[Question #9740] To Dr. Handsfield: I am very worried (Urethritis-Chlamydia).
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29 months ago
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Dr. Handsfield, good afternoon (I'm from South America, I use a translator).
I return to the forum and I apologize if I bother you with my questions, but in the last few days something happened that worries me a lot. A few days ago I asked about my risks for non-gonococcal urethritis. I am a man, 29 years old, heterosexual. On December 29, 2022, I received unprotected oral sex for 40 seconds from a very promiscuous friend (girl). This episode has emotionally devastated me as I have a girlfriend and had unprotected sex with her 4 days after this exposure (I know it was a mistake and I will regret doing it for the rest of my life).
I did these tests:
RPR Syph: 4 and 7 weeks negative.
Hiv: 4 and 7 weeks negative.
PCR urethral smear for gonorrhea: 3 weeks negative.
Chlam IGG-IGM: 3 weeks negative.
Clam Antigen x 3: 7 and 8 weeks negative.
At the 4th week I visited the urologist and the family doctor and they told me that I had no risk, to calm down. However, at week 6 I got a boil in my armpit, I made the mistake of taking an antibiotic called DICLOXACILLIN for 2 days (I only took 3 doses). The boil disappeared after a week.
Worried about chlamydia, at week 7 and 8, I had 3 urethral swab chlamydia antigen tests that came back negative, but I am concerned that the antibiotic I took (DICLOXACILLIN) affected my chlamydia tests. Something else happened: At six and a half weeks I began to develop symptoms of frequent urination, urinary urgency, and a feeling that I hadn't urinated all of it. My urologist ordered a urine culture and urinalysis. Urinalysis came back fine, normal white blood cells did not change, but urine culture was positive for E.Coli 100,000/CFU (this added to my anxiety about having chlamydia).
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29 months ago
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My girlfriend has pelvic pain in the right ovary that comes and goes and usually happens before each period (this has been happening to my girlfriend since last year, but 3 weeks after my exposure it started with more force). My questions right now are the following:
1- ¿E.coli es una ETS? De ser así, ¿la contraje por mi exposición al sexo oral sin protección?
2- Can I pass E.Coli to my girlfriend? (I am currently on antibiotic treatment).
3. Could I have had chlamydia and the DICLOXACILLIN antibiotic I took for the boil cured it and that's why I tested negative? (I have never had dysuria or flow).
4- Do my symptoms of frequent urination and tenesmus in the prostate coincide with urethritis?
5- Could my girlfriend's symptoms be PID due to Chlamydia? (His symptoms from her are not constant, they come and go.)
Dr. Handsfield, if I were your patient or your child, what advice would you give me? Could I just forget about this whole nightmare and get on with my life? I am suffering a lot from all this. I am very sorry to have to return to the forum (I know that you are very clear about your policy of repetitive questions). I apologize for this.
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Edward W. Hook M.D.
29 months ago
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Welcome back to the Forum and thanks for your question although I'm sorry you felt the need to repeat the same questions that you asked about a week ago. FYI, clients are not permitted to request who answers their questions: Dr. Handsfield and I have worked together for more than 40 years and although our verbal styles differ, we have NEVER disagreed on the facts and substances of our assessments. Your repetitive questions will not change that. As I told you earlier, there is no evidence whatsoever to suggest that the very low risk exposure you described has lead to an STI. This, in response to your questions:
1- ¿E.coli es una ETS? De ser así, ¿la contraje por mi exposición al sexo oral sin protección?
E. coli is NOT an STI. E.coli is normally found in the genital tract and can cause non-STI urinary tract infections which can be manifest as urinary frequency and urgency which, as I have told you previously, are NOT signs of an STI.
2- Can I pass E.Coli to my girlfriend? (I am currently on antibiotic treatment).
No, these bacteria are normally present in the urinary tract. Both you and your GF may, and probably due have E. coli present in your urinary tracts as most people do. This does not mean that you have transmitted her E coli to her and does not suggest a UTI.
3. Could I have had chlamydia and the DICLOXACILLIN antibiotic I took for the boil cured it and that's why I tested negative? (I have never had dysuria or flow).
No. Dicloxacillin could have cured chlamydia if present but chlamydia infections resulting from receipt of oral sex are very rare.
4- Do my symptoms of frequent urination and tenesmus in the prostate coincide with urethritis?
No, I've told you this before. The answer will not change. These symptoms could be due to an UTI or even prostatitis but do not suggest and STI.
5- Could my girlfriend's symptoms be PID due to Chlamydia? (His symptoms from her are not constant, they come and go.)
The symptoms of PID do not come and go. Some women do regularly experience pelvic discomfort at about the time they have their periods.
As you can see, the responses to your questions do not change. Your repetitive questions suggest that you are feeling quite guilty about your causal encounter. If you cannot control your guilt, I would suggest that you see a counselor who can suggest steps to help you address your guilt. There is no reason to think, nor evidence to suggest, that you have an STI. EWH
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29 months ago
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Thanks for your new answers Dr. Hook.
Sorry to come back on this topic. As you understand, many of us here are relieved to have answers from medical experts like you. Excuse me again, I am working hard with my psychologist on the issue of my anxiety and guilt.
Just a few follow up questions to close this topic for good:
1- What are the chances of having acquired chlamydia from this exposure to insertive oral sex?
2- I have read some comments from you and Dr. HHH that chlamydia in the throat is rare and that for scientific reasons chlamydia does not adapt very well to the throat. Has this changed in recent years with the advancement of science? I don't know the subject and browsing the internet is very confusing.
3. Was the onset of my symptoms (frequent urination, urgency, Tenesmus) at 6 1/2 weeks post-exposure too late to suggest chlamydia infection or urethritis?
4. If I hadn't taken Dycill in week six, I would be 100% sure that my chlamydia tests were conclusive, but because of that mistake, my chances go down. Is science on my side, Dr. Hook?
Thanks again Dr. Hook.
Please don't hate me, I promise this is my last question. Thank you for this forum, for your knowledge and for providing such rigorous information when the internet only confuses us.
Greetings from Argentina.
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Edward W. Hook M.D.
29 months ago
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Straight to your questions:
1. Based on the fact that oral chlamydia is very, very rare (1% of less) and the biological inefficiency of transmission, the time since your exposure and your negative test results there is virtually no realistic chance that you acquired chlamydia from the exposure you describe.
2. This remains an accurate statement.
3. As I have said before, these symptoms are NOT symptoms or chlamydial urethritis. In addition, had you acquired chlamydia and become symptomatic, it would be expected that your symptoms would have started earlier.
4. Science is on your side
Please put your fears aside. EWH
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29 months ago
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Thanks again Dr. Hook.
It reassures me a lot to read this information. One last question before closing this thread.
-My partner is in danger due to the exposure described or can we continue with our sexual relations normally?
Thank you for your patience, Dr. Hook.
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Edward W. Hook M.D.
29 months ago
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This will be the final response to this thread. In addition, I must warn you that should you return to our forum with new anxiety, driven, repetitive questions your question may be closed without an answer, and without return of your posting fee. There should be no further questions regarding this episode.
As explained earlier, you were not infected. Thus your partner is a no risk from you. There is no reason related to the episode. You described to abstain from your normal unprotected sexual practices with your partner.
This concludes this thread. Please don’t worry. EWH.
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