Hi Dr.

July 8 - I(M)had unprotected sex outside of my formal relationship. Took 200mg doxycycline next day. 

In following days I experienced symptoms that the urologist diagnosed as balanitis which got resolved. After some days I continued to have symptoms such as burning after urinating, a sensation of a full bladder, and occasionally burning in the testicles or perineum, never discharge, painful erection or ejaculation.

July 29th - Took a PCR via urethral swab for chlamydia, gonorrhea, ureaplasma, trichomonas, and mycoplasma, and it came back negative for all.

August 6 - I continued to have discomfort urologist prescribed 7 days of doxycycline 100 mg every 12 hours.

September 8 - First sexual relation with my partner(F) who I am pretty sure did not have anything at the time. Relationship was less than 3 minutes, without ejaculation as I started feeling discomfort.

September 24 - Took a PCR test in urine for the same panel of infections, and this time it came back positive for chlamydia, gonorrhea, and ureaplasma

September 29 - Started treatment 1 g of ceftriaxone for me and my partner each and 28 days of doxycycline for me and 14 for her(asymptomatic). Urologist diagnosed prostatitis due to chlamydia and said these are difficult to treat.

I’m not sure if doctors in Mexico are up to date but wanted to ask if these treatment would be appropriate.

Also wondering what happened to the first PCR panel that was negative and in case it was a flase negative why the 7 doxycycline days I took on August did not work at least for chlamydia.

Your symptoms are not typical of any STI and do not fit with any of the infections for which you were tested.  Your test results were reliable in showing you were not infected when tested July 29. No STI causes balanitis, burning after urinating (without discharge), "full bladder sensation", or testicular or perineal discomfort. Your symptoms were most suggestive of a psychological origin-- your anxieties and concerns about STI. You should not have been treated with doxycycline and certainly did not need treatment with ceftriaxone, and neither did your partner. Chlamydia does not cause prostatitis, and it is impossible you had chlamydia after taking 200 mg doxycycline after the sexual exposure.

I am confident you and your regular partner have no STI and never did. I would advise against any further treatment and against any more testing of any kind.

Let me know if anything isn't clear.

HHH, MD

Are you confident you regular partner wasn't having sex with outside partners during these events? When one member of a couple finds a need for new sexual experiences, the other often has done the same. Of course you're the only one who can judge that likelihood for your partner. If there is no chance of this, and if indeed you immediately had another test that was negative, that confirms the false positive nature of the 9/24 results. (However, you don't say exactly when that next negative test was done. If already on antibiotics, we're still left with the likelihood your regular partner became infected from someone else.) The proper procedure when the 9/24 result became available would have been to immediately re-test you AND to test your partner. (By the way, you can Ignore the Ureaplasma result. It's an entirely normal bacteria in the genital tract of both men and women and rarely causes symptoms or disease.)

Even if the 9/24 test results were true positives, I see no need for the prolonged treatment you were prescribed.

The October 8 negative results are reliable, regardless of the antibiotics. Those antibiotics are 100% reliable in actually curing gonorrhea and chlamydia; they never merely suppress the infection to give false negative test results. "Low bacterial load" is often mentioned as an explanation for false negative tests, but there is absolutely no proof or science that supports this; it is entirely opinion by mostly non-knowledgeable persons. After your current treatment, there is no medical need for test of cure. Of course you are free to be tested if you wish, but it would be strictly for reassurance, to confirm what you already should know for certain.