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Persisting Chlamydia
Dear Dr.
I have had a Chlamydia problem for a year now. It all started in September 2009 from an irresponsible intercourse. I was diagnosed and received a treatment of zitromax, it did not go away then I was medicated cipro xr 1000 for 7 days and 21 days of vibramicin. My next test in february came out negative. After a month or so I saw the simptoms again, since then I have been prescribed twice 2g zitromax, vibramicin and eritromicin. A couple mnths ago my urologist and an infectologist told me it had to be a false positive so I relaxed. I recently got a new girlfriend and we had oral sex, and I think she got a cough from the chlamydial infection. Recently I have felt pain in the pelvic area. The uretritis is very mild but with the erect penis a little discharge comes out. I´m worried even though my urologist doesn´t believe it that it might become a Urethritis or develop to rieter sindrome. Please help me out.
I have had a Chlamydia problem for a year now. It all started in September 2009 from an irresponsible intercourse. I was diagnosed and received a treatment of zitromax, it did not go away then I was medicated cipro xr 1000 for 7 days and 21 days of vibramicin. My next test in february came out negative. After a month or so I saw the simptoms again, since then I have been prescribed twice 2g zitromax, vibramicin and eritromicin. A couple mnths ago my urologist and an infectologist told me it had to be a false positive so I relaxed. I recently got a new girlfriend and we had oral sex, and I think she got a cough from the chlamydial infection. Recently I have felt pain in the pelvic area. The uretritis is very mild but with the erect penis a little discharge comes out. I´m worried even though my urologist doesn´t believe it that it might become a Urethritis or develop to rieter sindrome. Please help me out.
MEDICAL PROFESSIONAL
Sorry I misunderstood your statement about "anal itch and some discharge".
Although I am not familiar with medical services and tests available in Medellin or elsewhere in Colombia, I would think you could find a laboratory that does the modern chlamydia tests done in most of the world. In particular, look into a "nucleic acid amplification test" (NAAT), of which three are available in most countries: polymerase chain reaction (PCR, trade name Amplicor), transcription mediated amplification (TMA, trade name Aptima), and strand displacement assay (SDA, trade name Probe-Tec). Any of these tests almost certainly would show that you do not have chlamydia at this time.
Otherwise this information doesn't change my opinion or advice. You can go forward with confidence you don't have chlamydia, probalby have nothing serious, and probably do not require additional antibiotic treatment. You might consider printing out this thread and discussing it with your urologist.
Although I am not familiar with medical services and tests available in Medellin or elsewhere in Colombia, I would think you could find a laboratory that does the modern chlamydia tests done in most of the world. In particular, look into a "nucleic acid amplification test" (NAAT), of which three are available in most countries: polymerase chain reaction (PCR, trade name Amplicor), transcription mediated amplification (TMA, trade name Aptima), and strand displacement assay (SDA, trade name Probe-Tec). Any of these tests almost certainly would show that you do not have chlamydia at this time.
Otherwise this information doesn't change my opinion or advice. You can go forward with confidence you don't have chlamydia, probalby have nothing serious, and probably do not require additional antibiotic treatment. You might consider printing out this thread and discussing it with your urologist.
MEDICAL PROFESSIONAL
If you are confirmed to have NGU, my advice would be to try treating it with a combination of moxifloxacin (Avelox in the US, I don't know about Colombia) plus either metronidazole (Flagyl and other brands) or tinidazole (Tindamax). Moxi covers the organism called Mycoplasma genitalium and the others are active against trichomonas; either of these could explain longstanding recurrent/persistent NGU.
Note that other drugs of the quinolone group (ciprofloxacin, levofloxacin, and others) are not adequate. Only moxifloxacin has been proved to be active against M genitalium.
But I also stress that this should not worry you very much if the problem continues even after additional treatment. Persistent/recurrent NGU has never been shown to be serious; there are no known complications in either infected men or in their sex partners. It's an inconvenience but not an important health problem.
That should end this thread. Good luck.
Note that other drugs of the quinolone group (ciprofloxacin, levofloxacin, and others) are not adequate. Only moxifloxacin has been proved to be active against M genitalium.
But I also stress that this should not worry you very much if the problem continues even after additional treatment. Persistent/recurrent NGU has never been shown to be serious; there are no known complications in either infected men or in their sex partners. It's an inconvenience but not an important health problem.
That should end this thread. Good luck.
Dr. H. Hunter Handsfield,
Thank you and sorry that is what I found as a cause of Chlamydia, today I will have an appointment with the urologist and will take this thread. This morning I woke up with lattle bit of mocus like transparent secretion on the tip of the penis. From all the reading it leads me to having persistent NGU, what would be your recomendation if this was true.
