[Question #10418] Unprotected Oral

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23 months ago
Hi Doctors,

I am a 37 year old Male from the USA. I went to the strip club here in New York and during the lap dance, I rubbed my penis on her butt for maybe 15 seconds max and she gave me an unprotected blowjob for maybe 15 seconds, I could not get erect, so we stopped. I did not ejaculate. The next day I have lower back pain, only symptom. The pain is only is like a 2/10 and only occurs when I bend forward. 

I took a Chlamydia/Gonorrhea urine test through labcorp 5 days after exposure, which came back negative. Took uti test from Walgreens  1, 2 and 3 days after exposure, which came back negative.

Today is 32 days after exposure and I took another uti test, because I still have lower backpain, no other symptoms.  This time the uti dipstick turned color, just the Leukocyte part turned purple, Nitrate part remained colorless.

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23 months ago
Currently, my symptoms are my pee in the mornings is a dark brown, but after drinking water it turns back to normal color. I feel that my urine is a little cloudy and I still have a lower back pain, which only occurs when I bend forward, it is not constant.

What is your opinion on a false negative Chlamydia/Gonorrhea test from 5 days post exposure?

What is your opinion on a false positive uti test?

Can heavy alcohol and cocaine use give a uti or kidney infection?

Can I transmit a UTI to my spouse?

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H. Hunter Handsfield, MD
23 months ago
Welcome back to the forum. I reviewed your thread with Dr. Hook a few months ago and agree with all he said. Your current exposure and questions are very similar to the ones discussed the, so my replies are brief. You'll likely find more detail if you go back and re-read Dr. Hook's comments.

As before, receiving oral sex is low risk for all STDs and zero risk for some, including HIV. (There has never been a proved case of HIV transmitted oral to penis.) Your negative gonorrhea/chlamydia tests were valid; false negative are rare and you were very unlikely to be infected with them anyway. 

Back pain is not a symptom of any STD (or of UTI, despite what you might have found online); and no STI or any other infection can start to cause symptoms under 24 hr after exposure. Urine color is not in indicate or any infection either, and in any case UTIs are rarely if ever acquired by oral sex. White blood cells (WBC, leukocytes) can show up from time to time in the urine; when only on a single occasion and without typical symptoms, generally the results can be ignored. However, if you continue to test positive by the leukocyte esterase assay on urine dipstick, see a health care provider -- but it would have nothing to do with the sexual exposure a mont ago. Heavy alcohol does not cause UTI and is a rare cause of kidney problems -- and you provide no evidence of a kidney problem anyway.

UTIs are not transmitted between sex partners. (Sex can trigger UTIs in women, but in that case the infection result from bacteria she already is carrying in her genital area.)

All in all, at this point it is clear you never had any infection from the sexual exposure described and do not have any now. But as I said, see a doctor if you continue to test positive by urine dipstick.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD
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23 months ago
Hi Dr. Handsfield,

Yes, this is similar to my previous post a couple months ago, I just wanted to clarify that this exposure is new, happened last month mid August. As you can see it is always the same issue. I drink and then make poor decisions. 

I did take another chla/gon test and Urinalysis with culture today through Quest for my piece of mind. 

I did take another uti dipstick test and that came back clear of leukocytes. It just bothered me to have one turn purple, it turned purple immediately, I did have to force urine out, so it basically dribbled onto the stick, so idk if that caused the change.
 
Would 5 days post exposure for a Chla/gon urine test be sufficient time?

Do I have to worry about Trich, Mgen and/or Ureaplasma?

Thank you.
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H. Hunter Handsfield, MD
23 months ago
I knew it was a new exposure. Yes, 5 days is sufficient for conclusive gonorrhea/chlamydia testing.

None of the other three bacteria inhabit the oral cavity hence no risk from oral to genital contact. And ureaplasma doesn't matter anyway:  it's a normal bacteria present in up to 50% of people at any point in time and rarely causes any health problem.
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22 months ago
Off topic question: I was diagnosed 14 months ago with hsv-1, don’t know if its ghsv and/or Ohsv. From my previous post I was told that I most likely had it for longer than 14 months, I have never had an outbreak. 3 days ago I began itching my butt for a couple mins max, felt my underwear left in imprint, but after itching, it felt like my left buttock was numb/pins and needles feeling. I have been left with that feeling in my left buttocks for 1 day with flu like symptoms and on day 2 the flu like symptoms went away, today is day 3 and I feel better. I read that prodrome lasts 6hrs to 2 days, is that correct? How long in your experience does prodrome normally last?  If I feel better now, could have it been prodrome or more so my health anxiety? Thank you 
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H. Hunter Handsfield, MD
22 months ago
Follow-up comments are intended for clarifying the initial question not for entirely new issues. I'll just say that there is no realistic chance the symptoms have anything to do with your longstanding asymptomatic HSV1 infection and that all humans experience occasional anal itching. And recurrent herpes outbreaks are not accompanied by "flu like" symptoms; that occurs only with first HSV infections. HSV prodrome indeed typically lasts from a few hours to a day or two. If someday you have similar symptoms followed within a day or two by blisters or sores, get it checked out.

That concludes this thread. I hope the discussion has been helpful. Best wishes.
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