[Question #595] Do I Need Help?

40 months ago

I asked Dr Hook about a scenario where I received  unprotected oral sex for a couple of minutes with a woman I don't suspect was infected . I submitted a NAAT  urine test to the lab on day 5 for gono and chal, but it was lost on day 9 it was lost. I never had symptoms, but on  day 9 1 took a 1g zpack worried about NGU.  Day 10, I took a another urine test, but was worried about having gonorrhea.  That test came back negative,  but I went and took another test day 15 because of the taking  zpack,  I did not trust the first test results. In a panic. On day 16,  I went to the doctor and received a 250 mg rochp injection and 1g pack for gonorrhea as a preventive. The doctor says gonorrhea would normally show signs of symptoms. On day 17 my second test was negative. I also waited seven days before I went back to my partner after receiving my treatment.


I was assured by Dr. Hook I was not infected, to trust the test results, the treatment was effective,  and  it was safe to return to relations with my partner ( I was never with her prior to the treatment and never had no symptoms) . My concerns are on medhelp.org, I have seen Dr. Hook say that antibiotics can interferer with the test results.  So my question are:


1.  How do I know to trust both test results were accurate in this case?

2. What are the chances I was asymptomatic?

3. If I was asymptomatic, would the 250 mg injection and 1g pack kill gonorrhea where my partner was not at risk?

4. Was my partner safe after I received treatment ?

5. Should I move and feel safe again with my partner?

6. Do I need mental help ?

Sorry to follow up on this question, but I feeling sick about this incident. I have been over 4 months ago since this happened and getting on the medhelp site was not a good idea.

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
40 months ago
Welcome back. But I'm sorry to see you remain so concerned after the reassuring replies from both Dr. Hook and Terri Warren.

You are overly focused on the lab tests, as if they tell the story by themselves. They do not. The conclusions that you have (and had) no STD are based on several factors:  low risk exposure (as oral sex always is, low risk for all STDs and zero risk for some); no symptoms to suggest infection; negative tests; and treatment that would have cured you if in fact you had somehow been infected. The odds that all these factors would all be atypical and that you could still be infected are in the same range as the chance you'll be struck by a meteorite. To your specific questions:

1) Treatment interferes with testing, but not after only a day. The tests detect gonorrhea DNA, which persists a few days after treatment. But for the reasons above, this really doesn't matter anyway.

2) You were and are asymptomatic -- i.e. you don't have symptoms. There is no chance you have an asymptomatic infection, however.

3) The treatment is equally effective for symptomatic or asymptomatic gonorrhea.

4) Yes, your partner was safe.

5) Yes, move on.

6) Yes, I believe you do need mental health evaluation and care. Your worries are way out of proportion to reality, especially after the repeated, reasoned, science based reassurance you have had. Second, whenever someone suspects s/he has a psychological/emotional issue and asks about it, almost always it is the case. I agree that searching the internet repeatedly is not helpful -- it's just inflating your fears. Don't do it any more.

Bottom line:  All is well. You do not have (and never had) gonorrhea or any other STD from the incident you are concerned about. Do your best to move on without worry about it.

Best wishes--  HHH, MD


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40 months ago

Sorry Dr. Handsfield. I will do the best to move on.  Can you clarify comment 1) Treatment interferes with testing, but not after only a day. The tests detect gonorrhea DNA, which persists a few days after treatment. But for the reasons above, this really doesn't matter anyway. 


So does that mean, say I took the medicine, day 9,  day 10, test is not affected. Day 15, if medicine was effective,  it does not show because their is no DNA? Not having your expertise is confusing.   So in short, what you are saying is if the medicine killed it, DNA should show up on day 15. I will make this my last and final comment. Thank you so much. Your comet comment was really funny :)

40 months ago
To clarify, what I mean is there is no chance of masking the infection in the test because enough time ( 9 days) was given for the infection to present itself before I took something. So if the medication killed the infection, the tests would show the DNA. If both tests were negative, it was because not DNA was not in my urine because either the medication cleared the DNA  or I never had it. Thank Dr., you provide a great service.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
40 months ago
Daryl, you are seriously overthinking all this. You misunderstand the the effect of treatment on diagnostic testing. The reason the tests would become negative is because the infection was cured. With the treatments you had, there is no such thing as suppression without cure. In other words, you can be 100% certain you did not have gonorrhea at the times you were tested, and you cannot have it now if not reexposed. In theory, you could have been infected and then cured -- but most likely you were never infected at all. The likelihood of urethral gonorrhea from a single episode of oral sex is probalby under 1 chance in a thousand.

I hope that settle things once and for all. Please re-read my comments above in response to question no. 6. Best wishes.

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40 months ago
Yes, my anxiety has dropped greatly 98%. For the remaining 2% sanities sakes, if for the comet's chance I had something, was waiting 178 hrs before being with my partner sufficient time to kill the infection? A simple yes/no answer is fine.  I know at this point it is MOST unlikely, but this worry can drive someone to sickness.  Thank you so much and best of luck. Please close this after my last question.
40 months ago
Sorry I mean to say waiting 178 hours after receiving treatment sufficient time before getting back with my partner.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
40 months ago
"was waiting 178 hrs before being with my partner sufficient time to kill the infection? A simple yes/no answer is fine." Yes. Even 24 hours would have been sufficient. People are non-infectious within a few hours of receiving effective gonorrhea treatment.

That completes the two follow-up questions and replies included with each thread, so this one will be closed. Do your best to put all this behind you and move on with your life. As a final word, in case it helps:  If I were to answer your question at a personal and not professional level, I'll say that knowing what I know, if somehow I had been in your circumstance, I would never have been tested, not treated, and would have continued unprotected sex with my wife without worry.

Best wishes.

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