[Question #8630] Medication follow up.
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41 months ago
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Hi Docs sorry to be back so soon. This will be my last exchange.
Please read previous exchange for details but for ease
Oral sex with older male over a period of two months while having sex with partner.
Non specific penile issues caused me to go to urgen care who gave me a week of doxycycline.
After doxycycline I tested for STI and had results back negative
GUM clinic are pressing me to get my wife tested as the doxycycline could have cured my infection but prior to this I could have passed something to my wife
In the meantime my wife has took a single dose of azithromycin 1g for a sinus infection that has already started to work for that (I am secretly internally happy about this because of it been somewhat active with chlymidia 95% as dr hook told me)
So my question here now then is about the medication we all took which will help me decide if I’m to confess to wife and get her tested.
1) how likely would Doxy i took 2x 100g for 7 days have cleared a asymptomatic (no pus) Ghonnaria infection
2) if I had asymptomatic Ghonnaria, passed this to my wife and she’s asymptomatic (dr hook I know you said 90% but that’s still a lot of men asymptomatic) then would 1g Az have any affect on this could I safely say that with the low risk I’m asymptomatic followed by my wife somewhat treated (although not recommended dose and med) that she hasn’t got Ghonnaria.
3) if I had asymptomatic Ghonnaria, passed to my wife, doxycycline cured it. If I reinfected my self from my wife would I be asymptomatic again or would the second round be possible discharge?
Im quite happy of my extreemly low chance of chlamydia plus my wife’s meds that chlamydia is not a concern. So I just need go clear up the Ghonnaria issues, and then move on.
I’m overly concerned as this penile pain I have which I know is no STI related could make it difficult for me to notice painful urination or other more specific signs on infection.
I hope none of this is repetitive. I know Dr Hook has said move on and I’m gappy
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Edward W. Hook M.D.
41 months ago
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I’m sorry that you felt the need to return to the forum. Most of your questions are repetitive and suggest that you continue to seriously overthink this. Before I do address your specific questions, let me correct several of the statements you made in your introductory comments. For instance you said the doctor at urgent care gave you doxycycline but failed to mention that the doctor was not concerned about STIs and did not want to give you doxycycline until you pressed him to do so. You also note that at the GUM clinic, the person who urged you to have your wife tested was the nurse practitioner whose opinion differed from the more senior physician who you subsequently saw. That person agreed with me that there was no evidence of infection. Further, somewhere in the context of your questions you fail to acknowledge that you were exposed on three occasions by a single partner through low risk exposures, that you had no signs or symptoms typical of gonorrhea or chlamydia and that you have never had a positive test. Reply to your follow up questions:
1. While there is some geographic variation, 40-50% of gonorrhea is resistant to doxycycline and may not have been cured.
2. “…if…..if”. The azithromycin taken by your wife would be expected, like doxycycline, to cure some where in the neighborhood of 50% of gonorrhea, if present (remember there is no evidence that either of you have overhead gonorrhea).
3. If you were initially asymptomatic that in no way means that if you were reinfected with the same strain you would be asymptomatic.
As I said in our previous exchange, I really believe you were seriously overthinking this and would suggest that the most important thing you can do for yourself is to seek counseling to help you work through what appears to be profound guilt driven anxiety. Please feel free to share our exchanges if you choose to take this advice. EWH
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41 months ago
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Thank you Doctor.
Honestly I may just be coming across wrong but I’m not all that stressed/anxious about it.
I’m just trying to weigh up what’s best to do with wife. And I think all things considered it’s safe to move on but I just needed the facts.
I think a less than half chance it won’t have cured me a less than 10% chance I won’t get discharge and a 50% chance wife is no cured anyway it’s bordering on no risk, and not worth panicking about.
I will of course seek help if needed but will keep your wisdom in mind.
Just a slight follow up and a different slant on the above question I’m regards to Ghonnaria if I was to reinfect myself and remain symptom free if I was to keep having sex with wife would I eventually get discharge (so not clear and reifnfect but topping up an existing infection) ie would a couple infected with Ghonnaria always eventually be some symptomatic?
And would a dip test be LE positive for most men with urithal Ghonnaria
Please close the thread after this no need to ask more questions and the would serve no purpose.
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Edward W. Hook M.D.
41 months ago
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There is no way to answer your latest “what if” question- simply no data on this. Over time the majority of people,develop discharge. On some occasions, discharge is present which infected persons are unaware of. I doubt this would happen in your case.
Even in asymptomaticly infected persons, the LE test would usually be positive. EWH
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41 months ago
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Thank you Dr Hook :) I have enjoyed our correspondence it’s been great to speak to such a legend in the medical work
I have run the maths of chances of Ghonnaria in my wife
20% chance LE test missed (best guess)
50% Doxy cleared (1st test negative)
20% no reinfected by wife by 2nd test
50% wife’s treatment worked
50% chance wife would have symptom
10% chance I would have no symptoms (obvious symptoms)
6% he had Ghonnaria in his throat (worst case but been an older male in a town that Ghonnaria is not all that common 50per 100000) it’s probably a lot less.
10% chance if he had it I caught it maybe rising to 50% over the three occasions (best guess)
I think that’s around 1 in a million + mark.
Agreed?
Ie Zero and really not worth laying up thinking about. Thanks for helping me get to this conclusion.
Enjoy your weekend and take care. Thank you Doctor Hook… until next time ;) (Kidding)
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Edward W. Hook M.D.
41 months ago
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I agree entirely with your conclusion. Having work the numbers, I hope that this will able enable you to move forward and put your continuing concerns aside.
Just in case however, a word of warning. Repetitive and/or anxiety driven questions may be deleted without a response or without return of your posting fee. Your posts are moving into that realm. I trust you will not return with additional concerns regarding the scenario that you have been asking about. Take care. EWH
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