Exposure, Risk and Testing for STD's

Dr HHH -
I know this is my last question for the next 6 mos. Expanding with Dr results.
-12.27 I performed analingus to a masseuse, nothing visible. she licked my balls with manual stim to my penis.
-1-2 days later I got a sore throat. Raw, some white "dots" on either side nothing in back of throat.
-Saw Primary on 1.2.13.  He did not take blood, or swab throat, in fact, he said that's NOT how to test for it. Instead of swab testing I was prescribed a 5 day course of Z-Pack 250mg
-The 5 day ended on Sun after waiting 2 days i went back Wed to get blood and urine test (still no swab)-all results came back negative. Was this enough time to provide a true result or risk of a false positive? Is urine a good way to test for Gon?
-On Thur of last week I received another massage, where my testicles were licked/sucked, oil for masturbation.
-Fri and Sat had unprotected oral and vaginal sex with my wife, due to the fact I thought I was clean from test results.
-This Mon, had sensitivity at tip of the urethra, no buring w/urination, no discharge, some frequent urination...this is not new for me, it occurs every so often for about a day, maybe two. Wed it's a little uncomfortable, more like my underwear is irratating the it. It's not tingling, etc.
-I went to local County Clinic to get a throat swab, it was never done. They performed a swab of my Penis. I informed the NP that I never penetrated anyone other than my wife, the tip of my penis was NEVER in contact with a mouth or vagina.  She said bacteria from Oral Gonorrhea, will go through the whole body, affecting the entire system, eventually leading to an infection of the urethra.  This sent me on a tailspin. After all of the exhaustive reading and testing, I'm unsure what to do or believe. Is this true?  My Primary said it goes away, so do other threads here...I'm lost in this information, I understand nothing is 100% but it is varying widely.

Any thoughts - I believe I'm up against character limits -

[Edward W Hook, MD]

Welcome to the Forum. I'll try to help.  I read your interaction with Dr. Handsfield and agree with all that he has said.  The exposure you describe was very, very low risk for any STD and I sincerely doubt that you acquired anything.  If you had, there is a good chance that the azithromycin, while not in the dosage we use for gonorrhea, would have cleared the infection.  Thus, again, there is little to worry about.

That said, the folks in the STD clinic you saw were mis-informed about where and how to test. Gonorrhea is transmitted through DIRECT inoculation- thus oral sex leads to pharyngeal infection, not genital infection.  Conversely, the idea that the organism travels "through the body" to appear at a genital site is categorically wrong.  The specimen that should have been taken was a throat swab.

The symmptoms you describe do not worry me about an STD acquired through your interactions with your masseuse.

All this said, like Dr. Handsfield, if I were you I would not be worried about either of the exposures you mention, would not seek testing and would not hesitate to have unprotected sex with my wife.

I hope these comments are helpful. EWH

[Uncommon1]

Finally something to laugh about...I realize my character is in question, but my reference to character limits was the restriction put on the post. Perfect.

[Uncommon1]

Thank you for your reply I Dr, I appreciate it.
I have a couple follow-up questions...

I waited 2 days after finishing the antibiotic to take the blood and urine tests.  Is this enought time to wait for accurate results?

I'm shocked I can't seem to get a swab of the throat from my Primary or County Health Clinic, so I'm going to my ENT today, hopefully they will...I'll post results.

Lastly - here is the scenario which is concerning me...
For fear of Oral Gon, I only had vaginal sex with my wife, no oral, until after I thought I was std free, and the fact that I didnt have any penetration with anyone else. On Saturday, I gave oral because it's natural in our relationship and would have seemed out of the ordinary if I didnt, then she gave oral, then we had sex...Mon. I have the sensitivity at the tip of penis, still no discharge.  Is it likely that when I provided oral to her, I may have passed along Gonorrhea, and when I penetrated her, received it back?  Can it happen that quickly? I really stayed on the clitoris and side labia, never penetrating with my tongue. Woiuld NGU be in the fold?

It seems as though everything I see or feel is a symptom, and seeing that most is asymptomatic, I hope I'm dwelling on this too hard. I've run through everything from Gon, herpes, Hep B, etc. but the lack of understanding and testing from my health professionals kind of left me drifting I suppose.

I'll be done with this thread, until my results come in, I feel my questions may become an annoyance. Both you and Dr HHH address many concerns on this board, and I've seen many folks spin out of control, I know I'm close to the rediculous.

Can you please help me with the questions about testing, and transmission with my wife?

[Edward W Hook, MD]

Your urine test reuslts, whihc I have no doubt will be negative, will be reliable despite the recent antibiotics- believe the results.

Your proposed transmission of infectio to your wife through oral sex, following by passing it back to you is fanciful.  Any discomfort you describe is more a sign of anxiety than a manifestation of an STD.  This sort of transmission should not be a concern.

Please don't worry. EWH

[Uncommon1]

Thank you Dr I appreciate you trying to calm my nerves.
My urine tests did come back neg, I was just curious if the results were reliable after waiting 2 days from the end of my zpack.

Lack of professional testing and symptoms showing up left and right add to the stress.

For instance canker sores have been popping up like crazy in my mouth and on my tongue. I have always gotten them but not on my tongue. Could these be a sign of fighting an infection or stress?

I'll post my throat swab results if the ENT takes it.

Thanks again for easing my anxiety.

[Edward W Hook, MD]

This thread needs to end.  It appears that my efforts to provide information are just fueling unwarranted anxiety on your part.  Last answers.

Your question about antibiotics is repetitive.  I said above "Your urine test results, whihc I have no doubt will be negative, will be reliable despite the recent antibiotics- believe the results."

Canker sores may be a manifestation of stress. they are not a sign of fighting infection.

End of thread. EWH

[Uncommon1]

You're right, my apologies.
Thank you for your help.

[Uncommon1]

Dr Hook
May I ask you one last question regarding this encounter and Syphilis?
It wasn't a concern until the last couple of days which would be about 5-6 weeks past the event.

I had a cancer sore on my tongue, slightly painful.  It seemed like it was healing. Now about 7 days passed the arrival of that cancer sore I see what looks like a tiny white round circle on my tongue a little larger than a pinhead. It is not painful.  Is that how a Syphilis Cancher begins?

I promise this is my last question to you.
I'm very nervous and extremely stressed out about this.
I will not reply to your answer I promise.

[Edward W Hook, MD]

Syphilis lesions of the mouth are very, very rare and your exposure did not put you at meaningful risk for oral syphilis. Syphilitic lesions are not painful.  

Get a grip on yourself and address you anxiety and possibly guilt- that is your major problem here, not STD or STD risk.

Further questions will be deleted without comment.  EWH