Sexually Transmitted Diseases/GC NAAT test

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Question
Meatus
Meatus  
QUESTION: Hello,

Thank you for looking at my question.

About 16 months ago, I received unprotected oral sex (from an escort).  2-3 days later I noticed slight swelling of my meatus.  Approximately a week or so, I went to the local STD clinic.  They did not seem concerned.  Ran tests for everything (HIV, Syphillus, G/C).  They took urine (NAAT) and urethral swab for culture.  All clear.  I was up most of the night so there could be an issue of urine concentration leading to false negative?  Thoughts?

Only symptom (swollen meatus) never resolved.  Never had discharge.  Meatus changes in swelling status from very noticeable (after activity) to still swollen but not bad.  Also had a sore throat with a red oropharyngeal arch.  Was prescribed Nystatin swish and swallow for oral thrush as the level of sore throat and irritation seemed to be linked directly to diet in terms of sweets, soda etc.  Never really resolved.

Last July, I had another round of complete tests inc. complete metabolic panel, CBC.  All fine.  The G/C was another urine NAAT and the test was at 8am so if I remember correctly I tried to give them the most concentrated urine I could.  All clear again but symptoms persist.

Fast forward to now (approx. 16 months later), I have mild lower abdominal pain, testicles can be a bit tender, and I had dry skin with small vesicles on my hands and feet that when lanced leaked a clear fluid.  Also had sore throat that hasnt been as bad due to previous 3 month ingestion of 4 cloves of garlic per day. I went to the doc, and they gave me 4 weeks Diflucan.  Just about done with that course and throat/hand/feet symptoms have 97% resolved.  

I feel as though the Diflucan has brought on more symptoms in terms of the urogenital area however.  As a type, my testicles are tender and sore enough to make me aware of them more so than normal, and I feel pressure in my lower abdominal.  Some mornings I wake with lower back pain.  I'm fairly active in terms of exercising and have completed two 10 mile hikes that weren't on a beginner trail.

With that long history, Im not sure what to do.  My wife has no symptoms other that minor muscle issues in terms of soreness but she is a personal trainer and teaches classes.

I have a urine NAAT pending currently.  This time it was 100% a First void urine and very concentrated.  Retested neg for HIV and syphilis.

What are the chances for 2 false negative NAATs and a negative culture?  Would diflucan therapy cause an underlying GC infection to flare up?

ANSWER: Hi Ryan,

The NAAT is 99.6% accurate, so I don't know how much more comfort I could give you than that, but false positive are extremely rare and virtually unheard of. You are aware that urine is the most sterile substance that comes out of the human body, so the likelihood of your specimen become contaminated or mixed with Spiderman's DNA is less than the likelihood of Earth being hit by an asteroid in an hour. Diflucan is an anti-fungal medication used to rid the body of opportunistic organisms that have taken advantage of your body's natural flora during a bout of anti-biotic treatment or other form of aggressive medication management. Diflucan is such a safe drug that it is has virtually no common or uncommon side effects, merely rare ones. So really your issue is a swollen meatus, which could result from anything from the weather to you staring at it for way to long and "thinking" its swollen when in reality it isn't. We all have aches and pains that come and go and cant be explained by every little test, but it doesn't always mean we have cancer or the plague either :) I think you're stressing yourself sick and I've had numerous clients send my queries on this site telling me they've tested themselves 10's of times in the past year and wonder "what's wrong with them?" In reality, I think its in their head. I hope this gives you some clear insight as to the faithfulness of your test results, but the picture you sent me alone tells me I'm not that concerned about your external condition.

Best wishes,

John

---------- FOLLOW-UP ----------

QUESTION: Thank you for the reply.  I can assure you my symptoms are not fabricated.  Currently I literally have many symptomsof PID or prostatitis.  My testes are sore and swollen sightly,  lower back pain, as well as low frontal pelvic pressure continuously.  

At this point, I wish I wasn't making this up in my mind.  I hope the NAAT shows the infection.  Are you aware of the multiple forums of people describing my same symptoms and exposure unable to find answers?  

Do you know of any herbal therapies to try in the meantime?

Thanks you.

ANSWER: Hi,

False positives are practically unheard of in this day in age, so no I haven't heard of the "forums" you're speaking of. Since I'm not a N.D., nor an M.D., I cannot advise you in the area of "remedies" or "therapies." That would be a breach of conduct on my certification standards, but you could consult a naturopathic physician or osteopath if you don't want to consult with an allopathic physician.

Cheers,

John

---------- FOLLOW-UP ----------

QUESTION: Just FYI,

http://www.medhelp.org/posts/Urology/Persistent-Inflamed--Irritated-Meatus/show/

I don't expect a reply.  Thank you.

Answer
Ok, that's fine. Enteroccocus is a beneficial bacterium that lives in our gut and helps us break down food more efficiently during digestion, but that form of infection isn't exactly common so you would have to be tested for EXACLTY that if you went to the doctor.

Cheers,

John

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John Brice

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Educated and certified in STI information, HIV and AIDS, and trained in comprehensive sex education for teens and young adults. Providing counseling in sexuality, sexual interests, and sexual orientations, pregnancy prevention, safer sex initiatives, and teaching health education seminars to adults ages 18-65 for the past 3 years. Serve underserved clients in homeless shelters, workplace readiness programs, and detention centers. Three term AmeriCorps domestic service volunteer and Peace Corps nominee for Health Service to Lesotho and Rwanda. Providing services to the GLBTQIA populations of which I am a member.

Experience

3 years as a volunteer Emergency Medical Technician (Advanced) for 3 years and comprehensive sex educator for 3 years and parenting educator for 3 years. *North Carolina State Certified Emergency Medical Technician, #P083512 *Certified Health Education Specialist, #22589

Organizations
*American Public Health Association *National Commission on Health Education Credentialing

Publications
American Public Health Association, Student Assembly, Quarterly Newsletter 2012-2014

Education/Credentials
*Doctor of Education (candidate), K-12 Teacher Leadership; Capella University *Master of Public Health, Social and Behavioral Sciences; Capella University *Master of Education, Curriculum and Instruction; Concordia University-Portland *Bachelor of Arts, Psychology and English; East Carolina University

Awards and Honors
Graduated with Distinction from Capella University AllExperts, Top Experts of 2014 (One and Multiple Categories)

Past/Present Clients
*Over 180 clients, lasting 30 sessions, in 5 locations during Florida service. *Over 150 clients, lasting 18 sessions, in 2 locations during South Carolina service.

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