[Question #567] Risk of STDs/STIs from a single episode of unprotected intercourse

42 months ago

Hello Doctor,I am a male in mid 30s posted in a small town in an Asian country. I was buzzed last week and had a major lapse of judgement. I ended up having unprotected intercourse and unprotected oral with an asian woman who seems promiscuous.  From reading the posts on this forum, I came to understand that after a week of exposure, i shall get tested for CHLAMYDIA and Gonorrhoea. Once its about 6 weeks, then i shall get tested for syphilis and HIV. Do i need to get tested for anything else? 

 

I have been tested for all types of STDs/STIs in my home country and never had any of them but now i have been feeling slight burning sensation during urination and frequent urination. Now to get tested for CHLAMYDIA and Gonorrhoea, i went to a couple of clinics but since its a small town in an undeveloped country, the physicians don`t seem to have too much knowledge about these STDs and how to test them.  However, i found a testing lab that provides for testing of both CHLAMYDIA and Gonorrhoea. The problem is that they have a few types of tests for both the diseases. I`m mentioning them as below and i`d really appreciate if you could guide of on which type of tests to get done from the tests they provide. As per the lab, POLYMERASE CHAIN REACTION is done via urine sample.

 

 

Test Name:NEISSERIA GONORRHOEAE CULTURE
Diseases:Neisseria gonorrhoeae infection
Methology:CULTURE

 

Test Name:NEISSERIA GONORRHOEAE DNA PCR
Diseases:Neisseria gonorrhoeae infection
Methology:POLYMERASE CHAIN REACTION

 

 

 

 

 

 

Test Name:CHLAMYDIA DNA DETECTOR
Diseases:Molecular diagnosis of chlamydia trachomatis infection
Methology:POLYMERASE CHAIN REACTION

 

Test Name:CHLAMYDIA SPECIATION BY RFLP
Diseases:Molecular method for speciation of the infecting chlamydial pathogen
Methology:POLYMERASE CHAIN REACTION

 

Test Name:CHLAMYDIA TRACHOMATIS ANTIBODIES
Diseases:Immunologic confirmation of chlamydia trachomatis infection
Methology:ENZYME IMMUNOASSAY

 

Test Name:CHLAMYDIA TRACHOMATIS IgG ANTIBODIES
Diseases:Immunologic confirmation of chlamydia trachomatis infection
Methology:ENZYME IMMUNOASSAY

 

Test Name:CHLAMYDIA TRACHOMATIS IgM ANTIBODIES
Diseases:Immunologic confirmation of chlamydia trachomatis infection
Methology:ENZYME IMMUNOASSAY

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

Welcome to the Forum.  Your plan for testing is a good one although if you are beginning to have burning on urination, you do not need to wait for testing, you can get tested for gonorrhea and chlamydia now.  The tests you list are the proper ones.

As far as which tests to have done, the polymerase chain reaction (PCR) test is more sensitive than culture for detection of gonorrhea and more sensitive than the enzyme immunoassay tests for chlamydia.  Of the two PCR tests for chlamydia: the Test Name:CHLAMYDIA DNA DETECTOR
Diseases:Molecular diagnosis of chlamydia trachomatis infection, Methology:POLYMERASE CHAIN REACTION test is the correct one.  Both tests can be performed on a small amount of urine collected just as you begin to urinate.

I hope this information is helpful.  EWH

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42 months ago
Hello Doc,

Thanks for the info. I am going to test for gonorrhea and chlamydia now and i hope the results are negative. However, in case they come out positive, will you be able to guide me on which meds to take. Reason i ask is because local doctors do not have knowledge on these STIs. 

I think you forgot to answer my 2nd question which was - after gonorrhea and chlamydia,  do i need to test for anything other than syphilis and HIV?

