[Question #11572] [Question #11518] Follow up and Doubts!
 |
13 months ago
|
Hi Dr, just wanted to clarify some things please, regarding my previous questions.
The first Chlam/Gono throat swab was 2 days after start 1g amoxicilin for my tonsilitis. Then, second throat swab + urine test for the same STIs 4 days after that 8 day course 1000mg amoxicilin (15 days after last exposure). Day 27, i developed an open sore in my inner check, like an ulcer, (i think it was for bitting?), but completely healed after 3/4 days. I thought syphilis, but since it healed so fast... i dont know.
Did new tests for both HIV and Syphilis, 29 days after last exposure: 4th Gen HIV and VDRL(RPR), both Neg!
1) Should i repeat Chlam/Gono swabs+urine because of the amoxicilin?
2)The ulcer type thing on my cheek after 27 days, since it healed so fast in 3/4 days, can i forget being syphilis?
3)Would the inicial 1g of amoxicilin course, 1month ago, interfere with my final 6 weeks results for HIV and Syphilis? Can i still put my faith in the 6 weeks tests for Conclusive results for both?
4) Is my HIV and Syphilis tests at 29 days really good indicator for the final 6 weeks result?
I just want to put all this behind me after the 6 weeks, and resume sex with my wife with no worries. Its been a hell of a month, and for sure i will learn from all this and never do it again. I love my wife.
 |
H. Hunter Handsfield, MD
13 months ago
|
You're really having trouble accepting or believing the main points we discussed in your previous thread.
1,3) Antibiotics rarely make tests negative while an infection persists. They make the tests negative by curing the infection. You can rely on your negative test result, and on any future testing you might do.
2) Having had amoxicillin, syphilis was impossible; doesn't cause painful ulcers; syphilitic ulcers don't heal so fast; and your negative tests are conclusive.
4) I have never seen or heard of a patient who tested negative at 4 weeks and later turned out to best positive for HIV. And syphilis is impossible for the reasons already discussed.
You should have resumed sex with your wife long before now. You certainly can do so safely at this time.
I suggest you go back and re-read my closing comments in your previous thread.
HHH, MD
--- |
13 months ago
|
The ENT also found that my throat was irritated and red because of acid reflux, and probably my glands are acting weird because of inflamation and the previous tonsilitis. I believe the science and all your statements, that if it would be ARS, HIV test would be positive for sure. Im confident in that sir.
1) No need for any more chlam/gono throat swab+urine tests, even with the amoxicilin, they are 100% accurate, correct? would just be a waste of money.
2) Just to clarify, the "ulcer" type thing on the mouth was not painfull at all, but it stinged a little bit when i passed the tongue. But since it healed in 3/4 days, i can be confident it was not syphilis. And, 4 days after the last exposure, the start of 1g amoxicilin (2 times a day) for 8 days, would for sure abort any possible syphilis infection. So basically, with all this, the chances of me having syphilis are almost, if not zero. Is that it doctor?
3) After the 6 weeks have passed, there is absolutely no point in doing any more 4th gen HIV tests and VDRL(RPR) tests, despite the old saying and conservative 3 month period, and i can surely forget about all this and be 100% confident in my negative results for both of them. They are 100% conclusive at 6 weeks, correct doctor?
|
13 months ago
|
I feel confident in resuming sex with my wife. But, i wasnt going to take those risks without first trying to clarify all my doubts with you. I dont care about me, i just care about her safety. I'm sure you understand me Doctor.
Im looking forward to the 6 weeks and forget about all this and be happy. This was a learning lesson for me.
God bless you. and thanks for everything you did for me doctor. For sure you made an impact in my life.
|
H. Hunter Handsfield, MD
13 months ago
|
Our forum only deals with STI problems, and you don't have any. I have no comments or advice about your sore throat or other symptoms. Keep working with your ENT or other doctor(s).
1) Yes, correct.
2) You're already been informed it is impossible the ulcer was syphilis, including all my reasons for that evaluation. I haven't change my mind. Stop asking, no matter what other details come to mind.
3) All correct.
---
---
Of course you are free to test at 6 weeks if you wish, strictly for additional reassurance, if my reasoned, science-based evaluations is not sufficient to calm your fears.
Thanks for the thanks. I'm glad to have helped.
------
---
|
13 months ago
|
Hi Dr,
about one thing you said, regarding my chlamydia/Gono throat and urine PCR tests.
"Antibiotics rarely make tests negative".
The 1st PCR throat swab was done 2 days after starting the 8 day course of 1g of amoxicilin two times a day, so, done while on antibiotics.
The 2nd throat swab+urine PCR tests for chlam/gono were done 4 days after finishing the 8 day course of amoxi.
You said "rarely" makes tests negative, but in my mind rarely is not never.
So my question is:
1) In the unlikely scenario the first test missed the infection while on amoxicilin, would the second test 4 days after finishing it be accurate and 100% reliable? Since i've done 2 two tests, im assuming one could back up the other in that sense.
This tests are super expensive and i cant really aford too many. I want to know your opinion on this scenario, and if i can put my mind at ease with the tests ive done for these two STIs.
What would you do if i was your patient and with this scenario? Would you be worried or would you stop testing me for these STIs?
2) Also, have you ever seen a negative 6 week HIV 4th Gen and Syphilis vdrl become positive after 6 the weeks? Or you simply stop testing after that as they are 100% conclusive in that 6 week period?
Im doing my 6 week tests on Monday, and im confident in the results since i talked with you. The i will resume sex with my wife.
|
13 months ago
|
3) (forgot to add this) I also did a Trichomonas test in urine, 1 day ago. Negative. Was by microscope. I know it is not as accurate as the PCR but it was not available. I was still happy about the result. Do you think i should perform pcr or i can be confident in this? I have no urinary tract symptons whatsoever.
Should i also test for M.Genitalium? Or is it just me overthinking too many STIs? Like i said, no symptoms in my penis or urinating, nothing. In my head i think i dont need to test for this 2. I just wanted to hear your thought on this 2 in particular.
|
13 months ago
|
For the Trichomonas and M genitalium, i wont seek any testing if you say i dont need it. Based on my lack of symptoms.
|
13 months ago
|
I also did a standard urine test which showed all normal values, including leukocites, PH and all other things. All normal.
Sorry to add this details in separate message, I forgot to add it, and just thought they would be important after writing the other questions. Hope you dont mind doctor.
Hope you have a nice day
|
H. Hunter Handsfield, MD
13 months ago
|
Having had only condom protected sex (on two occasions, as I recall?) and an oral sex exposure, followed by the antibiotics you had, there is no point in syphilis testing (impossible, having had amoxicillin) and I would not advise testing for M. genitalium or additional tests for trichomonas; the microscopic test for trich was useless, but you were not at risk for either of these. There was no point in having a routine urinalysis, but in any case those results were normal. You have been over-tested and over-evaluated already. It's time to let it go.
That concludes this thread. Please note our policy against repeated questions on the same topic. Having had two discussions about these exposures and your subsequent testing etc, this will have to be your last one; future questions on these topics will receive no reply and the posting fee will not be refunded. This policy is based on compassion, not criticism, and is intended to reduce temptations to keep paying for questions with obvious answers. In addition, experience shows that continued answers tend to prolong users' anxieties rather than reducing them. Finally, such questions have little educational value for other users, one of the forum's main purposes. Thanks for your understanding.
I do hope the discussions have been helpful. Best wishes and stay safe.