[Question #12476] Test Result Question

7 months ago

Hi Doctors. I hope you both had a wonderful holiday season. I have a rather simple question. I had anal symptoms (even though condom use - the doctor said they are seeing more cases of positive Gonorrhea in the anus with fingers being used) and had tests run. I cannot speak to the doctor until later next week and had a question about the results. PCR results were negative for everything but they also took a Stool Culture for Gonorrhea. The result was "Mixed gram-positive and gram-negative aerobic flora". Does this mean I was positive for Gonorrhea? The doctor did give me a shot of Ceftriaxone as I went out of town after seeing them. Thanks

H. Hunter Handsfield, MD

7 months ago

Welcome to the forum. I'm happy to answer these questions.

This information is slightly confusing; I think you didn't get a very clear description of the tests by the doctor you saw. First, for sure you didn't get gonorrhea by fingering, and a properly condom that doesn't break is nearly 100% protection, so it's unlikely you were infected at all. The standard test for anal gonorrhea is a nucleic acid amplification test (NAAT), and PCR is a NAAT; that probably was the gonorrhea test (and almost certainly included chlamydia as well). Culture is rarely used anymore to diagnose gonorrhea, and the results you describe are exactly what every rectal culture shows; it just detected your normal rectal bacteria. In any case, if somehow you did have gonorrhea and it was missed by the NAAT, ceftriaxone is 100% reliable in curing it -- so if you had it after all, you've now been cured. And you can also be confident you don't have rectal chlamydia.

The only remaining issues are possible testing for HIV and syphilis and whether you have considered doxy-PEP. Any male who has anal sex with other men needs periodic testing, even if all exposures seem to be safe. If you haven't had these tests recently, now would be a good time, while it's on your mind. Also you might look into doxy-PEP, i.e. a single dose of doxycycline (200 mg) within 72 hours of anal sexual exposures, to prevent chlamydia and syphilis; it also reduces the risk of gonorrhea by 50%.

I hope these comments are helpful. Let me know if anything isn't clear. Happy new year and stay safe!

HHH, MD

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7 months ago

Thanks doctor. I use prep and doxyprep.

7 months ago

Doctor - thanks for your reply. I do go to a Sexual Health Center that focuses on Prep and Sexual Health. Maybe there were wrong but said they have seen more tops with rectum STIs which they attribute to fingering. They also relayed you could get Gonorrhea from kissing which alarmed me. They said it is not likely but happens. When I went in for 3 month check up, they did say the flora test was normal. Thanks for all that you do. I di

6 months ago

Doctor - my last question. I did get tested with pcr for oral gonorrhea 7 days after last incident and was negative. However, for last 3 weeks I have still experience a dry/minor sore

Throat. Should I get tested again or put this incident behind me. Could be allergies I guess.

H. Hunter Handsfield, MD

6 months ago

Oral gonorrhea rarely causes symptoms, and your negative test result is reliable. I am confident your current minor symptoms have nothing to do with the sexual exposure you are concerned about and see no need for additional testing.

Best wishes and stay safe.

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