[Question #12510] Follow Up Question #12398
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7 months ago
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I'm sorry for coming back again, but I'm worried about the possibility of gonorrhea complications and the insufficient dose of treatment.
I still don't trust the test I did at home. One reason is that the city where I sent the sample by cargo is 480 km away from here and I suspect that the sample may have been spoiled during cargo and there are other reasons I wrote.I went to another doctor and she said that the 2 boxes of doxycycline I had taken before could not cure gonorrhea and that rectal gonorrhea could be asymptomatic for years. She prescribed me a 500 mg ceftriaxone injection just in case. She said that 250 mg was actually enough, but she gave me 500 mg to avoid taking any risks and I had the injection yesterday morning and the doctor said that nothing else was needed and that it was enough. I know that according to the CDC, there is no need for post-treatment testing for uncomplicated urogenital and rectal gonorrhea. However, I am concerned that I may have complicated gonorrhea because I started treatment so late and had some symptoms beforehand.
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7 months ago
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I probably had ReA after exposure and the doctor said it could also be possible and gonorrhea could do it.(such as joint pain, skin rashes, diarrhea,petechiae, red eyes)
At that time, I had iron deficiency and received iron treatment.
And if I have experienced complications of arthritis and dermatitis due to gonorrhea, does that mean 500 mg will not be sufficient? According to the CDC, 1 g is necessary.
Additionally, the fact that I started possible gonorrhea treatment 22 months late scares me.
And, in the last blood test I had a few weeks ago (CBC, CRP, Sedimentation), everything was normal, and I still have no rectal or any other symptoms. Nevertheless, could there still be such complications?
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H. Hunter Handsfield, MD
7 months ago
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I'm sorry you remain so concerned. It is clear you have no ongoing STI from the exposure you are concerned about. It also seems that your reactive arthritis also has resolved, right?
You really are not being the rational person that you seem to be, at your core. Science is against your fears.
Nucleic acid amplification tests (NAAT) of all kinds, including those for gonorrhea, are extremely robust. That the specimen had to travel to the lab, and even if exposed to temperature extremes, does not significantly alter performance of the test. You did not have gonorrhea. And if you did, the treatments you had were entirely reliable. Gonorrhea does not become more resistant to treatment as time passes. And as I believe we discussed in your earlier thread, if you had acquired gonorrhea nearly two years ago, it would have been cleared by your immune system long go, even if you had not been treated. That you apparently had ReA does not change the response of gonorrhea (or chlamydia, or any other STD) to treatment for them.
Do your best to accept reality and move on without further worry. If you cannot, perhaps professional counseling would help to move you to a point of more rational analysis and acceptance of the truth.
HHH, MD
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7 months ago
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I'm sorry, doctor,I can't think rationally about these kinds of issues, you're right. And yes my ReA symptoms went away a long time ago. I will try to trust, as you said, regarding the NAAT.
Actually, I went back to the doctor this morning due to my anxiety the doctor said that I don't have a complicated condition and that as you mentioned, my ReA symptoms have already resolved, She said 500 mg is enough. However, She saw that I was very obsessive and prescribed me 1000mg Novosef(ceftriaxone) again and told me not to have any more questions in my mind and not to think about this issue.
I gave the medication to the nurse, and she administered the injection, but without reason ı suspect that the nurse mixed the vial with another vial after taking it out of the box. When I called to ask, they assured me that they wouldn't make such a mistake. However, I didn't see that moment.I gave the medication to the nurse, and she administered the injection, but I started to worry that nurse mixed the vial with another vial after taking it out of the box. When I called to ask, they assured me that they wouldn't make such a mistake. However, I didn't see that moment.
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7 months ago
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Maybe I misunderstood, but You mentioned in the previous title that there is no good data on the natural cleaning of infection from the rectal area.Honestly, your saying that it would be cleansed now has confused me. If the nurse did mistake, would it still be cleaned?
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7 months ago
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With your permission, I have a few additional quick questions for you in the final follow-up.
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H. Hunter Handsfield, MD
7 months ago
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Sorry, but it's your responsibility and our requirement to participate in this forum to "think rationally about these kinds of issues". I knew your arthritis symptoms had cleared because it isn't possible to have active ReA with normal ESR and CRP tests.
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Personally, I think it was a mistake for your doctor to accede to your anxieties by giving you another ceftriaxone treatment, at any dose. We would not have done so in my clinic. Antibiotics are not used to treat anxiety. And of course the idea that somehow you received the wrong drug is ridiculous.
"Little data" referred only to the timing of rectal infection clearance, but for sure it happens within a few months, every time.
You may add one more additional comment on this thread, not two or three as you just posted; and it must be very brief. If it asks for confirmation of information already provided, the thread will be closed without further reply.
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7 months ago
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I called the hospital twice and they said there would be no such mistake. Actually the nurse seemed very careful but I am worried because I am obsessed with thinking the worst because people can make mistakes and maybe this happened to me.
There are very few sources on the internet stating that gonorrhea is expelled from the body, unlike what you say; most say it does not go away without treatment. I'm curious, what is the reason for this?
When I asked my doctor if rectal chlamydia and gonorrhea could remain silent for years, she said "yes," and this worried me.Is the doctor wrong?
Can I be sure that I don't have an STI? Honestly, I've been living with this psychology for almost 2 years.
Thank you for your answers and help Dr Handsfield.
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H. Hunter Handsfield, MD
7 months ago
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"I am obsessed with thinking the worst...." You need professional mental health counseling.
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Gonorrhea "expelled": Dr. Hook and I are recognized as being among the world's top gonorrhea experts. He or I have been the authors of the main gonorrhea chapters in three of the world's most prominent medical and STD textbooks. You can accept our expertise or not, that's your choice. Your doctor clearly does not match our gonorrhea/STD expertise. Gonorrhea and chlamydia certainly can persist for long times in some cases, but when that happens, the standard tests are positive. You can trust your negative test results, as well as the repeated (and largely unnecessary) treatments you have had.
"Can I be sure that I don't have an STI?" Yes.
"...I've been living with this psychology for almost 2 years." See my first comment at the top of this reply.
We are not a counseling service. Repeated questions on the same topic are not permitted on the forum, especially when driven by anxiety, obsessions, etc. This being your second about the sexual exposure described and your gonorrhea/chlamydia fears, it must be your last. Repeated anxiety driven questions are subject to being deleted without reply and without refund of the posting fee. ASHA does not wish to collect fees for questions with obvious answers; repeated replies often prolong anxiety rather than relieving it (there's so often a "yes but" or "could I be the exception" sort of thinking -- exactly a you have experienced); and such questions have reduced education value for other users, one of the forum's goals. Thank you for your understanding.
I do hope the discussions have been useful. Best wishes to you.
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