Gonorreah treatment

[gethealthy]

I had unprotected oral sex while in Asia nine days ago in addition to general genital touching and protected sex with a condom. The following morning I felt a burning sensation in my penis and an urge to urinate ect ect Waited for 24 hours and then went to International clinic (Wednesday). Had full STD screening test done: urine, swab, blood. And started a dose of Q-Roxin (loxacin). The following day (72 hours after exposure) I was feeling no better and I felt like the prescription wasn't quite right so I went back and asked for something more aggressive. Doctor gave me an IV of ciproflaxin and  Gentamycin 80 mg. Tests results were returned on Friday night — all were negative except for enteric bacteria. Assured me I was not contagious.

Returned to USA and felt somewhat better. Had unprotected sex with my girlfriend thinking I was in the clear.

By following Monday symptoms clearly had not disappeared. Went to ER and was given Zithromax and Ceftriaxone (orally and shot). It has now been 48 hours and again, while I do feel better - less soreness in testicles, less persistent desire to urinate, I am still feeling a sharp stabbing pain in my urethra and generally not quite right. Took another test at STD clinic but will not see results for ten days.

US Doctor suggested that earlier test conducted in Asia was probrably too short a duration and therefore false negative. And that gonorreah is resistant to cipro also so original treatment was a failure.

Feeling  confused and uncomfortable. Do I have gonorreah? How long will it take for my symptoms to subside? Have I inadvertently exposed partner in US to STD?

Thanks for your insight.

[Edward W Hook, MD]

At this point it is difficult to say what is going on.  Persons can get gonorrhea or nongonococal urethritis (NGU) from receipt of oral sex (not chlamydia) but it is pretty uncommon.  The therapies you received would be likely to cure NGU but gonorrhea is not a sure thing.  A fair amount of the gonorrhea seen in Asia can be resistant to the drugs you received while over there.  On the other hand, the treatment received here in the U.S. (Ceftriaxone and Azithromycin) is the best treatment available with cure rates approaching 100%.  If you were infected at that time however, the tests taken will tell the story.  Thus, if your most recent tests are negative, it is my guess that you did not ever have gonorrhea or, in the unlikely situation that you did, it was cured before you got home.  Having said that, you may never really know.  If you remain concerned, the safest thing to do would be to tell your partner and suggest she seek preventative treatment with ceftriaxone and azithromycin as well.  Hope this helps.  EWH

[gethealthy]

Thank you Dr. But can you clarify what if any are the different symptoms between gonorrhea and nongonococal urethritis? Is the treatment the same?

And also, I am confused by the likelihood of transmission of gonorrhea from oral sex. On Medhelp there seems to be some consensus that it is uncommon. But in the general world it is always listed as a viable transmission method. Is this just aggressive sex education?