Looking for a second opinion

[thinkthreetimes]

Dear Doctors,

I am a male in my mid twenties and about 3 weeks ago, I made the mistake of having unprotected sex during a one night stand with a female co-worker who is also in her mid twenties.

About 4 days after possible exposure, I noticed a slight burning sensation during and after urination. The burning was very slight and I had no other common std symptoms (discharge, cloudy urine, etc).

I have had the same symptoms in the past and tested negative for stds, so I know my imagination likes to run wild.

To be safe, I went to the doctor about 3 days ago and he tested my urine for white blood cells. He said that there were no WBCs in my urine and that I probably didn't need to worry about stds. At the time he did not recommend any other specialized std tests and told me to come back in a week if the symptoms were still present.

I have heard that a white blood cell test is not sufficient to rule out stds, so I was wondering if you agreed with my doctors decision.

Please correct me if I am wrong, but I am currently under the impression that chlamydia symptoms do not appear sooner than about 7 days after exposure and that gonorrhea almost always causes discharge.

Having had symptoms appear at 4-5 days, no white blood cells in my urine and no discharge, is it at all likely that I have an std or any other UTI? I just started a trip and will be traveling outside the country for the next 3 weeks. During this time, seeing a doctor is possible, but difficult.

I plan on being tested for HIV, herpes, syphilis, etc at 6 weeks, but until then, do you believe it is necessary to have any further tests?

Thank you for your time.

[Edward W Hook, MD]

Welcome to our Forum.  I'll be pleased to comment.  In all probability you are fine and have nothing to worry about.  Given the absence of white blood cells on your examination, you can be confident that the symptoms you experienced were not due to infection- if they had been, there would have been WBCs present.  In addition, the absence of white blood cells and more obvious signs of infection is a strong indicator that you did not get another STD, effectively ruling out NGU and gonorrhea.  A small proportion of persons with chlamydia can be infected and not have white blood cells present but that number is very small.  If I were you I would not worry.

When you test in the future, I would advise against testing for herpes. the tests are not good enough to give reliable information in situations such as yours.  If you do not develop active herpes lesions in the two weeks following your exposure, you did not get HSV and I would not worry further.   The tests for HIV and syphilis, which I anticipate will be negative are more reliable.

I hope my comments are helpful to you.   EWH

[Edward W Hook, MD]

Welcome to our Forum.  I'll be pleased to comment.  In all probability you are fine and have nothing to worry about.  Given the absence of white blood cells on your examination, you can be confident that the symptoms you experienced were not due to infection- if they had been, there would have been WBCs present.  In addition, the absence of white blood cells and more obvious signs of infection is a strong indicator that you did not get another STD, effectively ruling out NGU and gonorrhea.  A small proportion of persons with chlamydia can be infected and not have white blood cells present but that number is very small.  If I were you I would not worry.

When you test in the future, I would advise against testing for herpes. the tests are not good enough to give reliable information in situations such as yours.  If you do not develop active herpes lesions in the two weeks following your exposure, you did not get HSV and I would not worry further.   The tests for HIV and syphilis, which I anticipate will be negative are more reliable.