False Negative Possible?

[Rowenta]

I recently tested positive for chlamydia and was treated with doxycycline. Ever since I had BV I've had an excess amount of discharge and I thought maybe the doxycycline would get rid of it so when it didn't I freaked out and assumed I still had chlamydia so the doctor gave me azithromyacin and a urine test (roughly 3 weeks after finishing doxycycline).  The test came back negative for chlamydia.

The discharge is still there however (no smell, no itching, nothing irregular other than amount). I dont see it in my underwear too much, I mainly see a lot drop into the toilet when I use the restroom. It doesn't really change much through my cycle, stays a consistent thickness and white color. I no longer get the clear elastic discharge I had before BV. Does this mean I'm infertile?  

I went back to the gyno and he is running test on a cervical swab. Could my first cervical swab have come up with a false negative or gonorrhea?  This is causing me a lot of stress and it's starting to show in my body. I can't sleep well from anxiety and I lose my appetite when the stress is really bad which is more often these days.

I'm sorry, I know I posted on the wrong forum but I didn't know how to go back.

[Edward W Hook, MD]

Welcome to the Forum.  I'll try to help.  To begin with, there is a less than 50% chance that your abnormal discharge was due to chlamydia.  The majority of chlamydia infections are asymptomatic and thus you may have had both chlamydia and something else when you were first diagnosed.  Having said that, it was certainly reasonable to re-check after treatment as part of the evaluation of your abnormal discharge.  Your negative test however is strong evidence that the treatment was effective.  While the urine test is slightly (less than 1%) less sensitive than the swab test, I would be surprised if your repeat swab test was negative unless you had been re-exposed to chlamydia.  I anticipate that your test will be negative and when it is, I would urge you to believe it.

So, what could be causing this discharge?  There are many possible causes of vaginal discharge in women.  Far and away, the most common is bacterial vaginosis and that is what I would check for first. Other possibilities are Candida (neither BV nor Candida are STDs) or trichomonas.  Any of these is a far more likely possibility than persistent chlamydial infection.  Another possibility which certainly should not be even considered until other possible causes are ruled out is that because of your recent diagnosis, you are more aware of your normal discharge than you had been in the past. From the sounds of things however that doesn't sound too likely.

This is the outline of how I would pursue this.  You need repeat specimen collection and evaluation using a microscope for tests for the problems I mentioned. This can all be done in the doctor’s office or, if he/she does not have a microscope, at your local planned parenthood or public health STD clinic.

I hope my suggestions are helpful.  Please let us know what further evaluation shows. EWH

[Edward W Hook, MD]

Thanks for the follow-up.  Glad (but not suprised) that the follow-up tests were negative.

The commercial tests for bacterial vaginosis and trichomoniasis, both of which repsond well to metronidazole are not as good as the tests for chlamydia.  I think a trial of metronidazole is a good idea. Please stick with the medication, even though it does not taste very good and please let us know how things come out

EWH

[Rowenta]

My doctor just called and said I tested negative on the bacterial, fungal and chlamydia/gonorrhea tests.  He said he is going to call in a prescription for flagyl anyway and to call back a week and a half after if the excess discharge still continues.

I am hoping this gets rid of the excess discharge. I'm really starting to wonder of my paranoia is just getting out of control or if something is actually wrong. I hate putting all of these medications into my body.

[Edward W Hook, MD]

Certainly stress and concern can have profound effects on a person's health and well being. This is something that you and your doctor should discuss.

As for diet, I am not aware that diet would influence vaginal discharge, sorry. EWH

[Rowenta]

Thank you doctor. I had a BV test done after my second dosage of antibiotics which came back negative, I was also given medication for a yeast infection. The yeast infection medication did nothing.

I went to the gyno last Thursday and told him everything. He took another cervical swab and said he was running a lot of tests but "from the look of the cells there is nothing abnormal." I will ask him if he ran the tests you suggested when he calls this week.

Could my diet and stress levels be contributing to this?  For about a week I was eating really healthy and was very happy/stress free and there was a significant improvement. But of course my paranoia started up again and as my period got closer it increased again.

I will update as soon as I hear the results.