[Question #9931] Chlamydia and Gonorrhea Test

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27 months ago
Hi doctors- I am really confused. 6 months ago I (make) engaged in mutual masturabation and protected oral with another man. I told my girlfriend and we worked it out. To protect our selves we both took cefixime (800mg) and doxy for 7 days. We also took gonorrhea and chlamydia test through labcorp which came back negative. However my girl friend has been experiencing large amounts of discharge (no itching or odor or burning, just increase in volume. Even though I know the exposure was los risk, my questions are this:

1. Is it possible that cefixime could have failed to cure gonorrhea? I know the cdc says it’s not the preferred option

2. Is it possible that the urine test was false negative? She took it midstream instead of first catch. 

3. Also, she peed in the sample cup at home (made sure it was in a secure specimen collection cup), then drove 20 min to drop the specimen off at labcorp (she has a phobia of peeing in public). Could this have effected the results 
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27 months ago
I also forgot to add that I engaged in mutual masturbation and protected (condom) oral sex at the end of July. My gf started to have extra discharge this month. It also comes and goes, it’s not consistent 
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Edward W. Hook M.D.
27 months ago
Welcome to the Forum and thanks for your questions.  I’ll be glad to comment. Your girlfriend’s discharge is likely to be something other than Gonorrhea or chlamydia.  The tests you were tested with are amongst the most sensitive tests in all of medicine and the therapy you both took is highly effective.  There are many potential causes of her increased discharge.  Since your casual encounter was was with another man, trichamonas is unlikely but she could well have bacterial vaginosis or a yeast infection.  Yeast infections are not uncommon following taking the antibiotics you both took.  My advice is that, rather than guessing what is going on she should be examined by someone who contest for bacterial vaginosis evaluate for the possibility of yeast.  In answer to your specific questions:

1.  Unlikely, the combination of medications you took is highly effecting, if you were even infected (remember, your tests were negative)
2.  No, the fact that the specimen is in midstream test would not markedly impair its accuracy.
3.  Same answer, the transport times would not negatively affect the performance of the test. 

A final thought, if your partner tends to have more discharge talking about having a white in the white that I brought to have with this is a Recents ABC one I think it’s a room following in common protect the dinner of course, this could be a manifestation of a latex allergy.

I hope the information I provided is helpful. I believe part of my answers are unclear over there or further questions, please don’t hesitate to use your update to follow ups for clarification. EWH.
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27 months ago
Thanks doctor. An additional question. She urinated in the specimen cup at home, then took it to labcorp (20 min drive) then had to wait about an hour before she was able to go in the back and transfer the urine in another cup (she did this without labcorp knowing because she has an extreme phobia of public rest rooms) would the fact that the specimen didn’t get to labcorp for about 1 hour 30 minutes make a difference in your opinion? 
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Edward W. Hook M.D.
27 months ago
Please see my reply number 3 above. A 1 1/2 hour delay between obtaining the specimen and providing it to the laboratory for testing would have no negative affect on the accuracy of the test results. EWH.---
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27 months ago
Thank you very much, I appreciate your insight. One other piece of info I forgot to mention is that she has been on doxy 200mg twice a day for a month for something else. Will this antibiotic clear up both gonorrhea and chlamydia (assuming that the previous treatments failed)? 
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Edward W. Hook M.D.
27 months ago
The doxycycline would certainly cure any chlamydia infection if present. In addition, doxycycline taken the way she is taking it with cure about 50 to 60% of all gonorrhea. That said, I once again urge you to believe your test results. You have been treated with appropriate therapy and you have negative test results. There is simply no reason to worry about gonorrhea or chlamydia. 

As you know, we provide up to three responses to each clients questions. This thread will be close shortly without further response. I hope the information I provided has been helpful to you. EWH. 
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