[Question #3818] chlamydia and HIV

32 months ago

Mr. Hunter

i had sex with lady, after 1 week i had discharge, sore throat, tonsil stones.

i went to hospital and had urine and urethral test, both neg. result, but DR. gave injection megion1g and 4 caps. of zithoromax 250 no changes, then he gave flagy 400 & cipropay 500 for 5 days, still no changed, went to new DR., repeat tests and all negative, then i had few night of heavy sweating the last is on second test (no fever).  

DR. gave unidox-10 days, again DR. gave suprax 400 -10 days no change. I redo test in new hospital and all negative, Dr. gave IV for 3 days 2x/day megion 1g, no changes. then i had very white tongue.

i had HIV 4thG combo test on 36 days of exposure, came negative, then DR. gave permixon160 for 1 month, no change.

i visit the ENT Dr. for my tongue, he gave flaunconazol 150 4 caps. and mouth gel.

In new hospital i redo all test, chlamydia came positive.

i had 2 test 4thG combo ,PCR at 73 days of exposure, test came negative. DR. gave tavanic 500 for 14 days but nothing changed. DR. gave doxydar 100 -10 days and mycosat for tongue. Then a general DR. made culture test but negative result- no fungal.

Note that the discharge i have is small and usually occur just in the night.

 my question are:

1. Do i need to repeat all HIV test with neg. results?

2. Why is my chlamydia not cured after the meds?

3. Am I possibly on prostata chlamydia infection? How to test and meds?

4. why i have white tongue? 

Note that all hospital i went to is using advanced lab for testing.
Edward W. Hook M.D.
Edward W. Hook M.D.
32 months ago
Welcome to ur Forum.  Your situation is difficult to determine.  Your initial symptoms were compatible with a chlamydial infection but could also be caused by self-limited viral infections..   It appears that you were tested for chlamydia with negative tests when your symptoms began, then treated with several antibiotics (azithromycin, doxycycline) which are highly effective for chlamydia and then had a positive test for chlamydia.  This is most unusual.  I would treat you again, with either azithromycin or doxycycline, 100 mg twice daily for at least 7 days (I would personally probably use the doxycycline).  In answer to your specific questions

1. Do i need to repeat all HIV test with neg. results?

No, your HIV tests indicate that you were not infected with HIV.  Your PCR and 4th generation tests confirm each other.  You did not get HIV from the exposure you have described.


2. Why is my chlamydia not cured after the meds?

As I said above, your results are quite unusual and hard to interpret.  Antibiotic resistant chlamydia are very rare.  On the other hand, tests are occasionally falsely positive.


3. Am I possibly on prostata chlamydia infection? How to test and meds?

Nothing you have reported suggests you have prostate infection.  Your small amount of morning penile discharge may be normal- a certain amount of small discharge on awakening is not necessarily abnormal.


4. why i have white tongue?

A white tongue can be normal and may not be a problem.


I hope these comments are helpful.  EWH


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32 months ago
could also be caused by self-limited viral infections.
How risky is that? how to test to be sure ? and can this be treated ?
I would treat you again, with either azithromycin or doxycycline, 100 mg twice daily for at least 7 days 
i already take Unidox for 10days and  doxydar 100 for 8 days both is doxycycline but azithormycin i take one time 4 cps , by this information which one you recommend and what is the maximum should be? 
On the other hand, tests are occasionally falsely positive. the test was AG is that possible to have it  falsely
Nothing you have reported suggests you have prostate infection.  Your small amount of morning penile discharge may be normal. but its still possible how to test that ?
its usually at night but not ALWAYS ,i did not have this discharge before burning sensation' when urinating , and sore throat still there and im worried for the chlamydia since it can lead to infertility 
for my tongue its not normal at all i hope that i can send you pic and i have burning sensation all the day 
in the few days i will repeat the test and i will update you of the result
Edward W. Hook M.D.
Edward W. Hook M.D.
32 months ago
could also be caused by self-limited viral infections.
How risky is that? how to test to be sure ? and can this be treated ?
Not risky.  self limited means it will go away on its own.

