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Possible Chlamydia
Hello. Thank you for your help. I posted several months ago about a low positive chlamydia test result. However, I have not yet had vaginal sex. I did have one oral encounter (gave with protection/received without) paired with one mutual masturbation encounter. I am female and my partner was male. I was STD tested a year later and my result came back with a low positive for chlamydia, and my doctor treated me with azithromycin. It was a nucleic acid amplification test conducted on a urine sample.
Dr. Hook replied to my questions, and was quite reassuring that the test result must have been a false positive. My provider, however, told me that it is completely possible that I contracted chlamydia from receiving unprotected oral sex. 1) Who has the more recent data? Is there any new literature that would suggest this is a possibility? I trust my provider, but I think he could have saved me from this anxiety if he had just re-tested me instead of treating. 2) Also, I don't have any medical training, but my partner's site of infection would have been his throat, and my site of infection would have to be my cervix, and the vagina is an acidic, unfriendly place for bacteria, correct? How could this be possible? 3) And if Dr. Hook's initial answer was correct, then why does my doctor think that contraction would have been possible? Even if my partner was infected (which is completely plausible, he was extremely promiscuous) 4) what are the chances that I could have had it?
Also, when my doctor was telling me about the test result, he said that from the result (as a low-grade chlamydial infection on a nucleic acid amp. test) he couldn't give me a 100% that I had it. 5) What does that mean? That even if someone were having unprotected sex and got this result, that it doesn't necessarily mean that they are infected? 6) What are the chances that you don't have an infection with this test result?
I'm worried about my fertility. Please help!
Dr. Hook replied to my questions, and was quite reassuring that the test result must have been a false positive. My provider, however, told me that it is completely possible that I contracted chlamydia from receiving unprotected oral sex. 1) Who has the more recent data? Is there any new literature that would suggest this is a possibility? I trust my provider, but I think he could have saved me from this anxiety if he had just re-tested me instead of treating. 2) Also, I don't have any medical training, but my partner's site of infection would have been his throat, and my site of infection would have to be my cervix, and the vagina is an acidic, unfriendly place for bacteria, correct? How could this be possible? 3) And if Dr. Hook's initial answer was correct, then why does my doctor think that contraction would have been possible? Even if my partner was infected (which is completely plausible, he was extremely promiscuous) 4) what are the chances that I could have had it?
Also, when my doctor was telling me about the test result, he said that from the result (as a low-grade chlamydial infection on a nucleic acid amp. test) he couldn't give me a 100% that I had it. 5) What does that mean? That even if someone were having unprotected sex and got this result, that it doesn't necessarily mean that they are infected? 6) What are the chances that you don't have an infection with this test result?
I'm worried about my fertility. Please help!
MEDICAL PROFESSIONAL
That is what I would do. EWH
Dear Dr. Hook,
I called my doctor, and he said that the test result was equivocal. Can I safely assume I don't have anything to worry about? Thank you for your help!
I called my doctor, and he said that the test result was equivocal. Can I safely assume I don't have anything to worry about? Thank you for your help!
MEDICAL PROFESSIONAL
Working through your comments:
The proportion of persons who have chlamydial throat infections is too low to accurately estimate just how low and transmission of infection through oral sex is similarly so very infrequent to estimate accurately.
It is recommended that at least 30 ccs of urine be collected for testing. Sounds like you might have had less than that. There are no data on what effect vitamins might have. Knowing how either might effect your test is unknown.
Correct. I have difficulty believing that you had chlamydia. No infection, no risk to fertility from infection.
As I said originaly, it is hard to critisize your physician for treating. In such situations better to overtreat than not.
Yes you can post about the possiblity of an eqivocal test result. EWH
The proportion of persons who have chlamydial throat infections is too low to accurately estimate just how low and transmission of infection through oral sex is similarly so very infrequent to estimate accurately.
It is recommended that at least 30 ccs of urine be collected for testing. Sounds like you might have had less than that. There are no data on what effect vitamins might have. Knowing how either might effect your test is unknown.
Correct. I have difficulty believing that you had chlamydia. No infection, no risk to fertility from infection.
As I said originaly, it is hard to critisize your physician for treating. In such situations better to overtreat than not.
Yes you can post about the possiblity of an eqivocal test result. EWH
Dear Dr. Hook,
Thank you. This does make me feel much better. I suppose you can't be more up-to-date on the literature than if you are actually writing it :) And I appreciate your aside about theoretical possibilities-it keeps the worst case scenario in perspective (though perhaps I really am moments away from being struck by a meteorite : )
I have some clarifying questions. When you say that "chlamydia infections are not present in the throat in any appreciable amount"...what exactly are the numbers? Are you saying that even if my partner had performed oral sex on other girls who were infected, that it would still be virtually impossible for him to have it in his throat, or just unlikely, or a 1/10, or 1/2 chance? And the chances of transmitting that in one instance would be even lower, correct?
Oh, another kind of strange thing to remember that may be relevant...my urine sample was an unusually small amount of liquid (I just remember the lab ladies commenting on it possibly not being enough) and I was taking a lot of vitamin supplements at the time (especially B vitamins). I thought B vitamins helped with stress levels and health, but I think I was excreting much of what I took in my urine...could either of those things affect my test result?