Thank you Dr. you have been very helpful.
Thank you and sorry that is what I found as a cause of Chlamydia, today I will have an appointment with the urologist and will take this thread. This morning I woke up with lattle bit of mocus like transparent secretion on the tip of the penis. From all the reading it leads me to having persistent NGU, what would be your recomendation if this was true.
Thank you Dr. you have been very helpful.
MEDICAL PROFESSIONAL
That's very unlikely. Reactive arthritis (formerly called Reiter syndrome) typically causes a lot more than just a little joint pain. There is generally severe arthritis, as well as typical skin rash and often inflammation of the eyes.
Reiter syndrome is no longer accepted as the correct name for reactive arthritis. Reiter was a Nazi war criminal who particiapted in fatal human experiments at Auschwitz (he intravenously injected concentration camp inmates with typhus), escaped prosecution at Nuremburg on a technicality, and then successfully rehabilitated his name. All this was uncovered by historical research in the 1980s and 1990s. His name should never be used in an honorific manor. For more information, google "Dr. Hans Reiter".
Reiter syndrome is no longer accepted as the correct name for reactive arthritis. Reiter was a Nazi war criminal who particiapted in fatal human experiments at Auschwitz (he intravenously injected concentration camp inmates with typhus), escaped prosecution at Nuremburg on a technicality, and then successfully rehabilitated his name. All this was uncovered by historical research in the 1980s and 1990s. His name should never be used in an honorific manor. For more information, google "Dr. Hans Reiter".
Dr.
Thank you very much. I´m less worried now but will take this thread to the Urologist. I´m still curious if any of those pains in the knees and hips as well as the pubicarea could be related with this.
Thank you very much. I´m less worried now but will take this thread to the Urologist. I´m still curious if any of those pains in the knees and hips as well as the pubicarea could be related with this.
very helpful re persisting chlamydia thanks
Dr.
Thank you, I will look into those terms. The itching is one thing, the discharge has been from the penis, I had never discharge from the annus, just itching and I am a straight guy, but this it is irrelevant. The las aclaration I want to give you is that the discharge from the penis is similar to mucus only in very little quantity.
A couple weeks ago I had pain in the knees and hips, and that is why I asked about reiter sindrome but I believe it could have been the result of something else and as a psycological thing I keep on looking into answers assosiated with this. The test were made in Medellin, Colombia. Certainly I have only had sex with one partner who is not infected with Chlamydia.
Thank you
Thank you, I will look into those terms. The itching is one thing, the discharge has been from the penis, I had never discharge from the annus, just itching and I am a straight guy, but this it is irrelevant. The las aclaration I want to give you is that the discharge from the penis is similar to mucus only in very little quantity.
A couple weeks ago I had pain in the knees and hips, and that is why I asked about reiter sindrome but I believe it could have been the result of something else and as a psycological thing I keep on looking into answers assosiated with this. The test were made in Medellin, Colombia. Certainly I have only had sex with one partner who is not infected with Chlamydia.
Thank you
MEDICAL PROFESSIONAL
OK, that helps. The immunofluorescence test for chlamydial antigen (IFI) is an older technology that is not very accurate and indeed can produce false positive results. (What country/city are you in?) If you were continuing to have unprotected sex with one or more partners who were not treated for chlamydia, there is a slight chance you were being reinfected. But this seems unlikely and I agree with your urologist: the continuing positive IFI results almost certainly are false.
Anal itching and discharge cannot result from urethral infection; that has to be a separate problem. If you are a gay man and have had receptive anal sex, you could have another STD to explain that part of your symptoms.
The symptoms of urethritis are abnormal discharge of pus or mucus from the penis, and sometimes discomfort on urination. (The clear discharge during erection is not abnormal, as noted above.) If you're having pain or discomfort in the genital or lower abdominal area, it could be a prostate gland problem or the chronic pelvic pain syndrome (CPPS). (For more information, you might google that term -- spell it out -- and start reading with the excellent Wikipedia article and the information from the Stanford University dept of urology, both of which will be near the top of the google hits.) You might discuss these possibilities with your urologist.
Perhaps the most important thing is this: recurrent/persistent NGU, chronic prostatitis, and CPPS all are only inconveniences, not serious health problems. Almost certainly you have nothing that will seriously harm you or a future sex partner. It is possible you will have to learn to live with your symptoms, but if they are not severe that should be pretty easy once you are confident you have nothing serious.
Anal itching and discharge cannot result from urethral infection; that has to be a separate problem. If you are a gay man and have had receptive anal sex, you could have another STD to explain that part of your symptoms.
