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Persistent Symptoms and Test of Cure???
Hello Drs,
I recently engaged in unprotected vaginal sex with a woman of unknown status and in the following week developed symptoms of mild dysuria, penile itching, and a clear mucus-like discharge that became cloudy briefly. I went for an STD panel where I was diagnosed with a chlamydial infection (all other tests were negative). I was prescribed 1g azithromycin single dose, however after 2 weeks the symptoms didn't resolve. Since that time I have been prescribed two rounds of metronidazole 2g single dose twice and doxycycline 100 mg bid for 14 days (symptoms hadn't abated, provider considered trich, and mycoplasm as possible culprits). I was also put on avelox 400 mg for 10 days as well. Currently I have 6 days remaining on the doxycycline and 9 days remaining on the avelox. I have not engaged in any sexual activity whatsoever since my diagnosis however I still have a very mild clear mucus discharge primarily in the morning; the penile itching and dysuria has abated. After all of these antibiotics, is there any reason to suspect possible treatment failure if this symptom persists? And do I need to go and conduct a test of cure? Also how long before I can resume sexual activity again monogamously knowing I'm not putting my partner at risk? My partner and I would like to enter into a monogamous relationship where we can engage in unprotected sex.
I recently engaged in unprotected vaginal sex with a woman of unknown status and in the following week developed symptoms of mild dysuria, penile itching, and a clear mucus-like discharge that became cloudy briefly. I went for an STD panel where I was diagnosed with a chlamydial infection (all other tests were negative). I was prescribed 1g azithromycin single dose, however after 2 weeks the symptoms didn't resolve. Since that time I have been prescribed two rounds of metronidazole 2g single dose twice and doxycycline 100 mg bid for 14 days (symptoms hadn't abated, provider considered trich, and mycoplasm as possible culprits). I was also put on avelox 400 mg for 10 days as well. Currently I have 6 days remaining on the doxycycline and 9 days remaining on the avelox. I have not engaged in any sexual activity whatsoever since my diagnosis however I still have a very mild clear mucus discharge primarily in the morning; the penile itching and dysuria has abated. After all of these antibiotics, is there any reason to suspect possible treatment failure if this symptom persists? And do I need to go and conduct a test of cure? Also how long before I can resume sexual activity again monogamously knowing I'm not putting my partner at risk? My partner and I would like to enter into a monogamous relationship where we can engage in unprotected sex.
MEDICAL PROFESSIONAL
Following the series of treatments you have had, there is no meaningful chance that you have persistent infection which would be a threat to sexual partners. The discharge you are describing could be due to some other, non-STI cause (and may have been that from the start, just coinidentally occurring at the time it did). I would suggest you seek the opinion of a urologist. Please let us know what h/she says. EWH
Dr. Hook,
I've completed the doxycycline 100 mg BID 14 and have 2 days left of the Avelox. Recently I've noticed increased discharge throughout the day. It is clear and mucopurulent. Also, I've been having some slight itching near the meatus and glans for the past two days. Would you recommend I follow up with a urologist? I'm very nervous about passing infection on to my significant other given I'm still symptomatic.
I've completed the doxycycline 100 mg BID 14 and have 2 days left of the Avelox. Recently I've noticed increased discharge throughout the day. It is clear and mucopurulent. Also, I've been having some slight itching near the meatus and glans for the past two days. Would you recommend I follow up with a urologist? I'm very nervous about passing infection on to my significant other given I'm still symptomatic.
Dr. Hook,
I've completed the doxycycline 100 mg BID 14 and have 2 days left of the Avelox. Recently I've noticed increased discharge throughout the day. It is clear and mucopurulent. Also, I've been having some slight itching near the meatus and glans for the past two days. Would you recommend I follow up with a urologist? I'm very nervous about passing infection on to my significant other given I'm still symptomatic.
I've completed the doxycycline 100 mg BID 14 and have 2 days left of the Avelox. Recently I've noticed increased discharge throughout the day. It is clear and mucopurulent. Also, I've been having some slight itching near the meatus and glans for the past two days. Would you recommend I follow up with a urologist? I'm very nervous about passing infection on to my significant other given I'm still symptomatic.
MEDICAL PROFESSIONAL
Correct. I see no reason for further evaluation.
FYI, a home HIV test would be conclusive for you 8weeks following your exposure. EWH
FYI, a home HIV test would be conclusive for you 8weeks following your exposure. EWH
To clarify Dr. Hook, am I correct in understanding that I can engage in unprotected sex with my partner immediately following my completion of the two weeks of doxycycline and 10 days of avelox without putting my partner at risk? Also at what time can I receive a conclusive result from an at home oral rapid hiv test? Are these accurate?
MEDICAL PROFESSIONAL
No,. this additional information does not change my opinion or advice. EWH
Thank you Dr. Hook!
I have one other symptom I failed to mention, in the last few days I've developed a mild pain in my lower abdomen that radiates into my left testicle. Seems to be worse when I'm sitting and almost non existent when standing. I'm very active and exercise quite frequently so I'm not sure if this is a related symptom or not. With this new information is there any cause for concern?
I have one other symptom I failed to mention, in the last few days I've developed a mild pain in my lower abdomen that radiates into my left testicle. Seems to be worse when I'm sitting and almost non existent when standing. I'm very active and exercise quite frequently so I'm not sure if this is a related symptom or not. With this new information is there any cause for concern?
MEDICAL PROFESSIONAL
Welcome to the Forum. From the sounds of things you were evaluated and treated by a knowledgeable clinician who did just what I would have done. Your initial illness sounds like non-gonococcal urethritis which can be caused by numerous bacteria but is most commonly due to chlamydia (up to 40% of the time). You were treated with the therapy recommended by the CDC (azithromycin, 1.0 gram) and then when your symptoms continued were treated with recommended therapy for persistent NGU (the metronidazole was for possible trichomonas). It sounds as though your symptoms are improved but not entirely gone. This too is common and is most often due to a combination of the time it takes for inflammation to go away and your own increased attentiveness to sensations and possible discharge on your part as a result of your symptoms.
At this point I see little reason to worry about treatment failure and would suggest that you move forward without further concern. I see no need for further testing. EWH
At this point I see little reason to worry about treatment failure and would suggest that you move forward without further concern. I see no need for further testing. EWH
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
