[Question #8672] Interested to here your thoughts

41 months ago

Hi,

I’m married with a family.

Been away from my family for the last 6 months. And while away I got close to a woman who also is a family woman. We got on and to pass the boring nights we drank and kept each other company. Eventually leading to sex. We both talked the STI and we both agreed we was safe enough. Anyway this went on for a few months, don’t regret it we both agreed no strings and it was fun.

Recentlyish maybe 2 months after starting my penis started to feel strange. Couple of days after I got a pain in the end of my penis, this was constant and wouldn’t go.

Told the girl I been sleeping with and we both went to get tested.

She was tested in all three sites (swabs) me just urine.

My test results came back positive for Chlymidia and Ghonnaria.

Hers was NEGATIVE (What!?)

I went back to get treated and the nurse was stumped. But gave me treatment and my recent partner went to get treated anyway, they are also retesting her out of interest.

My question is.

1) she’s only been with me and her husband. So I guess she got this from her husband does he need testing.

2) I only had sex with her and my wife (my wife over a year ago now) so do I need to tell my wife.

3) what’s happening with my positive test and her negative any input.

4) my symptoms are yet to go day 5 after treatment (still on doxy for chlymidia) I want to do a test of cure before coming home. To make sure it’s gone before I go home and have sex with my wife. Clinic said not to do for 4 week as will still be positive till then, is this true? Or can I test earlier. I would pay.

Thanks for you imput.

H. Hunter Handsfield, MD

41 months ago

Welcome to the forum and thanks for your question. I happened to log in very soon after you posted it: most users shouldn't expect nearly real-time replies!

Your question implies you understand some of the potential explanations for your gonorrhea/chlamydia situation, but there are others. First, that your results are falsely positive: the tests aren't perfect. However, false positive results are rare--and the odds of both your gonorrhea and chlamydia results both being false is very small. That said, your symptoms actually aren't typical; it's unusual to have either gonorrhea or chlamydia without obvious discharge (especially gonorrhea, which typically results in overt pus dripping from the penis. You also don't mention whether urination itself is painful -- which usually is the case with gonorrhea and often for chlamydia. Still, false positive are rare enough that we need to assume you had both, and therefore that your non-marital partner is infected.

So now we need to explain the apparently false-negative test results in your partner. That's not so unusual: the standard tests miss up to 5% of infections in women. Or she could have been infected, transmitted to you, and then the infections were cleared by her immune system. Or if she took antibiotics for some other reason (like a urinary tract or respiratory infection) that might have cleared her infections. Still, she would have had to acquire both gonorrhea and somewhere. Prolonged carriage of chlamydia is pretty common, but having gonorrhea a full year is unusual; it's usually cleared by the immune system within a few weeks or months. Accordingly, I agree her husband is a likely source.

Those comments partly address your specific questions, but to be explicit:

1) I agree her husband is a likely source and should at least tested, and perhaps treated.

2) If you have not had sex with your wife since starting your newer relationship, your wife does not need to be informed or tested.

3) Discussed above.

4) That your symptoms have not cleared over 5 days, or at least significantly improved, is consistent with the possibility they aren't due to gonorrhea or chlamydia. As noted above, pain alone -- without discharge, and apparently without painful urination -- is not the usual symptom for either of these STIs. In any case, you don't really have to wait for 4 weeks to have a test of cure. The tests for gonorrhea or chlamydia CAN stay positive as long as 3 weeks, but usually do not: a negative result in a few more days would be reliable. If still positive, you'd need another test after three weeks, however.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

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41 months ago

Wow that was a speedy reply.

Thank you. I knew I’d get a good answer from this forum.

I’ll report back when I get her second round of tests for the interest of the story if you like.

Ill let her know your advice about her husband and make sure he’s tested.

Interesting that you said the penile pain is not a symptom of STI the clinic said the same thing. In fact they suggested I see my GP rather than them as they didn’t seem to think testing was necessary. Only when I asked to be tested anyway did they invite me in. The nurse stripped my penis to look for discharge and couldn’t milk any. She was probably even more surprised than me when the results came back positive (especially for Ghonnaria)

And no no pain as such when urinating this discomfort/pain is still present when I pass urine. Is probably still present but no increase or notice much of a difference.

Odd. Just one quick follow up and I’ll try grab my other partners results for you in my final reply.