The symptoms of urethritis are abnormal discharge of pus or mucus from the penis, and sometimes discomfort on urination. (The clear discharge during erection is not abnormal, as noted above.) If you're having pain or discomfort in the genital or lower abdominal area, it could be a prostate gland problem or the chronic pelvic pain syndrome (CPPS). (For more information, you might google that term -- spell it out -- and start reading with the excellent Wikipedia article and the information from the Stanford University dept of urology, both of which will be near the top of the google hits.) You might discuss these possibilities with your urologist.
Perhaps the most important thing is this: recurrent/persistent NGU, chronic prostatitis, and CPPS all are only inconveniences, not serious health problems. Almost certainly you have nothing that will seriously harm you or a future sex partner. It is possible you will have to learn to live with your symptoms, but if they are not severe that should be pretty easy once you are confident you have nothing serious.
Dr. The diagnosis was done with an antigen test taking a sample of the secretion from the tip of the penis and this was the method every time. The last one that came with a positive was in June 2010. Chlamydia trachomatis ANTIGENO POR IFI
Resultado: Positivo ** Negativo. The discharge that I havewhich is not very abundant is completely transparent but when it all started it was yellow. Up till now I have had 4 lab tests for all STDs and the only one that has come out positive and persistently is Chlamydia. The doctor told me to stop testing and to leave so that we would not keep stimulating the organ.
My simptoms a the moment are, a little bit of anal itch and some discharge of the transparent yet very thick liquid that i feel coming out from the back of the urethra. What would be a persistent non gonococal urethritis and waht tests should I have done even though according to my urologist all of the causes for urethritis have been looked at.
Thank you,
Resultado: Positivo ** Negativo. The discharge that I havewhich is not very abundant is completely transparent but when it all started it was yellow. Up till now I have had 4 lab tests for all STDs and the only one that has come out positive and persistently is Chlamydia. The doctor told me to stop testing and to leave so that we would not keep stimulating the organ.
My simptoms a the moment are, a little bit of anal itch and some discharge of the transparent yet very thick liquid that i feel coming out from the back of the urethra. What would be a persistent non gonococal urethritis and waht tests should I have done even though according to my urologist all of the causes for urethritis have been looked at.
Thank you,
MEDICAL PROFESSIONAL
Welcome to the STD forum.
Like your own doctors, I am highly skeptical you have a persisting chlamydial infection despite the antibiotic treatments you describe. Ciprofloxacin isn't very active against chlamydia and is not recommended for treatment, but azithromycin (Zithromax), doxycycline (Vibramycin), and erythromycin all are highly effective. True treatment failures are extremely rare with these antibiotics and probably never occur except in patients who do not take the drug as directed.
That said, it is conceivable you have persistent or recurrent nongonococcal urethritis (NGU) or a prostate gland problem. Further, the genital types of chlamydia do not cause cough. There is a kind of chlamydia that causes respiratory infections, but it doesn't infect the genitals. Whatever is causing your partner's cough, it has nothing to do with your genital symptoms.
Therefore, before I can help further, I need more information. Exactly what kind of test was done for the initial diagnosis? What symptoms did you have then? Has the diagnosis of persistent chlamydia been made only because of your symptoms, or were other lab tests positive? Please provide the information on any and all chlamydia lab tests that were done. Were specimens taken from your urethra, urine, or blood? Also, please describe exactly what symptoms you are having now. (Of course having "discharge" during erections is not a symptom of infection; pre-ejaculate fluid is normally present when men are sexually aroused.)
Please provide the additional information and we'll take it from there.
Regards-- HHH, MD
Like your own doctors, I am highly skeptical you have a persisting chlamydial infection despite the antibiotic treatments you describe. Ciprofloxacin isn't very active against chlamydia and is not recommended for treatment, but azithromycin (Zithromax), doxycycline (Vibramycin), and erythromycin all are highly effective. True treatment failures are extremely rare with these antibiotics and probably never occur except in patients who do not take the drug as directed.
That said, it is conceivable you have persistent or recurrent nongonococcal urethritis (NGU) or a prostate gland problem. Further, the genital types of chlamydia do not cause cough. There is a kind of chlamydia that causes respiratory infections, but it doesn't infect the genitals. Whatever is causing your partner's cough, it has nothing to do with your genital symptoms.
Therefore, before I can help further, I need more information. Exactly what kind of test was done for the initial diagnosis? What symptoms did you have then? Has the diagnosis of persistent chlamydia been made only because of your symptoms, or were other lab tests positive? Please provide the information on any and all chlamydia lab tests that were done. Were specimens taken from your urethra, urine, or blood? Also, please describe exactly what symptoms you are having now. (Of course having "discharge" during erections is not a symptom of infection; pre-ejaculate fluid is normally present when men are sexually aroused.)
Please provide the additional information and we'll take it from there.
Regards-- HHH, MD
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