[Question #545] coincidence or further evaluation

39 months ago
Hi doctor Dr. Hook. You recently responded to one of my questions where i tested negative twice for gono (however I took antibiotics before one test) and once for chal due to an unprotected oral sex exposure. I never showed symptoms but I went for treatment because of my concerns, which I received a rocphine injection and 1g of azithromycin as preventative measure.  I then waited seven days before getting back with my partner and we were never together until after i received  treament. You stated my treatment and test results were sufficient and no worries moving forward. 

My question is what is the chance of false test or my treatment failing if I was infected? Here is why. Recently my partner was having back, stomach, and pain in the private area. My partner was diagnosed by the doctor ( which I wont share at this time unless you need more information); however, my concern is because of the pain in the private area . The only symptoms of PID this person has is pain in the abdomen and private area but it also goes along with the diagnosis. Could this be PID because of my unexposed oral event from a few months ago? I know it sounds crazy, but when my partners pain started, I felt like maybe my mistake was coming back to haunt me. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
39 months ago
Welcome back to the forum. As clealry stated in the introductory information, users don't have the priviledge of choosing the expert who will respond; Dr. Hook and I answer the STD/HIV questions based on availability and timing, i.e. more or less randomly.

Your partner's symptoms are a coincidence. The only STD from oral sex that could cause PID is gonorrhea. Other STDs from oral sex, such as nongonococcal urethritis (NGU), are not known to be caused by bacteria that can cause PID. The is a very small statistical chance that any one test for gonorrhea could be falsely negative; that you could have acquired gonorrhea without symptoms; or that the treatments you had would not have cured it. But the odds that all of those things happening -- including 2 negative tests -- is statistically too low to be realistic. Zero chance for all practical purposes. Therefore, you can be 100% confident your partner's symptoms are not due to gonorrhea from your oral sex exposure. In other words, I agree exactly with Dr. Hook's evaluation and advice.

As for your partner's symptoms, there is too little detail for me to say very much. "Private area" is nonspecific; you refer to abdominal pain, but is that all? Does she have any sort of genital pain (vaginal? labia?). Pelvic (low abdominal) pain is a common symptom of PID, but also of a large number of other disorders:  endometriosis, appendicitis, ovarian cyst, diverticulitis, and more; as well as mild, unimportant intestinal infections. PID is usually accompanied by other symptoms as well, such as abnormal vaginal dischrge. The important thing is that she be professionally examined to learn the cause of her pain. If she does so, you need not mention your other exposure or treatment. There is no realistic chance it has anything to do with your partner's problem.

I hope that helps. Let me know if you have other information about your partner's symptoms or if there is anything that isn't clear.

Best wishes--  HHH, MD

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39 months ago
She has no vaginal discharge, fever, pain during sex, or vaginal order. I am confident in what the doctor diagnosed, but I thought there was a small chance of PID because of my poor decision and the pain in the lower abdominal and vaginal.  Right now, her symptoms are improving. If I have additional questions, I will be sure to return. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
39 months ago
You didn't say what her doctor diagnosed, but I'm glad it's apparently not serious. I don't think you need be at all concerned about PID or anything else related to your outside sexual exposure. Best wishes.

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39 months ago
Is it safe for me to share that diagnosis information here? 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
39 months ago
I'm not sure what you mean. The forum won't share information with anyone, and I have no way to know your identify.

Note that the forum policy is that two follow-up comments/questions and replies are included with each new question, and we're technically at that limit now. But if you want to provide any more information, I'll be happy to comment one last time before closing the thread to new comments.

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39 months ago
She was told she has kidney stones. She had very bad back pain, then stomach pain, then it went down to her vaginal area, and the pain radiated down her leg.  That is where my concern happened. She is still having on and off pain today near her urethra and then at times her back and stomach. She is better but not 100%. Is this normal with kidney stones?  Should this be of concern to me? 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
39 months ago
The pain of kidney stones is very different than PID, and I agree this further description doesn't suggest PID. I'm sure her doctor is correct. 

So all is well. Support your wife as needed, if her symptoms continue. But don't worry about the oral sex event. It has nothing to do with her symptoms.

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