Doc. How do one know if he/she has a STD specifically Gonorrhea???I am having an unusual amount of discharge. Its yellow and thin and it has an awful smell. when it accumulates its worse, it has i think a little greenish colour to it. my clothes are stink every time I reach home (trousers). What is the cost of doing a STD test? Oh and I think I may have yeast infection also cause am always having discharge. am aware that you cant diagnose the problem without having seeing it, but I NEED a response, opinions and all possible suggestion.

Dear Dr. Gian,

I am a kidney dialysis patient that is six months away from a kidney transplant. As part of the process, I have been tested for Hepatitis A, B, and C, HIV, CMV and RPR. I tested negative on all of these tests. They did not test me for gonorrhea or Chlamydia and I am embarrassed to ask them for these tests. I do not produce a lot of urine and I was wondering if theses tests can be done on the little urine that I produce. I am a CAPD patient so I have a lot of dialysis solution in my ultra bag. Can you test this? Or is there a blood test for gonorrhea and Chlamydia?

Hi,

First off, do not be shy. It is your body and your health and you have permission to ask you Doctors. Yes, it is possible to run a GC and Chlamydia PCR test with a very small amount of urine and of course even with a swab to the urethral lining. These infections, even if present without symptoms, do not produce the same amount of concern in a pre-transplant patient when compared with the presence of the Hepatitis virus, or Herpes and Syphilis. And they are easily treatable with antibiotics. So go ahead and ask or call us. We’ll be thinking of you six months from now and wish you well.

Dr. Gian
 

Dr. Gian:

I was recently told my by doctor that I tested positive for Gonorrhea. I have been in a monogomous relationship for almost 2 years. I have no symptoms at all and neither does my boyfriend. My doctor prescribed Metronidazole vaginal gel (Metro-gel). I read the information included with the product and did some research online and I have found nothing that says this gel is used to treat gonorrhea. Are my findings right? And in the case of my boyfriend, what would his treatment be?

Hi

The Centers for Disease Control and Prevention (CDC) recommends that broad-spectrum cephalosporins and fluoroquinolones be used to treat uncomplicated gonorrhea .

CDC-recommends for the primary treatment of uncomplicated gonorrhea a single-dose, oral therapy with antibiotics of the calss of fluoroquinolones such as: Ciprofloxacin [500 mg] and Ofloxacin [400 mg])

Here are alternative treatment for gonorrhea:

Ceftriaxone 125 mg injected into a muscle, one time Cefixime 400 mg by mouth, one time Spectinomycin 2 g injected into a muscle, one time Cefuroxime Axotal 1 g by mouth, one time Cefpodoxime proxetil 200 mg by mouth, one time Cnoxacin 400 mg given by mouth, one time Erythromycin 500 mg by mouth, four times a day for one week

You partner should also be treated..

Be well.

Dr. Gian

Hello Dr. Gian,

I am doing a case study for my Microbiology class. I am having huge problems with doing a diagnoses of the symptoms that were given:
22 year old moderately sexually active female with slight fever- 38.5C frequent urination burning on urination vaginal discharge (no color or smell was indicated) small lesion on the labia urine analysis pH of 8.2 some white cells and few red blood cells and protein found in urine smear of Gram-negative cocci.

I first thought that the lesion was a dead give away for syphilis, however the smear of the Gram-negative cocci (not a sign of syphlis) leads me to believe that I am wrong. I am now leading to believe that it is Gonorrhea, but the lesion is throwing me off. What I am asking is if it is uncommon to have a lesion with gonorrhea or if it is possible to obtain one. Your help on this would be greatly appreciated. Thanks.

Sincerely,

Dan

Hi,

The young woman has a urethritis and vaginitis and a Gram negative coccus in the urine smear. Bacteria usually increase the pH as they break down urea to ammonia. I would say that your bet on Gonorrhea is a good one. Good luck.

Be Well.

Dr. Gian
 

Dear Dr. Gian:

My girlfriend and I have been together for nine months. We had sex for the first time on January 18, 2004. On January 26th, she went to the doctor because she suspected that she might have a bladder infection. She was prescribed an antibiotic, and then the medication was changed to another antibiotic. We both have been monogamus the entire time of our relationship, but on October 4th my girlfriend suspected another bladder infection. She visited the doctor on October 5th and was prescribed Ciprol 1000 mg. for seven days. During that same period, I had a slight discharge and soreness in my mouth, but no pain when I urinated. I visited the doctor and explained the situation with the doctor. She ordered urine cultures for Chlamydia and Gonorrhea. When I got my results, I tested positive for Gonorrhea. We have both been treated for this. My question is what is the possibility that this was a result of being infected by a partner we had before we were together? This last time that she had sex with someone else was August 13, 2003; my last time was January 17, 2004.
In 1974, while in the military, I was diagnosed and treated for Gonnorrhea. The symptoms were very apparent: discharge, burning sensation during urination, and pain. Can you explain why my symptoms this time were so mild, when the first time they were so definitive?


Thank you.

Hi,

It seems to me that the most important piece of information is that you had a previous infection with the Gonococcus bacterium in 1974. Re-infection...I have seen this over and over. It may be a matter of behavior in repeating the same mistakes or it may be a matter of poorly treated primary infection, or a sign of antibiotic resistance, as recently reported in Hawaii and California, or a combination of these factors bur this is not a uncommon situation both for Gonorrhea and Chlamydia.

You do not say whether your girlfriend was also diagnosed for GC. However I see that she took a Cipro dose enough for an army and so she should be all right. May be you want to consider retesting your urine in a couple of months.

Be well.

Dr. Gian