[Question #12060] Testing Negative but Symptoms
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10 months ago
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Hello, Hoping for some answers. Had an exposure with female CSW. (I am male). Tested negative for Gonorrhea and Chlamydia. Doc thought it could be a UTI was given Ciprofloxacin for 2 weeks.
Symptoms did not go away went to ER. ER Doc prescribed Cefixime 800MG for one day followed by Doxycycline 100MG twice a day for 7 days.
Symptoms continued. Went back to family doctor. Was given metronidazole to clear Trich. Twice a day for 7 days.
One week after finishing the Metronidazole, was tested for Trich and Mgen. URINE test for both came back negative. Also tested negative for hiv/syphilis (8 week mark)
Questions:
How accurate are the URINE tests for Trich and Mgen. Provided 40ML urine sample for test. Did not pee 2 hours prior to test. Should I believe my results? Do you recommend any other tests/ or retests as symptoms are still present.
Can I have sex with my regular partner?
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Edward W. Hook M.D.
10 months ago
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Welcome to our Forum. Thanks for your questions. I'll do my best to help.
It sounds as though you've done everything well. Your exposure was relatively low risk- most commercial sex workers do not have STIs and most exposures to infected partners do not result in transmission of infection. While ciprofloxacin is not the best treatment for STIs, cefixime and doxycycline in the amounts you took would cure almost all gonorrhea, and chlamydial infections. Your tests results prove that you were no infected. The metronidazole you took would cure trichomonas if present
Bottom line, at this point there is no evidence that you have had an STI. I see no need for further testing and no need to abstain from unprotected sex with your regular partner. EWH
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10 months ago
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Hello Doctor, Thank you for the reply.
I have just a few questions as a follow-up as my symptoms of Urethritis are not clearing and its hard to think this is anything else because all these symptoms started 12 days after my exposure! I am now at almost 3 months with these symptoms.
My questions are around Trich and Mgen.
1. Would the metronidazole clear my Trich (2x for 7 days). I read online that males are supposed to have a one time dosage?
Or would taking the medication for a longer period of time give better results?
2. Would taking all the antibiotics before the metronidazole has any effects of it lowering the success of the metronidzole? Ie antibiotic resistance?
3. I know I asked below, but how accurate are the tests for MGEN and Trich I took? Both were urine tests, and done 1 week after I completed the metronidazole.
4. Would testing for Trich and Mgen a week after finishing metronidazole be too soon to test?
This has been a really stressful time for me, with my symptoms not clearing. I look forward to hearing your response and i am thankful for the information this page provides!
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Edward W. Hook M.D.
10 months ago
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In follow-up:
1. Would the metronidazole clear my Trich (2x for 7 days). I read online that males are supposed to have a one time dosage?
The metronidazole that you were given is more than adequate for treatment of Trich. Have confidence that if trich were present you would have been coured
2. Would taking all the antibiotics before the metronidazole has any effects of it lowering the success of the metronidzole? Ie antibiotic resistance?
Metronidazole resistance is rather uncommon and, given the dose of metronidazole you took, you can be confident that if you had trich it would have been cured.
3. I know I asked below, but how accurate are the tests for MGEN and Trich I took? Both were urine tests, and done 1 week after I completed the metronidazole.
The urine tests you took are the current "gold standard" for diagnosis of MG and trich. If your tests are negative, you do not have these infections.
4. Would testing for Trich and Mgen a week after finishing metronidazole be too soon to test?
No
The assumption that, because of timing, this must be an STI may not be correct. Men occasionally get UTIs although I would anticipate that the symptoms you describe would have improved with the antibiotics you took. Non-STI prostatitis and kidney stones can also cause irritation of the sort you describe. Finally, when persons are worried bout STIs and looking for symptoms, there is a tendency to notice otherwise normal sensations that would usually not be noticed. If your symptoms continue to concern you, it is time to see a urologist. EWH
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10 months ago
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Hi Doctor, As per your advice I have booked an appointment with a Urologist.
I just have two final questions. I appreciate all the responses you have provided.
As I mentioned in my original post, When I went to the STI clinic to test I was asked by the nurse to provide a 40ML Urine Sample to test for Trich and MGEN. In your opinion, would the sample I provided with 40ML Urine provide accurate results? I have read that it should have been between 20-30 ML as more of a "concentration" is required for testing? Is this true? My test as I mentioned was Negative for both MGEN and Trich.
With the presence of symptoms, which I have (Urethritis) I am assuming even with the 40ML Urine Sample, my test would have came back positive if I had these STI's? Is that safe to assume?
Thank you for all your help doctor. I am hoping to move on after this question of my issues being related to an STI and live a normal life, but this has been very stressful.
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Edward W. Hook M.D.
10 months ago
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That you provided a 40 ml specimen does not chance the accuracy of your test results. You do not have trichomonas of M. genitalium. Believe your test results
I hope you will move forward. You do not have an STI.
This completes this thread. EWH
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