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Chlamydial Infection.

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Hi I spoke to a doctor with a reference number 124905 about a chlamydial infection. The doctors name was Dr Seebu Sebin Sebastian. This is a response to the conversion that has now run out of follow up questions: Well what are the chances that tetralysal did affect two test results? As I have not told you that I did start seeing another partner 2 weeks after my first clear test back on December the 2nd. We wore protection and I didn't even climax and no oral sex was done and I'm more than 100% sure that she is clear of any sti's. We had sex 2 more times in January before the pain begun and wore protection everytime with no condom splitting and only climaxing once and again no oral sex done. Should I tell her to get herself checked out or is it not worth risking my relationship for?
Idid have a tiny bit of discharge occasionally before I got treated for chlamydia and this all stopped once I had taken the azithromycin so it should have gone! I did not originally tell you about my new partner as I have already asked another doctor on here and it sounded as through he just presumed my new partner have me something and I know she hasn't so wanted an answer from a different viewpoint. The chance of chlamydia still being in my system after the azithromycin and two clear tests even through I was on tetralysal during both tests is surely highly unlikely? Thank you

Category: Family Physician-GP

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Category: HIV- AIDS Specialist
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Welcome back.

The tetralysal can cause a negative Chlamydia test by 'treating' it. As this antibiotic is good for Chlamydia infection also. So what mean if you had a negative test result it is not 'false negative', but a real negative test. So it is totally ok if you have not disclosed this to your partner

I would like to know what kind of Chlamydia tests were done ?
How is your symptom now ?
If you have any more concerns please let me know

Thank you

Patient replied :

So there is no chance that the tests were both false negatives then? the first test taken on the 2nd of December 20 days after I took the azithromycin was one given to me by a doctor at the university where you pee in the pot and fill out details and then hand it back into a doctor and they send it away, Im not sure if this test covers gonorhea as well.
The second test done on the 2nd of January was one where you go into the local GUM clinic walk in centre, again a pee in the pot type, this covered both chlamydia and gonohrea. I did not have a blood test for HIV etc as the doctor didn't think it was worth it. The doctor at the clinic did say that the previous test I had at the university would have been sent to the same place as is used at the GUM clinic so will be as reliable but I still went through with the test to make sure.
Symptoms have pretty much all gone, seem to get a slight ache when I keep thinking about it all so its probably nothing to worry about.

Having spoken to a lot of doctors I don't think I did have epidimo-orchitis, I think it was probably just epididmytis that I had for 12 days before getting treated as the testicle was not swollen and didn't hurt to touch, just the back of it was sensitive (where the epididymis is). The only symptoms were testicular pain when sitting or lying. having looked through what feels like every page on epididymitis on the internet my symptoms were not that severe and it was a relatively minor case that could have been caused by anything really, maybe another bacterial infection that could have not been chlamydia, or maybe not a bacterial infection as the case worsened with antibiotics and then had some pain after the course so it might have not even been bacterial. Would you agree that mine was a minor case of epididymitis from all the information I have given you or not?

"So there is no chance that the tests were both false negatives then? " - Well there we cannot be 100% sure with a lab test. Still it is most likely a negative test (not false negative ).

Having gone through all your symptoms - Yes it could be epididymitis only, as I have not directly examined you. However epididymo orchitis also has similar features and very difficult to differentiate between two. It could be a very mild case of epididymitis or as I said in the first reply it could be a non infectious epididymitis. The important fact to consider is that whether you have symptoms or not. Since you have good resolution of symptoms most likely you are cured. You just need to observe it for few weeks. Thank you

Patient replied :

Yea two false negatives would be highly unlikely, and as I have worn protection it is even more unlikely that I passed something to my partner as it can only be transmitted via seminal fluids. But I might suggest we go in for a routine check up to be sure, not mentioning what I have had. And yes I do think it was Epididymitis but will never really know if it was infectious or not. The doctor that examined me felt the testicle and there was no sensitivity there so diagnosed it as epididymitis, so I'm pretty sure it was just that.
The tetralysal I was taking was only 300g per day for 6 weeks is this enough to cure chlamydia or would it just coverup the chlamydia in a lab test?

Actually there is no 'covering up Chalmydia'. It could be enough to eliminate the bacteria altogether. The dose and duration seem to be adequate for that.

Patient replied :

Well if chlamydia can not be covered up then the tests should be accurate. The azithromycin should have cleared the infection in the first place. Am I correct in saying that there is no chance then of my girlfriend having the infection as I had protected intercourse with her 4 and a half weeks after the azithromycin, 3 weeks after starting tetralysal and one clear test a week and a half before? We have continued using protection and have not had any oral sex.
I would just like to ask that in the first consultation you mentioned that chlamydia tests sometimes struggle to pick up chlamydia if it has reached the Epididymis, is this common for it to not have picked up this? and also in my circumstances what are the chances chlamydia would not been picked up in two tests?


Picking up and false negative test is different.
Chances of the tests not picking Chalmydia are pretty low as I said earlier. (If at all this happened it is not due to the treatment) But it is still possible. But in that case you are less likely to be infective to your partner. And chances are that with all the antibiotics it was treated.

Again since you do not have much symptoms now you need to worry.

Thank you

Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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