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Avatar universal

Gonorrhea ? HIV?

Dr. 25 old hetero male,  never had std, no sex in 2 yrs. 2 Mo. Ago I had unprotected event with a 21 yr female in California. She had one previous partner, month before. My condom fell off and I couldn’t perform but penis touched vagina for about 5 min.  
5 days later Testicle Pain
3 days later I go to Doc and gives me doxy for 7 days, but checks my urine day after I start antibiotics!
2 weeks  later other testicle hurts, I go to a std clinic this time. They do urine and urethral swab. Doctor tells me I have gono. He gives me a shot of cetrioxone and 500mg cipro 2x a day 2 weeks. Pain diminishes but comes back in a week, testi feels better but not right. So I go back to 1st Doc and tell him I tested + for gono in another clinic, that I felt better but not 100%, and that I have Bubbles in urine  and not very clear. He checks Urine for gono and Chlamydia again and does urinanalyses finds traces of blood. He tells me finish cipro from std Doc. and come in a week to get results.





Doctor I have been depressed. I dnt know whats wrong, if im cured and I am afraid I have HIV. Around the 7th week after exposure I noticed a tender spot 2 inches to the left of my lower spine. HIV related node?

1.if i had gono why didnt it show on my first test?

2 if i did have gono shouldnt have the ceftrioxane got rid of it, or can combining this antibiotic with cipro make the bacteria harder to kill.

3. is my tender spot  in my lower back associated with hiv or ars? Ive also been running  recently, any relation?

4. since i contracted gono from a one night encounter what are my chances of hiv? should i assume the worst doctor?  

5.This was only one time exposure and I have never had a std before.  The girl that gave me gono was tested for gono, Chlamydia, and HIV 2 weeks after the incident and everything came back negative except Chlamydia.   I don’t understand, she tests +  for Chlamydia and I test + for gono only?

6. What do you recommend I do doctor? What do Iaskmydoc?








5 Responses
239123 tn?1267651214
MEDICAL PROFESSIONAL
Welcome to the forum.  I'll try to help.

Had you not said a test was positive, I would have been skeptical about the diagnosis of gonorrhea, especially following several days of doxycycline.  Gonorrhea can be highly resistant to doxy and related drugs, but it's uncommon.  Also, the course of events doesn't add up very well:  testicular pain moving from one testicle to another, apparently without discharge of pus from the penis (at least you don't mention it).  And as you say yourself, there is the problem of it being missed on the first test.  The gonorrhea tests are highly reliable; it would be unusual for the first test to not pick it up.  All this makes me wonder what kind of test was done and and whether it was false positive.  Can you talk to that doctor or clinic and learn exactly what kind of test was positive?

However, if you did indeed have gonorrhea to start, you can be sure it is gone now.  Ceftriaxone-resistant gonorrhea doesn't exist except for a few isolated cases reported in Japan.  Any symptoms continuing at this time surely are not due to gonorrhea, and probably not to any STD.

The bubbles or cloudiness of your urine is irrelevant.  These things, along with urine color, are related only to kidney function, diet, and fluid intake; no STD can have any such effect.

To your specific questions:

1) Gonorrhea test results:  See above.  My best guess is that you never had gonorrhea, i.e. that the supposedly positive test was false.

2) As I said, ceftriaxone is completely reliable.  Cipro would not impair its effectiveness.

3) Neither gonorrhea, HIV, nor any other STD is a plausible cause of the sore spot on your back.  HIV is extremely low risk from the sort of exposure you had, and you describe no symptoms that suggest it.

4) If you did catch gonorrhea, that might imply a slightly higher risk of catching HIV, but only slight.  The odds your partner had HIV are on the order of 1 in 1,000; and if she had it, the chance you caught it -- even considering the possibility of gonorrhea -- were no more than 1 chance in a few hundred.

5) Your partner's test results make me all that more skeptical about the gonorrhea diagnosis.  With those results, chlamydia would be a consideration for your earliest symptoms, but doxycycline is 100% reliable against chlamydia -- so for sure it's not a problem for you now.

6) It isn't clear in your question whether you still have symptoms and, if so, what they are.  If things have pretty much cleared up, probably you need do nothing more at all.  If you still have symptoms that suggest STD, you should follow up with the STD clinic or with your personal health care provider.  And if you're still worried about HIV, get tested; enough time has gone by for reliable results.  I recommend this strictly for the reassurance you will gain from the negative result, not because I think it likely you are infected.  I do not.

Sorry you have had all the confusing diagnostic test results.  But my sense is that whatever STDs you were exposed to or infected with, they are now gone -- and probably any continuing symptoms will fade with time.  But let me know if you can get more information about the positive gonorrhea test, and also clarify if you still are having symptoms that concern you.

I hope this helps.  Best wishes-- HHH, MD
Avatar universal
Thank you Dr. Handsfield.

Your opinion was the same as the first doctor I went to. He did not believe it was gonorrhea either because my only symptom was testicle pain on the epidymis. I never had any discharge and after I took the doxy the pain was gone within 3-4 days, and I mean entirely gone. But when the discomfort came back on the other testicle it was not as painful but it did hurt. When I went back to the first doctor he didnt believe I was positive for gonorrhea because of the NAA urine test he did on me which was negative 3 weeks earlier.

I called the std clinic.  The positive gonorrhea result came from a the urethral swab test.
The negative result which was the first test was from a urine test NAA.

How reliable are urethral swabs doctor?

Urine NAA?

My symptoms have pretty much cleared up. I do feel a lot better since your post and I feel I may have been thinking about the issue too much. My testicle does not hurt anymore except if I touch the epididymis I feel very little discomfort, but not like I did before.

Like you said before any remaining symptoms will probably fade away with time.

When do you recommend I test again for chlamydia and gonorrhea. It has been 3 weeks and half since I received the ceftrioxone injection and a week and a half since the last cipro pill?

I also did a Home Access HIV test yesterday. Hopefully everything turns out okay and it can only be a warning that I can learn from.


Once again doctor thanks for your reply.
239123 tn?1267651214
MEDICAL PROFESSIONAL
Thanks for the additional information, and thanks for the thanks.  Happy to have helped.

"Urethral swab" doesn't help much.  Any of several tests can be done on swab-collected specimens.  Maybe just a microscopic exam?  Culture?  NAAT?  Other?  In any case, urine NAAT rarely misses gonorrhea -- so I'm even more convinced you didn't have it.

Follow-up gonorrhea tests generally are not recommended to check for cure; the combination of effective treatment plus resolution of symptoms is virtually 100% guarantee against persistent infection.  But you certainly could do it if you will feel better knowing a follow-up test is negative.  Any time more than 3 weeks after completing treatment is fine.
Avatar universal
Thank you Dr. Handsfield, I feel a lot better. I will do a follow up test in a month or two if i dont have any symptoms.

My home Access test for HIV 1 came back negative. Is this a reliable result at 8.5 weeks after the exposure?

Once again thank you
Avatar universal
I had unprotected sex with a female 7 weeks ago. Last week I had pain on urination, and discomfort in my penis afterwards for a while. Also , I needed to urinate soon after drinking,and had discomfort around the area of my bladder

My doctor did a blood chemistry test which came back normal, and a urine test (not sure what kind of), which also came back normal. He said he doubts that I have an std because my urine contained no pus.

I also had a mild fever, so the doctor put me on 500mg levofloaxicin/day for 5 days. I have finished the course but still have symptoms.

I worry I may have chlamidya, is this likely?
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