[Question #3926] Persistent Chlamydial Symptoms

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85 months ago

I am a 26 y/o male and am writing about concerns over persistent symptoms after chlamydial infection. About a month and a half ago, I had unprotected vaginal sex with a female. About 3 weeks later I noticed some yellow discharge and then some burning and tingling followed. I went to the local health dept a few days later and was diagnosed with NGU and treated with Azithromycin 1g.

A week later I still wasn’t noticing improvement, so went to an urgent care. The urgent care prescribed me doxycycline 100mg BID x7days as well as treatment for trich, Flagyl 2g. They also ran a urine screen which was +chlamydia. I took the doxycycline as prescribed and my symptoms improved a little bit but there was still some minor clear discharge every now and then if I milk my penis. I scheduled an appt with a PCP (PA) last week and she ran another urine test for chlamydia and she felt that it was just post infection inflammation and that it would clear with time. My test result came back negative. I was beginning to feel almost back to normal until I made a bad decision last Saturday to masturbate and it caused irritation inside my penis and ive felt a little more burning over the last 5 days and some minor clear discharge upon milking the penis. I went back to the health dept yesterday and am waiting their results on another chlamydia test to ensure it is negative.

Im mainly reaching out for advice from experts just to give me a peace of mind. Is it common for chlamydia symptoms like this to continue? Do you feel that there could be another infectious cause at this point? Do you feel like my next step should be to schedule an appt with a urologist? I am beginning a new relationship and am concerned.

Thank you in advance for your time and thought.     
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Edward W. Hook M.D.
85 months ago
Welcome to our Forum.  Thanks for your confidence in our advice.  I have several comments but to give you the bottom line, my advice for now is to wait things out and I suspect they will subside.  

 The azithromycin you took is 97% effective for Chlamydia and the doxycycline is 100% effective.  Further, if you happened to also have trichamonas the metronidazole would have cured things.  Thus the chance that your persisting, but apparently improving irritation is due to treatment failure is extraordinarily low.  

I think it is too early to see a urologist at this time.  The only other possible thing you might do at this time is to,ask to be tested for Mycoplasma genitalium (NOT Mycoplasma hominis) which is an occasional cause of persistent urethritis.  To be honest however, I think all will subside with time and I would urge you not to worry.  I hope this is helpful.  If there are further questions, please feel free to use your up to two followup questions.  EWH
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