown (with standard testing) in the other 70%.  If that was his diagnosis, you and he both should have been treated with an appropriate antibiotic (usually doxycycline or azithromycin).  But at this point, it simply is impossible for me--based on your description of tests done, symptoms, etc--to know whether you have bacterial vaginosis (BV), yeast, trichomonas, nonchlamydial cervicitis, or (conceivably) herpes, some combination of these, or something entirely different.  (Except a garden-variety UTI never sounded likely and I'm pretty sure had nothing to do with any of this.)

As to your specific questions:  1) The diagnosis of BV is imprecise, even in the most expert hands.  (A BV researcher once did a little experiment during a meeting of ObG infectious diseases experts at her university.  She had ~10 of them examine several specimens under the microscope.  They were all over the map in their judgment as to whether the specimens showed "clue cells", the microscopic hallmark of BV.  And these 10 experrts inluded at least 5 widely renowned STD specialists.)  So having a firm diagnosis one time that isn't confirmed at another examination isn't very unusual.

2) If you have BV, clindamycin (Cleocin) should work.  It's not the most commonly prescribed therapy, however.  But as you suggest, if you don't have BV, then it might not be effective.

3) Yeast is the most common cause of vulvar itching, but many other things can do it.

Some advice:  If your partner and you have not both been treated simultaneously with drugs active against NGU, that might be a next step.  Or it might be best to stop all treatment for a couple of weeks, and then have both of you examined (at the same time) by an STD knolwedgeable provider.  In any case, you need to rely ona personal evaluation by provider who knows a lot about STD and female genital infections in general.

Good luck--  HHH, MD
Helpful - 0
Avatar universal
Hi Bunghole,

  Thanks for your comments. I am sorry my posting was a bit confusing but let me clarify on some points:

  1. So far I've had two chlamydia/ghonnorea tests - the first one was done on 3/20 and the 2nd was done yesterday, in different places. The first one was negative, and the second one is still unknown (waiting for the result)

  2. I've had two Vaginosis tests as well - the first was done on 3/29 (when I went back to the doctor for follow-up) and the 2nd was done yesterday, in a different clinic. For the first one, the doctor said that there was "something" and for the 2nd one, the doctor (a different doctor) said I don't have Vaginosis.

  #2 is where the confusion came from. Since I didn't start using Cleocin until AFTER the 2nd test, the bacteria should still be there, right? Or, if I never had Vaginosis to begin with, should I be concerned about having other STDs? Should I stop having sex with my current b/f (or possibly alarm him about anything)? I keep thinking that I must have something due to my ex-boyfriend's symptoms (his doctor was surprised about his test result too).

  Yeah, I know, I waited 9 days before starting the treatment for no good reasons, but the idea of using the intra-vaginal creme just isn't very appealing...

  Thanks again!
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Avatar universal
Hi Bunghole, I was never treated for Chlamydia - I only got tested. It was my ex-bf who was given the antibiotics. But I'll take your advice & try not to think about it as much. Thanks. :)
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Avatar universal
antibiotics is treatment for chlamydia
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