[Question #8658] Possible DGI?
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41 months ago
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Hello Dr, I’m a heterosexual male and approx 3.5 months ago received unprotected oral sex from a woman at a massage parlor, since then I’ve had no symptoms until 1 week ago when I started having a sore throat on the right side, fever, pain in my left knee joint, and my muscles suddenly became very sore and I lost my appetite. I went to an urgent care and was tested for viral hep and the flu, all were negative. I was given a z pack for possible strep but was not tested, since I took the antibiotics my fever has gone as well as most of the soreness but now I’m having some slight burning when I pee and a very slight burning sens. In my rectum and some lower left abdom. discomfort. My question is could this possibly be DGI and could it have taken this long to present symptoms?
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H. Hunter Handsfield, MD
41 months ago
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Welcome to the forum. Thanks for your question.
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Disseminated gonococcal infection (DGI) doesn't behave at all like this. It's causes an acute form of arthritis, generally with high fever, severely inflamed joints, and has onset soon after acquiring gonorrhea (probably always within a month). And if you had acquired gonorrhea from receiving oral sex, it could not cause symptoms in your genital tract, rectum, throat or abdomen.
If your joint pain and/or other symptoms persist, see a doctor -- you could well have some sort of arthritis (rheumatoid, reactive arthritis, and others). And for general reassurance about STIs, you could have a urine test for gonorrhea and chlamydia and blood tests for syphilis and HIV. But none of these is a likely cause of your joint pain or other symptoms.
I hope these comments are helpful. Let me know if anything isn't clear.
HHH, MD
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41 months ago
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Thank you very much doctor that’s very helpful. I had some follow up questions.
1. If I had an asymptomatic infection and my body cleared it, would it be possible that I gave it to my wife and was reinfected after my body cleared it?
2. Is it possible that the z pack I took could be causing my symptoms I currently have? I’m experiencing some lower abdominal discomfort, sensitivity in the testicles, as well as difficult bowel movements and some slight burning sensation when I ejaculate. None of which were present before I took the z pack.
3. Would you recommend I go get tested based on these symptoms?
4. If it were an infection that we’ve been passing back and forth would the antibiotics have cleared it? Or is it possible they only took care of part of the infection and left me with these new symptoms?
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H. Hunter Handsfield, MD
41 months ago
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1) The frequency of oral gonorrhea is low in women, even the most sexually active. (Men who have sex with men are at far greater risk.) Therefore, it's unlikely you were exposed to gonorrhea. When gonorrhea infects the urethra, over 95% develop obvious symptoms; asymptomatic infection is rare. So the chance is nearly zero that you caught gonorrhea, never knew it, and infected your wife. But I cannot say that is impossible. If you want to check it out, the only way is to inform your wife of the situation and for her to be tested. If I were personally in your situation, I wouldn't do that.
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2) Azithromycin can cause abdominal cramping and transient diarrhea, but only for a day or two after taking it. And certainly not the other symptoms you describe.
3,4) Your symptoms do not even hint at any STI and therefore not the result of anything you are sexually transmitting back and forth with your wife. I wouldn't know what to test you for. I have to wonder if most of them are the physical manifestations of anxiety about all these issues. I am confident you have no infection of any kind from your massage parlor events.
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