From:
Sent:
To: drgian@stdweb.com
Subject: nucleic acid amplification Should I get retested?
Thank you Dr. Gian, I hope you can help me. Very worried. Made a big
mistake but learned a valuable lesson about what is important to me.
Don't want to hurt my wife. Should I get retested for Chlamydia and
Gonorrhea?
Background History:
51 year old male with history of a few gout symptoms (big toe pain).
Never tested for Uric acid levels. What I figured to be typical urinary
problems of a guy in his 50's, low volume stream, sometimes slow to
start, slight dribble. Monogamous relationship for 27 years. One time
mistake, drunk and had exposure to unprotected sex w/coworker 7 mo. ago.
2 mo. ago, (5 mo. after unprotected encounter) sudden tingle,
irritation in penis, frequent urge to urinate, little volume, slight
burning in head of penis. Volume seemed to increased during this time,
could be due to increase in water intake. Self treated with cranberry
pills and D-mannose but UTI has not cleared. Within the week full STD
panel through Labsafe .com, LabCorp collection point, negative results
for all tests. Chlamydia and Gonorrhea urine test (nucleic acid
amplification), however because of my urgency to urinate after holding
urine for 4 hrs. the sample used was actually a midstream catch. First
oz or two went in the toilet. I ended up providing 3 or 4 oz sample. I
have since read that with this type of testing, first catch is required.
What are the chances I would have a false negative. After all, I have
had minimal exposure. One time.
Question:
1. Is it likely that a false negative would happen given
the midstream catch I supplied?
2. I have not gone to the Dr. (family friend) for fear I have STD.
Self treated with 500MG of Cephalexin 12hr. for 5days now. Penis
irritation and urgency has gone away but back pain is still there. I
know that Cephalexin can be effective against Gonorrhea but not
Chlamydia. I want to discontinue self medication and see my doctor but
want to be reasonably sure that I don't have an STD. My wife does not
have any symptoms, the co-worker I was exposed to does not have any
symptoms. What is the possibilities that both would be symptom free, and
my symptoms without discharge, would show up 5 mo. after one time
exposure? Does my symptoms sound more like a UTI either from obstruction
Kidney stones, etc.?
Thank you for any help you can provide.
Hi,
the first urine catch is
the proper way to collect urine for a Chlamydia and
Gonorrhea
amplification test. This is done after withholding urination for at
least three hours to obtain the maximum concentration of DNA particles
of the infective agent. So a mid stream catch may reduce the test
sensitivity.
Your history
suggests however a garden variety urinary tract infection ( E. coli,
etc.) and this is best treated with Bactrim (Trimethoprim-sulfamethoxazole)
a Sulfa medication. Bacterial cells produce folic acid, a chemical
necessary for their growth. Sulfamethoxazole kills the bacterium by
interfering with the enzyme that helps form folic acid. The combination
of a sulfamethoxazole with trimethoprim is effective because high levels
of the drugs are achieved in the urinary tract and urine, which kills
bacteria directly at the site of the infection.
If it gives you peace of mind you may want to
retest for Chlamydia
Be well.
Dr. Gian