Also, from the way that I am reading your response, it sounds like you think it is pretty much impossible that I contracted chlamydia from this encounter and that my fertility should be fine-that any problems I could potentially have would be completely unrelated to this, right?
The equivocal test result seems like a reasonable explanation that would mostly alleviate my fears...I actually want to call and ask my doctor if that is the case because it sounds as though an equivocal test result could likely be a negative (right?)...and in conjunction with the fact that I've never had penile contact makes this even less of something I should still be thinking about. I really wish I'd been retested instead of treated...I guess my provider didn't believe I wasn't having unprotected sex? Or I suppose I can understand that if a physician thinks there's even a remote possibility that a girl is carrying around chlamydia, it's better to treat then to potentially let it fester...still, it could have saved me so much angst.
Can I post again once I hear whether I had an equivocal test result? Thanks again for your help! I really appreciate your expertise and knowledge.
Thank you. This does make me feel much better. I suppose you can't be more up-to-date on the literature than if you are actually writing it :) And I appreciate your aside about theoretical possibilities-it keeps the worst case scenario in perspective (though perhaps I really am moments away from being struck by a meteorite : )
I have some clarifying questions. When you say that "chlamydia infections are not present in the throat in any appreciable amount"...what exactly are the numbers? Are you saying that even if my partner had performed oral sex on other girls who were infected, that it would still be virtually impossible for him to have it in his throat, or just unlikely, or a 1/10, or 1/2 chance? And the chances of transmitting that in one instance would be even lower, correct?
Oh, another kind of strange thing to remember that may be relevant...my urine sample was an unusually small amount of liquid (I just remember the lab ladies commenting on it possibly not being enough) and I was taking a lot of vitamin supplements at the time (especially B vitamins). I thought B vitamins helped with stress levels and health, but I think I was excreting much of what I took in my urine...could either of those things affect my test result?
Also, from the way that I am reading your response, it sounds like you think it is pretty much impossible that I contracted chlamydia from this encounter and that my fertility should be fine-that any problems I could potentially have would be completely unrelated to this, right?
The equivocal test result seems like a reasonable explanation that would mostly alleviate my fears...I actually want to call and ask my doctor if that is the case because it sounds as though an equivocal test result could likely be a negative (right?)...and in conjunction with the fact that I've never had penile contact makes this even less of something I should still be thinking about. I really wish I'd been retested instead of treated...I guess my provider didn't believe I wasn't having unprotected sex? Or I suppose I can understand that if a physician thinks there's even a remote possibility that a girl is carrying around chlamydia, it's better to treat then to potentially let it fester...still, it could have saved me so much angst.
Can I post again once I hear whether I had an equivocal test result? Thanks again for your help! I really appreciate your expertise and knowledge.
MEDICAL PROFESSIONAL
Welcome back to our Forum. I'm sorry that these concerns have continued to plague you but I can understand how you can feel torn when some unknown person over the internet tells you one thing and your own doctor tells you another. My original answer stands. My reasoning is based on my specialist in STDs and STD research, including having written over 50 papers (conservative estimate) of my almost 300 published papers on chlamydia and diagnosis of chlamydial infections. I will repeat a few of the facts on which I base my statements:
1. Chlamydia is transmitted by direct contact, not by masturbation despite the theoretical possibility that it could happen (there is also a theoretical possibility that you will get hit by a meteorite while reading this)
2. Chlamydial infections are not present in the throat in any appreciable amount.
3. As a re-read this and your earlier question I noticed that your doctor told you that your test gave a "low positive" result. This is a meaningless term- either you have chlamydia or you don’t. As I thought about this more however, it occurs to me that some of the nucleic acid amplification tests do sometimes give results which are "equivocal". If this is what your doctor called low positive it is almost certain that you did not have chlamydia. Most equivocal test results do not confirm when further testing is performed.
Thus, I have to disagree with your doctor. The chance that you had chlamydia are negligible and not worth worrying about. Similarly, for you to be worried about your fertility at this point is not advisable either.
I hope this is some help. EWH
1. Chlamydia is transmitted by direct contact, not by masturbation despite the theoretical possibility that it could happen (there is also a theoretical possibility that you will get hit by a meteorite while reading this)
2. Chlamydial infections are not present in the throat in any appreciable amount.
3. As a re-read this and your earlier question I noticed that your doctor told you that your test gave a "low positive" result. This is a meaningless term- either you have chlamydia or you don’t. As I thought about this more however, it occurs to me that some of the nucleic acid amplification tests do sometimes give results which are "equivocal". If this is what your doctor called low positive it is almost certain that you did not have chlamydia. Most equivocal test results do not confirm when further testing is performed.
Thus, I have to disagree with your doctor. The chance that you had chlamydia are negligible and not worth worrying about. Similarly, for you to be worried about your fertility at this point is not advisable either.
I hope this is some help. EWH
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STDs can't be transmitted by casual contact, like hugging or touching.
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