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Concerned about Chlamydia/LGV

  Would a 10 day treatment w/ Cipro (500mg, twice a day) before positive test results came back for Chlamydia infection cause 7 days of Doxy and 1g of Azithromycin to be ineffective?  I read that Cipro will not treat Clamydia and then read a study that said it can slow down the growth of it and cause it to be persistant.
  Also, when I as being examined by the second doctor he noted that one side of my lypnodes in my groin was enlarged, he did not seem too concerned, just noted it.  I was treated w/ 7 days of Doxy and a shot before labs came back and then 1g Azithromycin after when I still had irritation in my penis. I was also treated with Flagy for possible Trich and more Cipro (30 d) for possible Prostitis. All labs coming back negitive, including no WBC in my urine.  The enlarged lypnode was never noted again. Concerned that may have or had LGV.  I don't remember having a sore on my penis, did have a tear in the skin on my penis the next morning after the incident from rough sex and it healed in 4 days. I was infected in Bulgaria from a woman from Germany.
   My concern is that I may have caught LGV strain rather than the typical strain and that the week of Doxy and week Azithromycin would not be enough to completly cure it.  The driver for this is the enlarged lypnode that was on exam, I just recently read about  LGV, and a couple cases in hetro sex transmission.
   1.Can a regular genital infection cause a lypnode to be temporary enlarged?
   2.Could the tear I got on the skin of my penis allow the infection to get into my lypn system?
   3.Would the chalmydial treatment I recieved cure LGV if I had it, I know the standard treatment is Doxy for 21  days?
   4.Would I now (2 years later) have other symptoms if I had LGV?
  I also would like to note that about 8 months later I was put on a 2 1/2 month course of Doxy for a gland disfunction in my eyes.  So I don't know if that would have been too long after possible exposure to do anything.
  

  
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239123 tn?1267647614
MEDICAL PROFESSIONAL
It doesn't matter, since the other drugs you had definitely were sufficient.  But the answer is yes, sulfamethoxazole/trimethoprim (Septra or Bactrim) is active against chlamydia.  In fact, it is a back-up recommendation that can be used when patients cannot tolerate either azithromycin or doxycycline.

That should end this thread.  Take care.
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Avatar universal
Doc, one other question I forgot to ask in relation to my issue (over two years had a lot going on).  Also in the course of treating my possible prostitis I was given Septra for six weeks, I find conflicting information on wheather it would treat Chlamydia effectively or not.  What is your experience?
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239123 tn?1267647614
MEDICAL PROFESSIONAL
"Lymph node swelling that they refer to in LGV I assume pretty severe and painful?"  Yes.

Your HSV-1 is far more likely oral than genital.  If genital, the only recurrent symptoms would be genital blisters/sores.  Lymph node inflammation is the norm with primary herpes but rare with recurrent outbreaks, and is probably never the only herpes symptom.

I agree with your eye doctor.  These various symptoms are not related to one another nor to the sexual exposure when you acquired chlamydia.
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Avatar universal
   Thanks Doc, That makes me feel better.  Just a little more information on the subject for my own knowledge before I put this out of my mind.
   Is the lymph node swelling that they refer to in LGV I assume pretty severe and painful?  Mine was not, I did not even know it was there and I guess it went away quicky.  I seen some pictures of LGV and it looked pretty acute and nasty.  

   During the all the testing I recieved,  I did come up positive for HSV1 and neg for HSV2.  Don't know if I got infected during this incident or had it for a all time, I guess over 50% of people have type 1.  But that also could have caused my enlarged node if I got it genitally right?  I remember when I was a kid getting a cold sore or two.  Never had any genital sores.

    Just a little nervous due to dealing with all the urinary tract problems, prosititis like problems and eye problems for the last two years that seemed to crop up after my infection.  I was even dead convinced for a while that my eye issues were related to it as well, perhaps a reinfection from my old contacts after treatment for the chlamydial genital infection.  But eye doctor said that its was not related and later testing confirmed it was not.  Being I just learned about LGV and the symptoms, I wanted your expert opinion and some more information.  Thank you for answering my questions!  
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239123 tn?1267647614
MEDICAL PROFESSIONAL
Welcome to the STD forum.

In reply to the opening question:  Prior treatment with cipro would not make later chlamydia treatment less effective.  Cipro itself would cure some chlamydial infections -- it's not an ideal drug, but often would work, especially in the large dose you took.  Having had cipro plus doxycycline plus azithromycin, it is not possible you still have a chlamydial infection of any kind, including LGV.

LGV is exceedingly rare in the US, currently with fewer than 100 reported cases per year in the entire country.  And almost all of those are rectal infections in gay men.  It's pretty much the same story in all industrialized countries.  In any case, as I said, in the exceedingly unlikely chance you had an LGV strain, you can be sure it has now been eradicated.  To your specific quesitons:

1) A "regular" genital chlamydial infection, i.e. uncomplicated urethritis, is not a likely cause of inflamed lymph nodes.  The "tear" in your penile skin is a more likely cause.  But slighly enlarged nodes in the groin are an extremely common finding, usually without obvious cause.  In any case, I doubt it was related to your chlamydial infection.

2) The tear was not likelyt to predispose to LGV.

3,4) There is no way you have persistent LGV for 2 years without symptoms.  You have had plenty of treatment, especially given your later treatment with 2+ weeks of doxy.

You can be sure there are no lingering health effects of your past chlamydial infection.  It's long past time to move on without worry.

Regards--  HHH, MD
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