Alex
Edward W. Hook M.D.
Edward W. Hook M.D.
42 months ago

Actually, I did answer your 2nd question although perhaps my reply was buried.  Testing for syphilis and HIV is the only other routine testing I would perform.  I would certainly NOT test for problems such as herpes.

The treatment for gonorrhea is typically a single injection of ceftriaxone, 250 mg, given with a single 1.0 gram dose of azithromycin taken by mouth.  For chlamydia, treatment is just a single 10. gram dose of azithromycin, taken by mouth.  EWH


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42 months ago
Hello Doctor,

My test results for  gonorrhea and chlamydia are still pending but i got test results for Urinalysis and Urine Culture. Urinalysis shows presence of bacteria and Urine culture shows presence of Escherichia coli with a count of more than >100000 CFU with sensitivity to all antibiotics. I am copying the test results below for your reference.   I have two questions on this 
1. Can the presence of E. Coli also mean possible gonorrhea and/or chlamydia or other STDs,   or is E. Coli are mutually exclusive of STI/STDs? 
2. What should be antibiotic treatment for E.coli . I read online that a 7 day course of ciprofloxacin 250 Mg twice a day should be able to get rid of this bacteria. I am in a very remote area and i do not trust local physicians here which is why if would really help if you can guide me on the treatment for E. Coli. Also, should i begin the antibiotics for E. Coli or should i wait for test results of gonorrhea and chlamydia, which wont come out until Friday because the test center sends the samples to a larger town for testing.

As always, your help is much appreciated.

Test Report Status Final Results Biological Reference Interval Units
CLINICAL PATH
URINALYSIS
COLOR YELLOW
METHOD : GROSS EXAMINATION
APPEARANCE CLEAR
METHOD : GROSS EXAMINATION
PH 6.0 4.7 - 7.5
METHOD : DIPSTICK
SPECIFIC GRAVITY 1.015 1.003 - 1.035
METHOD : DIPSTICK
GLUCOSE NEGATIVE NOT DETECTED
METHOD : DIPSTICK
PROTEIN NEGATIVE NOT DETECTED
METHOD : DIPSTICK
KETONES NEGATIVE NOT DETECTED
METHOD : DIPSTICK
BLOOD NEGATIVE NOT DETECTED
METHOD : DIPSTICK
BILIRUBIN NEGATIVE NOT DETECTED
METHOD : DIPSTICK
UROBILINOGEN NORMAL NORMAL
METHOD : DIPSTICK
NITRITE NEGATIVE NOT DETECTED
METHOD : DIPSTICK
WBC 1-2 0-5 /HPF
METHOD : DIPSTICK, MICROSCOPY
EPITHELIAL CELLS 0-1 0-5 /HPF
METHOD : MICROSCOPIC EXAMINATION
RED BLOOD CELLS NOT DETECTED NOT DETECTED /HPF
METHOD : MICROSCOPIC EXAMINATION
CASTS NOT DETECTED
METHOD : MICROSCOPIC EXAMINATION
CRYSTALS NOT DETECTED
METHOD : MICROSCOPIC EXAMINATION
BACTERIA DETECTED
METHOD : MICROSCOPIC EXAMINATION