1) is this penis pain enough of “none STI symptom” to assume something else is happening at the same time? Or is it (all be it rare) a showing of a STI ? Is it safe enough to assume that it’s a lingering symptom of my diagnosis and just let it play out. Find it hard to believe I’m unlucky enough to catch 2x STI and have something else at the same time. But just find it interesting that both you and the nurse dismissed this as a symptom

H. Hunter Handsfield, MD

41 months ago

Pain at the tip of the penis often is referred pain, reflecting an internal genital or pelvic problem like prostatitis (which is rarely if ever due to STI) or the pelvic muscles, sometimes reflecting increased muscle tension which in turn can be caused by genitally focused anxiety. Have you had any other symptoms like testicular, lower abdominal, or rectal area discomfort or pain? Or a urinalysis to check for non-STI urinary tract infection? If the penile pain persists after completing doxycycline, I would suggest seeing a urologist. But in direct reply to your question, it doesn't suggest any other STI.---

41 months ago

Thanks doctor very interesting.

My latest partner rang the clinic today to chase results of her retest. They are in and negative. All three sites all by swab. So that’s two tests done on her negative.

I in the meantime still feel the same in my penis.

I contacted the clinic and they are now fairly sure that my results was reported wrong. Like you they don’t seem at all concerned about my penile pain been related to STI and to have both Ghonnaria and Chlymidia without “symptoms” strikes them as odd. Add this to the fact that she is negative and seemingly not false negative (2x pre antibiotic test) I mean none of this matters as we have both been treated. Apart from the matter that if possible she would like to avoid telling her husband.

They have invited me back in they are going to re run the test (day 6) they said if it was a true positive then this test will be positive too. If negative then they are even more sure the old test was false and then my new partner dosnt need to tell her husband . (Or me my wife). They are also going to get a doctor to see me to run some tests around my penile pain as they are sure it’s not an STI.

I can’t say that I have noticed any other pain or discomfort the penile pain is the predominant annoyance. Not saying if I focused that there is not discomfort elsewhere but like I said main symptom is the penis tip pain

So that’s me then. To close

1) do you agree if my test this time is negative it’s safe to assume my first test was reported wrong. Would 6 days clear and turn a test negative or no?

2) could perhaps what is happening is she’s is infected further up (PID) and this is why her swab is not picking it up? Not sure how the mechanics of that works.

3) how quickly would antibiotics work typically for symptoms of STI.

Thanks. I’ll also share this post with the nurse and doctor when I see them

H. Hunter Handsfield, MD

41 months ago

In thinking about this, I also have been trending toward the probability that your reported test results were wrong. As discussed, false positive results are rare, and would be expected to be especially rare for both gonorrhea and chlamydia. I think you're implying your doctor is concerned about a specimen mix-up rather than mistaken results per se, and that's my thinking. I asked Dr. Hook to review our discussion, as we do sometimes for atypical situations. and that was his thought as well. This is really rare -- for obvious reasons, most clinics and labs take special care in specimen labeling and management for STI diagnostics. Perhaps this could be sorted out by a careful look at the medical records of other patients evaluated in the clinic or whose specimens arrived in the lab at about the time you were there. (Another concern that will be on your doctor's mind is that a truly infected patient may be going untreated.) In any case, I think you and your partner are on safe ground in not informing your spouses.

Those comments address question 1.

2) This doesn't happen. Upper tract infection always is detectable in urine or vaginal swabs. After all, the organisms must be in the lower tract in order to transmit to a partner.

3) For successfully treated gonorrhea, symptoms just about always are somewhat better within 24 hours and 90% better by about 3 days. Chlamydia a bit slower, but not much. For either one, persistent symptoms for a week is solid evidence they are not the cause of your penile discomfort.

Threads normally are closed after two follow-up exchanges, but we'll keep it open for now. I'm interested in hearing the outcome after you've seen your doctor and/or the mystery is solved (e.g. a specimen mix-up confirmed). But let's limit further comments to that aspect. We generally avoid getting into evaluation or advice of non-STI genital symptoms.

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41 months ago

Well, I think the mystery will continue.

They was unable to follow up or chase the labs for possible mismatch or incorrect report.

They did retest me and I’m negative for both, they are confident would still be positive if the original was true even while on treatment as would expect till take my body a while to fully remove traces. I have read on here that this is not a safe assumption so I dunno what to do really.

They really aren’t sure what to advise in regards of contact tracing except we “should be all clear” but it’s hard to contemplate leaving it to chance when other innocent peoples health is on the line.

We are leaning towards coming clean for the safety of everyone. But it’s quite a brave thing to do.

Anyway thanks for your help.

The other bit of good news is my penis tip pain has finally subsided after around a week.

H. Hunter Handsfield, MD

41 months ago

Indeed, the negative re-test suggests the original results were false. However, it's not a sure thing. Although it CAN take as long as 3 weeks for test results to become negative after treatment, the research on this shows that they often are negative within several days.

I agree it would brave (if difficult) to inform your spouses, but I believe it's the right thing to do. Best wishes that it all works out. Good luck.

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