[Question #1146] Question about PID

48 months ago

Hello Doctor. About four months ago, I received unprotected oral sex from a  41 year white woman other than my girlfriend for about 3 minutes.  I went about 15 days without symptoms, but I panicked because I read men can not have symptoms. At the time I was taking doxy for foot infection.  Anyways, I went to my doctor, and he collected a urine sample.   I was having  a severe panic attack to where I could not breath worried about an infection or HIV. He said I should be okay.  Feeling bad for me I guess he gave me an injection and 1g tablets. A few days later my urine test was negative.


I continued relations back with my partner a week later after she returned from her vacation. All was good.   Two months ago, she complained of severe back pain,   could not walk, severe pain in her stomach and vagina.  We ran to the hospital. She had blood in her urine and the doctor said she had a few kidney stones. They also performed a CT scan of her  pelvis.  Everything was negative. Last week she was complaining  a little irritation when she peed. She was given some medicine for a UTI.

Looking online I read about PID.  They seem similar but different to some of these issues .

My questions are :

Is it possible my actions could have caused this issue to my partner? 

Are my negative  test results and treatment reliable?

What were my chances of catching something  1 out 10, 1 out of 1,000?

What would PID look like if it was my fault? What would be the incubation period?

Would a CT scan identify PID?

Should I re-test?


Guilt is killing me more at this point.




48 months ago
I forget to mention I was not with my regular part post my exposure as she was on vacation.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
48 months ago
Welcome to the forum. Thanks for your question.

First, oral sex is safe sex, with a very low risk of any STD of any kind, and zero risk for some. Second, despite what you read about asymptomatic infections, in fact the large majority of men with any STD develop very obvious symptoms. This is especially true for gonorrhea, which is the only STD from oral sex that has any chance of causing PID. (Chlamydia is rarely transmitted by oral sex.) And it would be pretty much impossible to acquire gonorrhea or any other PID-causing infection while taking doxycycline. Other than gonorrhea, there has never been a known case of PID that resulted from an infection acquired by her partner from oral sex. And the standard urine STD tests (for gonorrhea and chlamydia) are highly reliable, so for sure you did not have either of them.

As for your partner's back pain, it's really not a PID symptom, despite what you found by online searching. Some women with abdominal pain due to PID may have some pain radiation into the back. In any case, she had another obvious cause for her back pain. Also, the CT scan almost certainly would have detected PID if she had it.

Those comments pretty well address your specific questions, but to be sure there is no misunderstanding:

     Possibility your exposure caused your partner's problems?  Zero.

     Negative tests and treatment reliable? Yes, for sure.

     The chance you caught anything was probably under one in many thousand, maybe 1 in a million. Zero for practical puproses.

     PID symptoms are low abdominal pain, vaginal discharge, and fever. Nothing like your partner's back pain. Incubation anywhere from a few days to several weeks, but that doesn't matter one way or the other.

     Yes, CT would have detected PID.

     You should not have any further testing of any kind.

I hope this has helped. Best wishes and stay safe for any non-marital sexual exposures (as you did, since oral sex is safe!). Let me know if anything isn't clear.

Best wishes--  HHH, MD

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48 months ago
That's great?  I was only on the doxy a couple of days before the test. Any chance the doxy might of hide an infection or does the negative test means it would have killed it? Sounds like either way I am in the clear.
Edward W. Hook M.D.
Edward W. Hook M.D.
48 months ago

Welcome to our Forum. I'll be glad to comment.  Your partner's problems do not sound like PID but are more consistent with either a urinary track infection or kidney stones, neither of which would be an STI.  The exposure you describe four months ago was low risk-  most people do not have STIs, particularly oral STIs which can be transmitted through oral sex and few STIs are acquired due to receipt of oral sex- there are no cases of HIV documented to oral resulting from oral sex.  The major infections which might occur due to oral sex are gonorrhea or non-gonococcal urethritis due to bacteria other than chlamydia (chlamydia infections from oral sex are very, very rare) and although some such infections may be asymptomatic, most cause symptoms.  Further, in your case if you were taking doxycycline during your time of exposure, this is likely to have prevented acquisition of STI as well.  Having said this., let me now answer your specific questions:

Is it possible my actions could have caused this issue to my partner? 

See above, there is virtually no chance that your actions have led to your partners recent problems.

Are my negative  test results and treatment reliable?

Yes, the tests were reliable. Similarly, your treatment which sounds as though it was an injection of ceftriaxone and azithromycin pills is recommended therapy for gonorrhea, chlamydia and NGU.  thus in the most unlikely event that you had one of these, the treatment would have cured it.

What were my chances of catching something  1 out 10, 1 out of 1,000?

Overall, estimates are difficult to come up with.  Given the specifics, in the neighborhood of 1 in 1000 or less.  Not something to be worried about.

What would PID look like if it was my fault? What would be the incubation period?

This does not look or sound like PID/  Do not worry about it.

Would a CT scan identify PID?

Yes, a CT would provide evidence of PID.

Should I re-test?

Re-testing is a waste of time and money.


I hope these comments are helpful to you. EWH

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48 months ago
Final question, but it seems beyond the point. I took the doxy about three days before my test as a stepped on a nail the week before. Any chance that interfered with the test by hiding an infection? Either way, seems like my treatment shot took care of it.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
48 months ago
For sure you weren't infected. If the organism had been able to take hold despite doxycycline, the test would have been positive. Still no worries. Do your best to let it go.

It would appear Dr. Hook and I were answering simultaneously -- so you got advice from both of us for the price of one. As you have seen, we agree exactly with one another (which is virtually always the case).

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48 months ago
Thank you doctors. For two months now, I have felt responsible for my partners every illness.  I have had bad anxiety and stomach aches. This helps provide me some closure.  Good luck moving forward.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
48 months ago
It is likely your mind is subconsciously conflating a sexual decision you regret with the health consequences of that decision. They aren't the same. Deal with the former as you need to, but disregard the latter. It isn't an issue.

Best wishes.
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