[Question #423] Possible chlamydia?

34 months ago
Dear doctor,

Please excuse my English.

Two months ago, after receiving a fellatio was tested for chlamydia, antigen urine test, and was positive. A new Ag urine test negative the next day to the antibiotic and also negative a Naat Rt-Pcr urine test 7 day later. My wife and I were treated with zitromax 1g. On december 17th, I made the same error receiving oral sex from the person who probably passed me the chlamydia. That day I took 1.5g of azitromycin but after eating a lot of food. After 25 minutes, I threw up (no too much). 
I had sex with my wife on December 19. Mainly anal sex. Excuse the detail: I noted my penis was covered of líquid feces after the sex.
On December 26, I started to have urinary symptoms: mainly discomfort on pubic área and urgent urination. I was tested on December 28 for chlamydia, gonorrhea and trycomones by Naat Rt-pcr and was negative. As the symptoms continued (including prostatitis-like symptoms), I took monurol (fosfamicine) 3g, on January 1, 3 and 5. The symptoms have definitely no cleared up and January 7, at 16:00 h I took 1g of azitromycin. Yesterday, January 8, at 08:00h I had vaginal sex with my wife. 
The symptoms seem to have stopped from yesterday.
In your opinión, I could pasa chlamydia to my wife? The Naat test on December 28 could be a false negative since I took azitromycin but the dose was not correct being partially thrown up?

My symptoms can come from the "dirty" anal sex?
Thank you so much

Edward W. Hook M.D.
Edward W. Hook M.D.
34 months ago

Welcome to the Forum.  Your text is a little hard to follow.  From your question it appears that in the past two months ago you have had a number of tests for chlamydia, only one of which, a single urine antigen test was positive.  Whether that test was correct or not is questionable since the next day a repeat test was negative and since acquisition of chlamydia from oral sex is very, very uncommon but, irrespective, at about that time you and your wife were both treated with azithromycin which should have been highly effective if you were infected.   You may have been re-exposed on December 17 and since December 26 a week after rectal sex,  have had urinary symptoms.   You have had negative tests for chlamydia and other STIs and have taken both azithromycin and fosfamycin.  You ask whether or not you or your wife might be infected with chlamydia or whether your rectal sex may have caused your symptoms.

    Rectal sex can lead to urinary tract infections and this may or may or may not explain your recent symptoms.  You do not mention whether or not your wife has been tested for chlamydia or for other partners.  My suspicion is that you are not infected with chlamydia and that your symptoms may be related to bacteria acquired by rectal sex.  You need to establish your current infection status.  I suggest that you and your wife both need be tested to understand what is going on.

I hope this reply is helpful.  EWH

---
34 months ago
Thanks doctor. Your assumptions are correct.

Just one further question: 

Can my Naat test of December 28 a false negative due to my partial intake of antibióticos (1,5g of azitromycin) or after 11 days the test would not be affected by this?

Thanks


Edward W. Hook M.D.
Edward W. Hook M.D.
34 months ago
False negative NAAT tests for chlamydia are very unusual.  Also, 1.5 grams of azithromycin would be curative for chlamydia.  Thus, whether or not you had chlamydia earlier, your negative test at 11 days following azithromycin should be considered proof that you were not infected at that time.  EWH
---