[Question #10160] How worried should I be?
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25 months ago
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Hi Dr's,
Below is the summmary.
- A prostitute provides unprotected oral sex, where I ejaculated in her mouth. I also slapped my penis on her pussy. No sex (unless the slapping counted?).
- 4-5 days later I had unprotected sex with my wife, oral ejaculation.
- 12-14 days after the encounter with the escort, I had pain when urinating and small amount of white/yellow substance on tip of penis. The next day I (stupidly) took 1 g dose of azithromycin without testing.
- 3 days later, symptoms have almost completely gone.
My questions are:
- Is it unlikely I had Gonorrhea based on symptoms presenting 12-14 days later?
- Is it more likely I have/had an NGU or Chlamydia?
- If Chlamydia, what are the odds I've passed it onto my wife, based on that one sexual encounter, 4-5 days after seeing the prostitute?
- How effective will the took 1 g dose of azithromycin be for my situation?
Thankyou
Below is the summmary.
- A prostitute provides unprotected oral sex, where I ejaculated in her mouth. I also slapped my penis on her pussy. No sex (unless the slapping counted?).
- 4-5 days later I had unprotected sex with my wife, oral ejaculation.
- 12-14 days after the encounter with the escort, I had pain when urinating and small amount of white/yellow substance on tip of penis. The next day I (stupidly) took 1 g dose of azithromycin without testing.
- 3 days later, symptoms have almost completely gone.
My questions are:
- Is it unlikely I had Gonorrhea based on symptoms presenting 12-14 days later?
- Is it more likely I have/had an NGU or Chlamydia?
- If Chlamydia, what are the odds I've passed it onto my wife, based on that one sexual encounter, 4-5 days after seeing the prostitute?
- How effective will the took 1 g dose of azithromycin be for my situation?
Thankyou
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Edward W. Hook M.D.
25 months ago
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Welcome to the Forum. Thanks for your questions. I'll be glad to comment. The exposure that you describe, receipt of oral sex from a commercial sex worker was relatively low risk for acquisition of STIs. Following receipt of oral sex gonorrhea may be acquired, as can non-chlamydial NGU which is irritation due to introduction on non-STI mouth bacteria into the urethra during oral sex. Chlamydia is only very, very rarely acquired from receipt of oral sex. The time sequence you describe, as well as your symptoms are more compatible with non-chlamydial NGU or chlamydia than gonorrhea as the symptoms or gonorrhea most typically occur 3-5 days following sex.
You did not do yourself any favors by taking the azithromycin. This would cure most chlamydial infections and non-chlamydial NGU. It would only cure about 70% of gonorrhea. If you had chlamydia or gonorrhea, there is about a 20% chance that you transmitted it to your wife.
At this point we're stuck with just guessing what is going on. You are better, you don't know what you had, and thus you do not know whether or not your wife was exposed. EWH
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25 months ago
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thankyou for the infomation Dr. hook.
A follow on question i have is.
- If I did have Chlamydia and/or Gonorrhea, how long is it likely that I could still test positive, after taking azithromycin? For example if I was to test 5 days later or 7/8 days later?
- What would be the most efficient and least efficient test to do? Swab, Urine or blood?
A follow on question i have is.
- If I did have Chlamydia and/or Gonorrhea, how long is it likely that I could still test positive, after taking azithromycin? For example if I was to test 5 days later or 7/8 days later?
- What would be the most efficient and least efficient test to do? Swab, Urine or blood?
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Edward W. Hook M.D.
25 months ago
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Tests for gonorrhea or chlamydia can remain positive for 2-3 days following successful treatment. By 7 days few tests would be positive and at 10 days following successful treatment all tests would be negative.
Blood tests are of no use. Swab tests are very slightly more sensitive than urine tests, particularly if the urine test is the first part of a urine specimen collected after not voiding for several hours (the longer you hold it the better)
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