Chlamydia y gonorrhea

[peruviangirl]

Hi doctor,

I am afraid of catching Chlamydia and gonorrhea for a long time and not know it since it is almost always asymptomatic. First of all, I would like to tell you that I have never been to std testing until two days ago, because my fiance wanted to do the test before getting married later in the summer.

I have read a lot of scary things about those infections. I never had symptoms and as you know, the culture is, no symptoms, no check ups. I had sexual relations since 14 years old with about 12 men. I used protection in the most part except with my boyfriend who I have been with 3 years between 18 and 21. I found out he was cheating on me and left him. I was so depressed and eveything, it didn't even occur to me to go get tested, just hiv 3 months ago it was neg.

I have surfed the net and found out that if a chlam/gono infection is not treated, it could develop in a pelvic infection (PID) and could even be asymtomatic and lead to infertility. Last year, I saw my ex back and we had a night and unfortunately i became pregant but fortunaly, I did lose the child naturally. However, the doctor never really had the time to perform exams of all sorts on me.

So now, I am in Medellin, colombia and I am trying to find a laboratory that does genetic amplification with urine sample to test and nobody offers that, not even PCR. I called about 20 laboratories and the only thing they offer is
Antigen Detection with Immunofluorescent direct   and they took a swap in my endocervix. Now I also read that most of these tests really have a lot of false negative. Also, if my chlamydia has become higher in my body..ovaries, falopian tube etc...will it detect it from there?

Also for gonorrhea, I have a Thayer-Martin method

1 - Is Antigen IFD technique trusty?
2. -If my chlamydia/gonorrhea infection is higher will it be detected?
3 - If I had chlamydia for 3-6 or more, PID would start not being asymtomatic
4 - Should I take medication to prevent?

[Dr. Jose Gonzalez-Garcia, MD, MRCGP, PhD]

The simple high vaginal swab might pick up gonorrhoea, but not chlamydia.
That is an alternative treatment as well: azithromycin 1g (will treat chlamydia) and cefixime 400mg (will treat gonorrheoa).  Ciprofloxacin is not really useful anymore for these.
Kind regards,
Dr José

[peruviangirl]

what about:

1g of Azitromicyne and 400mg of Cefixime or Ciproflaxin 500mg??

[peruviangirl]

Thanks doctor,

But the PCR test are not available where I am. What do you recommend me? Just go ahead with the empirical treatment. The doctor at the laboratory took a swap from my endocervix...it's no good then?

I am kinda lost, even if yo tell me to do a PCR test, there is NONE available here ....

Thank you

[peruviangirl]

Also, i would like to know that if we had unprotected sex and he got hsv 1/2 igg and igm negative, does it mean we are both ok? I have never had a test for this. We prolly had unprotected sex 10 times.

[peruviangirl]

So, I went and go ahead with doing the exams:
-Hiv (again)
-Sifilis
-Clam
-Gono
-Herpes
-Pap test

but my worries again for clam and gono are still up :(

[Dr. Jose Gonzalez-Garcia, MD, MRCGP, PhD]

Hello,
Thank you very much for your post and welcome to our STD forum. My apologies for not having replied to you sooner.
Chlamydia is extremely common and people can carry it for years without knowing as it can be completely asymptomatic (in up to 80% of women).  In contrast, gonorrhoea would typically cause some symptoms of pain and discharge, although up to 50% of women can also remain asymptomatic.  
Chlamydial infections are very common and do not appear to impair fertility in most people who are treated properly.  If untreated it can lead to PID either symptomatic or silent episodes which are associated with infertility.  I f unable to conceive, women can have further investigations to check the Fallopian tubes.

1 - Is Antigen IFD technique trusty?
THIS IS NOT AS ACCURATE AS A PCR TEST; WE WOULD ONLY USE A PCR TEST, EITHER FROM HIGH VAGINAL SWAB OR URINE SAMPLE.
2. -If my chlamydia/gonorrhea infection is higher will it be detected?
YES, IT WOULD BE DETECTED EITHER IN A SWAB OR IN URINE.
3 - If I had chlamydia for 3-6 or more, PID would start not being asymtomatic
NOT ALWAYS, AS MENTIONED ABOVE.
4 - Should I take medication to prevent?
IF IN DOUBT, YOU CAN ALWAYS GET EMPIRICALLY TREATED WITH A ONE WEEK COURSE OF DOXYCYCLINE 100MG TWICE DAILY, BUT SO SHOULD YOUR PARTNER.


Regarding your other question about herpes.  If you bothe have negative hepres serology for IgG and IgM for type 1 and type 2, that means that you do not have the infection.
Kind regards,
Dr José