Aa
risk factor vs. symptoms help needed
Dr. HHH-
Thank you for all you do.
I had contact with a transexual prostitute not too long ago. We both touched eachother with our hands, but oral and anal (give and receive) was all done with condoms. Even with a condom we both ejaculated in the condoms through manual stimulation. Although she may have MAYBE started to ejaculate as she was pulling out of me.
A couple days later a started experiencing typical gonohrrea and chlaymdia type symptoms (mild discharge, testicular pain, mild burning). My doctor did not test me for std's but gave me a one time dose of Cipro and a 10 cycle of doxycycline. I am on day 4 of the medicine and stil have symptoms. I also am on day 5 of not necassarily a headache but a light headed, almost dizzy feeling, and also not neccasarily diarrhea but soft stool. I have alot of rectal discomfort and have an urge to go constantly. There is also some on and off mild pain in my lower abdamin.
I was tested negative for HIV a week after exposure, although if I understand correctly that a week is FAR too early for detection. I am kinda playing the waiting game now. What exactly is my risk, and would a 3 week test be more conclusive? thank you again for all you do.
Thank you for all you do.
I had contact with a transexual prostitute not too long ago. We both touched eachother with our hands, but oral and anal (give and receive) was all done with condoms. Even with a condom we both ejaculated in the condoms through manual stimulation. Although she may have MAYBE started to ejaculate as she was pulling out of me.
A couple days later a started experiencing typical gonohrrea and chlaymdia type symptoms (mild discharge, testicular pain, mild burning). My doctor did not test me for std's but gave me a one time dose of Cipro and a 10 cycle of doxycycline. I am on day 4 of the medicine and stil have symptoms. I also am on day 5 of not necassarily a headache but a light headed, almost dizzy feeling, and also not neccasarily diarrhea but soft stool. I have alot of rectal discomfort and have an urge to go constantly. There is also some on and off mild pain in my lower abdamin.
I was tested negative for HIV a week after exposure, although if I understand correctly that a week is FAR too early for detection. I am kinda playing the waiting game now. What exactly is my risk, and would a 3 week test be more conclusive? thank you again for all you do.
MEDICAL PROFESSIONAL
You still provide no information that makes me suspect HIV. Vantin has no effect on HIV, so obviously your GP agrees. Please addresss any additional quesitons to your GP. I won't have any further comments.
Dr. HHH, I returned to my gp ans was given Vantin. Some symptoms (discharge, loose stool) have gone away, but others (severe headache, testicular pain) persist and have been for 2 weeks now. I have no noticeable rash, no fever, but I do have a scratchy throat and cough. So, 2 week headache, scratchy throat/cough, testicular pain....mean anything of concern?
thanks again
thanks again
MEDICAL PROFESSIONAL
Don't call and ask for "something else", if that means a different antibiotic. It would be much better to be examined and properly tested rather than just guessing at alternative treatments. If not confident in your own doc's STD knowledge, visit your local health department STD clinic.
Thank you so much for you response. I failed to mention my sore throat as well, but I'm sure that is an irrelevant symptom as well. I will call my provider ASAP and request something else. It just seems odd that the timing of these symptoms occur shortly after the sexual event. What I mean by "mild" discharge is a little moisture and at time a cloudy discharge if squeezed and pulled to "milk" it out.
Thank you again.
Thank you again.
MEDICAL PROFESSIONAL
The exposure was low risk. If indeed you had a urethral infection, my bet it that you did not acquire it during the exposure you describe.
As for your symptoms and the diagnosis, it is a shame the doc didn't test you for STDs. I don't know what "mild" discharge means -- it it was just a little moisture at the opening, it might mean nothing; testicular pain doesn't go along with urethritis due to chlamydia, gonorrhea, or anything else. In the very unlikely chance you caught something during the exposure you describe, gonorrhea really is the only possibility -- the symptoms of chlamydia or NGU don't show up before 7-10 days. (Two days is early for gonorrhea too, but possible.)
Further, the treatment you were given was fine for NGU and chlamydia (doxycycline) but inadequate for gonorrhea. Cipro is no longer recommended, because cipro-resistant strains are very common, especially among men who have sex with men, which likely applies to your transgender partner; and doxy also is unreliable against gonorrhea. So conceivably your symptoms are continuing because you have persistent gonorrhea. However, most likely you never had any urethral infection at all; that's the best possibility for the lack of response to antibiotics. Thus, your next action should be to return to the provider, explain your continuing symptoms and the things you learned in this reply, then follow his or her advice for further evaluation.
As for HIV, the expousre you describe carried no realistic risk, given the nature of the exposure and use of condoms. You are correct that a 1 week test is meaningless, except that it proved you weren't infected before this exposure. You really don't need testing at all, but if your nerves get the better of you, just have a single antibody test 6-8 weeks after the event.
In summary: If you have urethritis, which I tend to doubt, you caught it sometime before the events with your transsexual partner. Even though I raised the possibility of gonorrhea, I doubt you have it. You were not at risk for HIV, but it's fine with me if you get tested in a few weeks to prove it to yourself. Follow up with your health care provider about your continuing symptoms.
Best wishes-- HHH, MD
As for your symptoms and the diagnosis, it is a shame the doc didn't test you for STDs. I don't know what "mild" discharge means -- it it was just a little moisture at the opening, it might mean nothing; testicular pain doesn't go along with urethritis due to chlamydia, gonorrhea, or anything else. In the very unlikely chance you caught something during the exposure you describe, gonorrhea really is the only possibility -- the symptoms of chlamydia or NGU don't show up before 7-10 days. (Two days is early for gonorrhea too, but possible.)
Further, the treatment you were given was fine for NGU and chlamydia (doxycycline) but inadequate for gonorrhea. Cipro is no longer recommended, because cipro-resistant strains are very common, especially among men who have sex with men, which likely applies to your transgender partner; and doxy also is unreliable against gonorrhea. So conceivably your symptoms are continuing because you have persistent gonorrhea. However, most likely you never had any urethral infection at all; that's the best possibility for the lack of response to antibiotics. Thus, your next action should be to return to the provider, explain your continuing symptoms and the things you learned in this reply, then follow his or her advice for further evaluation.
As for HIV, the expousre you describe carried no realistic risk, given the nature of the exposure and use of condoms. You are correct that a 1 week test is meaningless, except that it proved you weren't infected before this exposure. You really don't need testing at all, but if your nerves get the better of you, just have a single antibody test 6-8 weeks after the event.
In summary: If you have urethritis, which I tend to doubt, you caught it sometime before the events with your transsexual partner. Even though I raised the possibility of gonorrhea, I doubt you have it. You were not at risk for HIV, but it's fine with me if you get tested in a few weeks to prove it to yourself. Follow up with your health care provider about your continuing symptoms.
Best wishes-- HHH, MD
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