chlamydia diagnosed

[Concerned0877]

A few days ago on Thursday, I was diagnosed with Chlamydia. I believe it is as a result of having unprotected anal gay male sex with a partner on Jan 14, 2012, where I was the insertive partner. I decided to get tested for HIV 30 days after that exposure and it came out negative, and my partner says he also has been tested since and is also negative. About three weeks after that sex exposure (sometime during the week of February 05) I began to have burning sensation symptoms and difficulty urinating. Unfortunately, it took me a little over 2 weeks to go get tested and diagnosed (Feb 23, 2012). The doctor gave me an antibiotic shot (do not know the name of medicine). The next day (Friday) I began to take another antibiotic (Azithromycin 500mg tablets) which is suppose to be taken for 3 days. Today, Sunday, is my third day taking the medicine. Here are my worries:

-Today I woke up feeling cold/flu like symptoms including a bad cough, phlegm, nasal congestion and and very fatigue. I also feel feverish.
- I masturbated and there was traces of what looks like blood in the semen (pinkish color). I don't remember seeing blood in my semen at anytime during these weeks except for today.
-It still burns when I urinate with difficulty urinating.

My questions:

1) How common are to have these symptoms on the last day regimen of taking these antibiotics?
2) Shouldn't these symptoms be going away by now?
3) Is my fatigue and ill feeling related to the Chlamydia or perhaps antibiotics or both?
4) How long before these symptoms go away?
5) Could the Chlamydia have evolved into something else?
6) Should I seek medical attention today?

Thanks.

[Edward W Hook, MD]

Bloo in your ejaculate is nothing to worry about. This occurs in men with and without genital infections and typically occurs a couple of times and goes away by itself.  


We suggest that persons treated for chlamydia abstain from sex until a week following initiation of therapy. EWH

[Concerned0877]

I'm not sure if my symptoms have improved or is unchanged now that there is also blood in the semen. I did not notice any blood in the semen before today.

1) How common is blood in the semen during a Chlamydia infection?
2) Could the blood be further damage caused by the Chlamydia?
3) Am I still contagious (final day of antibiotics)?
4) How long does it usually take for all symptoms to go away for good after taking all the prescribed antibiotics?

Thank you.

[Edward W Hook, MD]

Welcome to the Forum.  I will be pleased to comment.  Chlamydial infections are the most common reportable STD in the U.S- last year over 1.3 million cases were reported to the CDC.  Recommended therapy is either azithromycin 1.0 gram (1000 mg) given as a single dose or doxycycline, 100 mg orally given twice daily for a week. The two drugs appear to be equally (and highly) effective.  With respect to your specific questions:

1) How common are to have these symptoms on the last day regimen of taking these antibiotics?
It can take 2-3 days for the symptoms of urethral (penile) chlamydial infection to resolve. It is not clear to me if your symptoms are improved but still present which would be OK or unchanged.  If they are unchanged, you should seek further or repeat evaluation.  

2) Shouldn't these symptoms be going away by now?
See above.

3) Is my fatigue and ill feeling related to the Chlamydia or perhaps antibiotics or both?
No, the symptoms of a cold that you describe are not likely to be related to chlamydial infection but could represent some otehr process, most likely unrelated to your sexual exposure unless here are other anal or genital symptoms you have not mentioned.  

4) How long before these symptoms go away?
See above.

5) Could the Chlamydia have evolved into something else?
See above.

6) Should I seek medical attention today?
Perhaps.  As I said above, if your penile symptoms have not changed, you should be re-evaluated by someone who can examine you and comment- whether or not you do that today is up to you.  It doesn’t sound like you need to do so emergently.  . As for the cold-like symptoms, that too depends on how poorly you feel.

Sorry I can't be more specific. perhaps I will have another comment or two if you want to provide a bit more detail. EWH