[Question #12762] risk from oral
5 months ago
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Had unprotected oral in May 2024 from a female swinger whose partner is bisexual. My main partner was pregnant. Same day had 500mg cipro single dose and after 72h 200mg doxy bd for 2 weeks along with 1 dose of azithro 250 or 500 mg a week after. No symptoms. Urine NAAT PCR 7 weeks afterwards negative (even for mycoplasma, all bacterial stds) but detection threshold of 500 copies/ml. Concern also that urine was not first morning void but decent timing since last urination (and propably first void).Mild urethral twinging a couple of months after wards, no other symptoms. 6 months post caesarean (9 months post event) had sex with partner and 3 days after complained of vaginal stinging but mainly itching that improved with canesten (might be a confounder) and some abdo cramps 2 weeks afterwards. Since naat was negative and also vdrls and virus pcr negative, should i re-test to exclude gonorhea? Very worried especially for gonorhea although bayesian statistics say not to worry
5 months ago
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contact was late 40s/mid 50s. 3-4 weeks after naat had some penile irritation but attributed it to wearing same suimsuit which would dry up on me for several days. Attributed wifes cramps to possible ovulation pain. Did not take 2g azithro myself as had gi side effects in the past. Regarding cipro risk encounter was in the UK where gono resistanve to cipro is 46% so thought it would halve my risk (data from 2021)
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Edward W. Hook M.D.
5 months ago
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Welcome to the Forum and thanks for your questions. I'll be glad to comment. While testing is always a personal choice and if you need the reassurance, is easy to do, I anticipate that should you test, your repeat tests will also show that you were not infected. Why-
1. You do not know that your casual partner had gonorrhea or any other STI. In fact, most persons involved in swinging are cautious and are not infected.
2. If that partner was infected, most single exposures do not lead to infection.
3. You have negative tests. The tests are quite sensitive. The limit of detection is far, far below the level of organisms typically found in infected persons
4. The antibiotics you took- cipro and doxy even if you did not take azithro, while not recommended therapy do have some activity against gonorrhea and could have treated an infection in the unlikely circumstance that you were infected
5. The symptoms you describe are really not those of an STI.
Testing is always a personal choice however, should you test, as I said above, I anticipate that follow-up tests will be negative. I think you are on "high alert" for possible symptoms and worrying about symptoms that you would normally not focus on or attribute to other causes.
I hope these coments are helpful. EWH
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