[Question #9524] Follow up Question #9508
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31 months ago
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Hi Doctors,
let me start by thank you both and acknowledge that I really appreciate your support and advice. I hate having to come back to ask but I feel it necessary for my own piece of mind.
As mentioned in my previous post I have been monitoring myself for any symptoms of LGV. I continue to experience the symptoms mentioned previously, lose bowel movements and minor stomach pain accompanied by urgency to use the toilet (pain only prior to movements).
In addition i recall now experiencing sore knees and heels of my feet which I still have now I understand that chlamydia can lead to Reactive arthritis and conjunctivitis (I believe that the latter is due to possible direct exposure to contaminated fluid and not Auto-inoculation) but i am not sure re the RA. In my previous question I asked about a one off discharge (which appears to be precum from night time erection) I would appreciate if you could answer the following questions for future clarity and to help me further understand.
1. Is discharge associated with STI constant or can a single event be enough?
2. Assuming that 7 weeks is to far out for symptoms if gonorrhea?
3. Is 6 weeks sufficient for conclusive results on a HIV and syphilis test?
4. When can I retest all sites again for all stds after my treatment?
2. Do you in your expert opinon believe i could still have LGV?
3. Does it sound like I might have Reactive arthritis from this exposure? And is conjunctivitis common with chlamydia?
Thanks in advance and sorry if these questions are frustrating, I understand if they are as I am equally frustrated with my current situation.
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Edward W. Hook M.D.
31 months ago
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Welcome back to the Forum. On this occasion I happened to pick up your follow-up questions. In preparing to respond I reviewed your earlier interaction with Dr. Handsfield and agree with all that he said. Like Dr. Handsfield, I would urge you to have confidence in the doxycycline treatment you took- even if your rectal infection had been caused by an LGV strain of chlamydia it would most likely have been cured with 7 days of doxycycline. Further, I would add that both the reactive arthritis and conjunctivitis that occasionally follow chlamydial infection are thought to reflect stimulation of the immune system by infection, not active infection itself and is not related to auto-inoculation of the bacterium to different sites in the body. In response to your specific questions:
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1. Is discharge associated with STI constant or can a single event be enough?
Most typically STI-related discharge is a continuous of progressive (worsening) process, not a single event.
2. Assuming that 7 weeks is to far out for symptoms if gonorrhea?
Correct
3. Is 6 weeks sufficient for conclusive results on a HIV and syphilis test?
Yes
4. When can I retest all sites again for all stds after my treatment?
You could certainly re-test at this time. I anticipate that your tests will be negative and, when they are, I encourage you to move on and look for other causes of your symptoms.
2. Do you in your expert opinon believe i could still have LGV?
Your symptoms do not sound like those of LGV- I suspect something else, likely non-STI related is going on.
3. Does it sound like I might have Reactive arthritis from this exposure? And is conjunctivitis common with chlamydia?
See my comment above. It does not sound like you have reactive arthritis.
In reading your follow-ups I find myself wondering whether you have been on the internet looking for answers for your symptoms. If so, I urge you to stop. Unfortuantely, the internet is full of misinformation and it is challenging to differentiate what is correct and what is not.
I hope these comments are helpful. EWH
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31 months ago
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Thank you Dr Hook, you response has helped me greatly.
And yes unfortunately of course I have been googling, it is very easy to find lots of conflicting and rather misleading information on the web hence my return to seek clarity from this forum.
I feel much more reassured by your responses to my questions and will more on with my life now.
One final question for clarity and to complete my understanding are you saying that reactive arthritis and conjunctivitis are in response to my immune system fighting the infection (in this case chlamydia) and being weakened not chlamydia?
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Edward W. Hook M.D.
31 months ago
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Thanks for your thanks. I'm pleased my comments have beenhelpful.
Your statement about reactive arthritis is correct. It is thought that the immune response to chlamydial infection leads to both the joint discomfort and conjunctivitis which are part of reactive arthritis. FYI, RA is uncommon and may not only follow chlamydial infections but also non-STI GI infections caused by campylobacter. It's the result of an overactive, mis-directed immune system. To be honest however, the symptoms you describe do not suggest RA. EH
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31 months ago
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Thanks Doctor for your clarity and for your valuable time I truly appreciate it.
I have for my own piece of mind sought testing but the GP will not allow me to undertake testing before 21 days have elapsed since my completion of antibiotics I am not sure why?
My understanding was that around 2 to 3 days after starting treatment the infection would be non infectious (although recommended to take 7 days to ensure clearance) and that a week post treatment my body should have pass all remaining DNA of chlamydia from my body which could result in a false positive due to previous infection?
Also am I correct in assuming that the DNA would only be present in the site of infection ie my rectum not my throat or urine?
I understand that your response to this will be my last so thanks in advance.
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Edward W. Hook M.D.
31 months ago
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Like you, I am not sure why your doctor will not test sooner. Perhaps someone else would.
Infectious DNA can persist 7-10 days following effective treatment for an STI.
You are correct- if you were infected DNA would be present only at the site of infection/inoculation, not elsewhere
Thanks for your thanks. Closing this thread. EWH
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