[Question #4330] Help, please

30 months ago
Hello, I am hoping you can help shed some light on a very distressing situation. My husband and I have been married nearly 3 years, and apart from a very brief separation in early 2017, we have been on what I have thought to be solid footing. Before I start, I should let you know that I was last screened for all STDs as part of a pregnancy panel in June of 2017.  This included, among other things, HIV, Hepatitis, Syphillis, Gonorrhea and Chlamydia.All were negative. Yesterday, my husband told me that he hadn't been feeling well for 2 days.  He was complaining of lower right abdominal pain and pain inside his penis. Later in the day, he started to complain of light staining in his underwear from discharge (clear to white colored). This morning, he was having excrutiating back pain and complained that his urine was dark and had an odd odor.  He went to an urgent care where he was told he likely had Gonorrhea or Chlamydia and was prescribed two different antibiotics, although lab tests are pending.  When he came home, he accused me of cheating with my new boss with whom I travel. I have done NOTHING of the sort. My husband and I Iast had oral sex 5 days ago and vaginal sex approximately 10 days ago. He said the doctor said it lined up perfectly with me giving him an STD. I am devasted. I would like to mention that this has been a particularly stressfull 2 months in my life. My new job is very demanding and my mom just died. I developed an odd rash on my body 3 weeks ago. I had 3 little bumps that scabbed under my left breast, 3 on my left hip and one behind my knee.  They were not painful. I went to my derm asking if they could be shingles because of stress, but she said they were too far healed to tell.   She said they could be anything, even herpes. Can you shed some light on this?  Could I have given him herpes without knowing I had it? If this is Gon/Chlamydia, could I be a carrier in my throat without knowing I had it? I have never had a throat culture. Thank you. 
Edward W. Hook M.D.
Edward W. Hook M.D.
30 months ago
Welcome to the our Forum although I, like you, wish you did not feel the need for out services.  I have read your description of the recent events involving your husband and am not convinced that his problem is an STI.  A number of the symptoms that you describe are not at all characteristic of STIs- these include abdominal pain which is extraordinarily rare among men with STIs and dark urine.  While I cannot examine him myself, there are a number of diagnoses that I think of for these symptoms before I think of STIs- these include hepatitis (potentially from food), kidney stones, prostatitis, and other non-STI abdominal problems. I disagree with the doctor who say them that his symptoms lined up "perfectly" with STI and I am confident that I know far more about STIs than the doctor who saw him.  My suggestions are:

1. Wait for the STI test results.  If they are negative, this is all the more unlikely to be an STI.
2.  See if the treatment he received helps the symptoms.  Even if they do, the response to therapy could be non-specific and represent a number of other possible problems.
3.  It is of value for you to go and be screened tested for STIs, including at the throat.  While I doubt that infection is present, I think proving it might be reassuring to your and your husband. 
4.  the bumps you describe do not sound like an STI.  It sounds as though they did not sound that way to your dermatologist as well. 

You may want to share this response with your husband.  I suggest you wait for the test results. Please let me know what they show and I can comment further.  I should also point out that we permit just a total of three responses for each posting.  I look forward to hearing from you once there is more information available.  EWH
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30 months ago
Thank you so much! I shared this with my husband and he would like to offer some points of clarification: 

1) The pain is more in his lower groin than abdomen

2) The discharge comes out clear and a bit sticky and dries white. The discharge is getting heavier by the day, enough to make his underwear  a little damp

3) He has also had a low-grade fever (99.7) and is chilling

Does this change your assessment at all? 

Also, for my own knowledge, because I have never had a throat culture, if I had been exposed to gonorrhea, how long would it persist in the throat? Indefinitely?  For years? We have had oral sex countless times since we reunited in Jan of 2017 and he is only now experiencing symptoms. Also, I  was on oral doxycycline 100mgs a day for 3 months for perioral dermatitis (May-July of this year), would that have been effective against gonorrhea if I had contracted it in the throat years ago? 

Edward W. Hook M.D.
Edward W. Hook M.D.
30 months ago
Thanks for the additional information.  The additional information you provide further suggests that this is not an STI.  If this were gonorrhea or chlamydia, the treatment he received would have taken care of it.  In my opinion, he needs to see a different doctor.  STIs do NOT typically cause fever of this sort and do not cause lower abdominal or groin pain.  My suggestions remain the same- you should be tested, Including the throat but this really does not sound like an STI. 

Finally, asking "what if" questions about gonorrhea is not helpful.  EWH
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