re-treated for chlamydia

[greatly concerned]

About 2 months ago, I had unprotected sex with a co-worker. 3 weeks later I began noticing discharge and also experienced flu-like symptoms. Results came back positive for chlamydia. I saw a physician, was given a shot and azithromyacin.I felt better for a while and the problem seemed to clear up but I noticed minimal discharge about a week to 10 days later. I went back to doctor for retest and results were "equivocal". He put me on doxycyclin for 10 days. I took meds for the entire course and thought all was well. I again noticed slight discharge w/in the last few days. I went back to the doctor, was retested(waiting on those as we speak)and given Flagyl to possibly treat trich. Am I fighting an uphill battle???

A major issue:
I had sex with my regular partner towards the end of the doxycyclin. Is it possible I could have passed this on to them and then they repassed it on to me within 1 day?

Thanks for your help

[H. Hunter Handsfield, M.D.]

Somebody esle just asked a similar question.  See http://www.medhelp.org/forums/STD/messages/4506.html.

[stillHurting]

Trich testing in males:

I know that the wet-mount or culture results are unreliable in males, but I had read that the urethral swab PCR tests for Trich were mostly reliable, with a sensitivity ~ 90%.  Is this not the case?

[greatly concerned]

very confusing, but as I told the doc and his nurse...my actions were completely voluntary so I guess the consequences are hell....
My doc is pretty confident that the results are gonna be neg. for chlam., and is fairly certain that they will be neg. for the trich as well.
I've read alot of comments on here about over reacting and high anxiety and I'm starting to think that's the case with me.

[Wear/a/Jimmy]

Been going throught the same thing:

1) 12 hours after HIGH risk of exposure took 1.5 gram oral zithro

symptoms disapeared, but started to come back about a week latter

2) took 4 days of doxy, too short I know but the stuff was havoc on my body

3) took 1.250 grams of zithro a week after the doxy

Had two gram stains done after meds...  One study said pos. one study said neg. Studies done at 2 different locations at 24 hours apart.

Was placed on 3 weeks of erthromyacin, after 4 days the testicular pain has subsided, but now I get a slight burn when I pee. Doc says I have a bladder infection...

It is rather confusing

[H. Hunter Handsfield, M.D.]

Between the azithro and doxy you're definintely in the clear with respect to chlamydia, and so is your partner.  Can't say about trichomonas, however.

[H. Hunter Handsfield, M.D.]

I didn't understand until now that you might be relying on a test in yourself to determine whether trichomonas might be the problem.  There is no commercially available test that is reliable in men.  The only way to know whether that is a possible explanation is for your partner to be tested herself.

[greatly concerned]

Thanks Doc!
My apologies... my regular partner is female. One of my concerns was that since I didnt complete  the full 10 days of doxycycline and had unprotected sex with her at day 6 of meds that I infected her. I have to feel confident that with the initial treatment and then the 6 days of doxy before I had sex again should have cured me. My symptoms are minimal compared to what they were a month or so ago....not fun at all... from reading other postings and comments here, the treatment is pretty much 100% effective, so hopefully I am in the clear!!

Thanks again

[H. Hunter Handsfield, M.D.]

About 10-20% of men with nonconoccal urethritis (NGU) have recurrent symptoms after treatment, similar to what you describe.  That's most common when chlamydia isn't the cause of the original NGU, but it happens sometimes with chlamydia as well.  Your doctor followed exactly the right strategy:  CDC recommends switching to doxycycline if azithromycin was used first, or vice versa; and if the problem continues, to treat for possible trichomoniasis.

If your partner originally was infected--or if s/he was exposed after you were infected but before you were treated--you could have been reinfected.  However, symptoms cannot start only a day after exposure.  If your partner is a woman (you don't say one way or the other), then trichomonas seems a possibility, but trich is not known to be a problem among men who have sex only with men.

Persistent/recurrent NGU sometimes requires prolonged treatment, up to 3 weeks or even longer.  Even with that, some cases continue to have symptoms on and off.  The good news is that this apparently isn't an important health threat:  it doesn't lead to infertility, cancer, or any other complication, and no harm to one's sex partner(s).  Some such cases may be due to some sort of recurrent inflammation of the urethra, without actual infection--even though chlamydia or another infection started the problem.

Bottom line:  Based on the treatment you were given, you seem to have a provider who knows about STD management.  Continue to follow his or her advice about the details of your continued treatment and follow-up.  But don't lose a lot of sleep over fear of some horrible outcome.  That isn't going to happen.

Good luck --  HHH, MD