[Question #10838] Trich exposure
 |
19 months ago
|
Thanks for the service you provide to the community, it is indeed a very valuable resource, specially in STD topics where it is really easy to find misleading and confusing info.
I am a male with a stable female partner, however, I engaged in oral sex and protected anal sex with an old friend, having 3 episodes of me receiving oral sex. He tested all neg for 7 stds including chlamydia, gonorrhea and trich rectum and genital. Throat swab came a bit late after those 3 episodes with a surprising positive for trich on him.
* I have read oral trich is uncommon, in fact we only tested for it cause that combo test was the only way to get chlamydia and gonorrhea test. Test is a PCR. I also read that a lot of times T. Tenax can cause false positives, he uses braces, so oral inflammation is expected. Could this be false positive?
*What is the probability I was infected? I received oral Saturday, Monday, Tuesday and made urine test on Thursday after getting his results. Is this too soon?
* I took 2g metronidazole yesterday, what would you say is the absolute minimum I need to wait to engage in unprotected vaginalis with my female partner without risk? 7 days seems a lot and avoiding sex for that long will be complicated.
Thanks
 |
Edward W. Hook M.D.
19 months ago
|
Welcome to our Forum. Thanks for your questions. There are no good answers here. Trichomonas vaginalis is quite rare in the oral cavity and when present if generally though to be residual from prior encounters. On the other hand, Trichomonas tenax is a well described oral pathogen, typically associated with gum disease (presumably this would include inflammation related to braces). Trichomonas tenax has been describe as well on rare occasions in the male urethra. Positive oral PCR tests for trichomonas In the single study I am aware of were due to T. tenax. Apparently some PCR tests do a better job of not accidentally picking up T. tenax than others.
Your negative test is good news. If you had trich testing at 3 days should have detected it. Taking a dose of metronidazole further reduces that likelihood that you have trichomonas at this time. There are good scientific data that in women 7 days of metronidazole provides a substantially higher cure rate for vaginal trichomoniasis than a single dose. These studies have not been replicated in men. Certainly a single dose of metronidazole cures most trichomoniasis in men. If I were you, I would not worry further and would not avoid unprotected sex with a regular partner.
I hope this perspective is helpful. EWH
--- |
19 months ago
|
Thanks for your response, Dr Hook.
Yes, I am referring to potentially the same paper on T. Tenax being picked up by some PCR hence me bringing it up.
Additionally, I just tested yesterday and sent urine sample to lab, so I will get results by next week. I was provided a pee holder where I think I peed to much (to the top, 100ml maybe) and got a test tube filled from it (a few ml) Will that large initial collection render test incorrect?
I provided my sample before taking meds.
Given that I have not gotten a negative back and I took meds 24hrs ago, when would you say us safe to resume unprotected sex with my female partner?
Finally, I got a neg test a couple months ago, and I have seen my male friend then. He has only been with me for a year too, so I guess if this was a real oral infection, I would have already been infected and tested positive a couple months ago?
|
Edward W. Hook M.D.
19 months ago
|
Most of the studies on the impact of volume on accuracy of PCR tests have been done for gonorrhea and chlamydia and have shown no change in accuracy when larger than recommended volumes of urine are collected.
As I said above, I would not hesitate to resume unprotected sex with your partner were I you.
Your final question is a bit of a "what if" or "could it have been" question. It does not change my assessment. EWH
---