STIs and other infections

Patient

Q: Hi. I live in Thailand. I recently contracted and treated clamidiya and gonorhea. Before i got the treatment my elbow, which I broke several years ago and has a metal pin, started to swell with what looked like a cyst. After taking the anti-biotics I went to a hospital and the doctor drained a yellow thick puss. However the swelling came right back the same day. I went to another doctor who cut the skin and put in a drain and has taken a culture to find out what is the cause of the infection. This time the liquid was more like water and blood. The drain is still in place. My question is can the elbow infection be as a result of an sti (either directly or indirectly) and is this typical of any one sti in particular (that I have already treated or am yet to discover)? The doctors I have seen have not been able to answer this. Thanks in advance. (PS Its atypical for me to contract an sti. I normally practice very safe sex but slipped up this one time. This is the first and only time it will happen).

Symptoms:  Swelled liquid filled cyst like swelling on my elbow.
Doctor

A:  
Your elbow infection can be because of a STI and may in fact be an acute infectious arthritis. Acute infectious arthritis is a joint infection that evolves over hours or days. Most patients have a simultaneous genital tract infcetion due to STI causing organisms. The infection spreads from infected mucosal surfaces (cervix, urethra, rectum, pharynx) via the bloodstream. The infective organisms reside in synovial or periarticular tissues i.e the joint tissues. It is usually bacterial in origin—in younger adults, frequently Neisseria gonorrhoeae. However, non-gonococcal bacterial infections such as Chlamydiae, streptococcus etc. can also occur and can rapidly destroy joint structures.
Symptoms seen in this condition include rapid onset of pain, effusion, and restriction of both active and passive range of motion, usually within a single joint. To establish a diagnosis, one requires synovial fluid analysis and culture. Treatment is done with antibiotics and drainage of pus from joints. The treatment you have followed seems to be alright so far. Wish you a speedy recovery.

Comments / Follow Ups

Patient: Thank you very much. It's sometimes very difficult to get some good advice in Thai hospitals and i appreciate the fast response.

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