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A brief summary.  On 1/28/09 I had unprotected oral and unprotected vaginal intercourse with a CSW at a massage parlour.  After, I immediately became concerned.  The worker stated she did not have any STDs and "usually" used condoms - but who knows.

24 hours later, I went to Dr.  He gave me a shot (not sure what it's called, but it was in the bum).  He also prescribed 2 500mg tablets of Azithromycin.  Dr also ran tests on urine which came back negative for chlamydia and gonorrhea, but the sample was only taken 24hrs after exposure.  Approx 4-5 days after taking the antibiotics, I engaged in intercourse with my wife.

I have not had any noticeable symptoms of any STD (maybe 1 day where it seemed to burn a little when I had to pee, but not very noticeable).  5 weeks after this exposure, my wife began to complain of burning when peeing.  She has had a couple of UTIs in the past.  She took Azo tablet for the symptoms, so the Dr's office was not able to read the sample very well.  They said they did a culture, and it showed positive for an infection.  She was prescribed 1 weeks supply of Bactrim, and her symptoms have seemed to disappear.  My questions are:

1.  How reliable would the tests for gonorrhea and chlamydia be 24 hrs after exposure?

2.  If I did contract one or both during this encounter, how effective would the antibiotics I was given have cleared the infection?  Would the infection have been gone within the 4-5 days I waited to have sex with my wife?

3.  Does the fact that the Bactrim has seemed to clear up the symptoms point to UTI vs some type of bacterial STD?  Would the culture the doctor's office did have showed chlamydia or gonorrhea even with the effect of the Azo tablet?

Thanks in advance for your time.  
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239123 tn?1267651214
Welcome to the STD forum.  I'll try to help.  The bottom line is that your probably weren't infected; if you were, you were treated adequately for the common treatable STDs; and therefore there is little or no risk to your wife.

First, the statistical chance your massage partner had an STD is pretty low, although of course not zero.  But if she was infected, the chance of transmission was under 50% for all common STDs, and closer to 10% or lower for most of them.

Second, although testing at 24 hours is a bit early, it would pick up most (all?) gonorrhea and many if not all new chlamydial infections.

Third, you were adequately treated.  The injection probably was ceftriaxone, which is recommended against gonorrhea; the azithromycin would prevent both chlamydia and NGU (called NSU if you're in the UK); and either drug would cure incubating syphilis.  Any infection present was eradicated within 24 hours, so your wife was not at risk at all.

Finally, UTIs are common in women.  Although the symptoms can resemble those of gonorrhea or chlamydia, they actually are quite different most of the time.  If your wife's symptoms were typical for her past UTIs, there is no reason to suspect any other cause for her symptoms -- and her positive urine culture proves it.

All is well.  My only parting shot is that if and when you return to a massage parlor, insist on condoms if things get "out of hand" -- or bring your own condoms.  A word to the wise.

Best wishes--  HHH, MD
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239123 tn?1267651214
University of Washington
Seattle, WA
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