I would treat you again, with either azithromycin or doxycycline, 100 mg twice daily for at least 7 days 
i already take Unidox for 10days and  doxydar 100 for 8 days both is doxycycline but azithormycin i take one time 4 cps , by this information which one you recommend and what is the maximum should be? 
If you have not been re-treated since the chlamydia positive specimen was collected, I would err on the side of caution and re-treat.  OTOH, if you were treated again after the positive test, I would just re-test to make sure it was gone.

On the other hand, tests are occasionally falsely positive. the test was AG is that possible to have it  falsely
Yes

Nothing you have reported suggests you have prostate infection.  Your small amount of morning penile discharge may be normal. but its still possible how to test that ?
its usually at night but not ALWAYS ,i did not have this discharge before burning sensation' when urinating , and sore throat still there and im worried for the chlamydia since it can lead to infertility 
No, you need to accept my comment and relax.

for my tongue its not normal at all i hope that i can send you pic and i have burning sensation all the day
Sorry, we do not accept pictures.  All too often they are misleading.

I look forward to hearing your follow-up test results.  I anticipate they will be negative.  eWH

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32 months ago
Hi Doc, I had several test done recently, Hepa B / C, Syphilis, Urethral culture and CT/NG ( PCR),  it's all NEGATIVE.
However, symptoms of sorethroat (making me uncomfortable all the time) , urethral discharge (not really normal as you said it may be ) still persist till now.  Both symptoms started in Feb. 19, 2018 which is the 1st day I started taking the antibiotics, 5th day after having sex with lady.

For my tongue, I had 2 new test (1. culture and 2. B12). The result is Negative and Normal for B12. However, up to this moment my tongue is totally white and I believe it's not normal.

Please give me your opinion on the above cases.

Question ;
1.  what are the other possible bacteria/viruses that maybe causing discharge ? and what are the best test to do to diagnose my condition?

Please note, tomorrow I will have an appointment with a Infectious diseases doctor to discuss the result of my tests (mentioned above). I will update you should they will require me to do any other test.
Also note that in the last 2 months I lost approximately 10kg weight. And for the last couple of weeks, I am not being able to sleep at all.  Probably because up until now, I can not find a concrete answer on my health issues.

Thank you very much for your untiring attention and consideration on my queries. 



Edward W. Hook M.D.
Edward W. Hook M.D.
32 months ago
Thanks for your follow-up.  Your repeat test results confirm my earlier impression that your problems are unlikely to be due to a bacterial STI and suggest that you should look for other, non-STI causes of you difficulties.  Your tongue discoloration and the urethral discharge you describe may be unrelated.  

The only bacterial STI cause of a discharge that might ( but probably is not) cause a persistent discharge is Mycoplasma genitalium.  You might ask the infectious disease doctor to consider testing for this.  I also suggest that you not urinate for at least an hour before you see the ID Doctor.  This will assist him in his evaluation when he examines you.

For your tongue concerns, you might ask the opinion of an ear, nose and throat (ENT) specialist.

I hope these final comments are helpful.  This is my 3rd reply to your questions.  Therefore, as per Forum Guidelines, there will be no further replies from me.  I will leave the thread open for a day or two so you can provide the results of your interaction with the ID Doctor.  EWH


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31 months ago
Dear Doctor,
My journey to this health issue had been long and you were so helpful with your untiring sharing of information.
Sad to say, I had my test result today which POSITIVE "Molecular detection of Mycoplasma genitaluim DNA by Real-Time PCR".
With this result, please advise me with the best medication since I have already taken 2 cycle of Doxycycline ( 7 and 10 days ) and 1g of Azithromycin (1doz) and both of these did not help.
I just would like to commend your outstanding help to my health issue as I won't have any idea of this mycoplasma should you did not shed light on the matter. Nor my 6 doctors did not mention anything about this on my series of visits and consultation.



Edward W. Hook M.D.
Edward W. Hook M.D.
31 months ago
Mycoplasma genitalium may be resistant to both azithromycin and to doxycycline.  At this time the preferred alternative therapy is moxifloxacin, taken for 7-10 days.  The ID Doctor should know this

This will conclude this thread.  Thank you for sharing your results.  EWH
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