CULTURE, URINE WITH SUSCEPTIBILITY
CULTURE; URINE
SPECIMEN SOURCE URINE
CULTURE POSITIVE
METHOD : STANDARD CULTURE TECHNIQUE ;CONVENTIONAL IDENTIFICATION
ORGANISM ESCHERICHIA COLI
METHOD : STANDARD CULTURE TECHNIQUE ;CONVENTIONAL IDENTIFICATION
COLONY COUNT >100000 CFU/mL
METHOD : MANUAL
FIRST LINE ANTIBIOTICS
COTRIMOXAZOLE SENSITIVE
METHOD : SENSITIVITY BY DISC DIFFUSION [KIRBY BAUER METHOD]
AMPICILLIN SENSITIVE
METHOD : SENSITIVITY BY DISC DIFFUSION [KIRBY BAUER METHOD]
CEFUROXIME SENSITIVE
METHOD : SENSITIVITY BY DISC DIFFUSION [KIRBY BAUER METHOD]
NORFLOXACIN SENSITIVE
METHOD : SENSITIVITY BY DISC DIFFUSION [KIRBY BAUER METHOD]
CIPROFLOXACIN SENSITIVE
METHOD : SENSITIVITY BY DISC DIFFUSION [KIRBY BAUER METHOD]
NITROFURANTOIN SENSITIVE
METHOD : SENSITIVITY BY DISC DIFFUSION [KIRBY BAUER METHOD]
GENTAMICIN SENSITIVE
METHOD : SENSITIVITY BY DISC DIFFUSION [KIRBY BAUER METHOD]
AMOXY/CLAV SENSITIVE
METHOD : SENSITIVITY BY DISC DIFFUSION [KIRBY BAUER METHOD]
AMPICILLIN-SULBACTAM SENSITIVE
METHOD : SENSITIVITY BY DISC DIFFUSION [KIRBY BAUER METHOD]
OFLOXACIN SENSITIVE
METHOD : SENSITIVITY BY DISC DIFFUSION [KIRBY BAUER METHOD]
SECOND LINE ANTIBIOTICS
CEFIXIME SENSITIVE
METHOD : SENSITIVITY BY DISC DIFFUSION [KIRBY BAUER METHOD]
CEFTRIAXONE SENSITIVE
METHOD : SENSITIVITY BY DISC DIFFUSION [KIRBY BAUER METHOD]
CEFTAZIDIME SENSITIVE
METHOD : SENSITIVITY BY DISC DIFFUSION [KIRBY BAUER METHOD]
LEVOFLOXACIN SENSITIVE
METHOD : SENSITIVITY BY DISC DIFFUSION [KIRBY BAUER METHOD]
NETILMICIN SENSITIVE
METHOD : SENSITIVITY BY DISC DIFFUSION [KIRBY BAUER METHOD]
AMIKACIN SENSITIVE
METHOD : SENSITIVITY BY DISC DIFFUSION [KIRBY BAUER METHOD]
PIPERACILLIN/TAZOBACTUM SENSITIVE
METHOD : SENSITIVITY BY DISC DIFFUSION [KIRBY BAUER METHOD]
CEFOPERAZONE/SULBACTUM SENSITIVE
METHOD : SENSITIVITY BY DISC DIFFUSION [KIRBY BAUER METHOD]
THIRD LINE ANTIBIOTICS
IMIPENEM SENSITIVE
METHOD : SENSITIVITY BY KIRBY BAUER METHOD
MEROPENEM SENSITIVE
METHOD : SENSITIVITY BY DISC DIFFUSION [KIRBY BAUER METHOD]
TOBRAMYCIN SENSITIVE
METHOD : SENSITIVITY BY DISC DIFFUSION [KIRBY BAUER METHOD]
DORIPENEM SENSITIVE
METHOD : SENSITIVITY BY DISC DIFFUSION [KIRBY BAUER METHOD]
COLISTIN SENSITIVE
METHOD : SENSITIVITY BY DISC DIFFUSION [KIRBY BAUER METHOD]
POLYMYXIN B SENSITIVE
METHOD : SENSITIVITY BY KIRBY BAUER METHOD
TIGECYCLINE SENSITIVE
METHOD : SENSITIVITY BY DISC DIFFUSION [KIRBY BAUER METHOD]



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

As per Forum guidelines which permit three interchanges with each client per question, this will be my final response. 

1. E. coli is a different bacteria from the bacteria that cause gonorrhea and chlamydia and is not an STI.  The level of E. coli seen in your urine suggest a urinary tract infection, not an STI.

2. Ciprofloxacin is among the antibiotics that will cure this infection.  I suggest you speak with a local doctor about which of several possible antibiotics might be helpful.  EWH

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