Oral Sex and STD

[joecool]

A female partner gave me oral sex about 12 days ago.   A day afterwards I started having a burning pain in my pennis.  There was not a discharge..  I took azithromizin 500mg one a day for 6 days for a sinus infection I had at the time and still had the burning and pain with no discharge.  I have just started taking Levaquin 500mg once a day.  So my questions are  what Std's could I have gotten from my female partner doing oral sex on me?  Will the antibiotics  take care of naything I could have contracted when she performed oral sex on me.  Also, the day after the oral sex i had unprotected intercourse with another female partner.  Could that female partner be infected the day after i had the oral sex performed on me by the other female?  Should she be treated too? I had a swab test performed last week while I was taking the zithromizin and will get the results this coming wednesday.  Will this swab test be accurate?  If it comes back negative does that mean I did not have clamida and gorneria?

thanks for you assistance

[H. Hunter Handsfield, M.D.]

My bet is that your penile pain had nothing to do with the oral sex event.  Pain without discharge is not a common STD symptom in men; even when discharge and pain are present, the pain comonent typically is trivial, only a little minor discomfort on urination.

To your specific questions:

1) What STDs from oral sex?  Chlamydia zero, HIV almost zero, syphilis extremely rare, HPV zero to low.  Gonorrhea possible, but unlikely; among other things, gonorrhea almost always causes symptoms within 3-5 days.  Herpes due to HSV-1 and nongonococcal urethritis (NGU), sometimes due to entirely normal oral bacteria.  None of these is likely to cause pain without discharge or other symptoms.  But if you were incubating gonorrhea or NGU, the azithromycin and levaquin would have prevented them.  The fact that the treatment made no difference is further evidence that the pain was not due to any STD.

2) In theory, if you were infected by the oral sex event, you could have transmitted the infection to your partner the next day.  But since almost certainly you didn't catch an STD anyway, partner no. 2 probably does not need treatment.  However, it wouldn't hurt for her to see a health care provider for STD testing, just to be super safe.

3) The azithromycin made your swab test useless.  Any infection you might have had would have been negative because of the antibiotic.

It was a mistake to treat yourself without seeing a health care provider.  Don't take anymore treatment of any kind.  If the pain persists, see a health care provider. But whatever the explantion turns out to be, it won't be an STD from the oral sex event.

I hope this helps.  Best wishes--  HHH, MD

[joecool]

I didn't start the Azithromycin until a couple of days after the female partner performed oral sex on me.  I have taken the Levquin 500mg  for two days now and the burning has subsided consideably.  So if this wasn't an STD but a NGU could this have been transmitted to my second female partner?   I have heard that one dose of Levquin will cure gonorrhea.  Is that true?  

[H. Hunter Handsfield, M.D.]

The additional information doesn't change my opinion or advice.  I continue to doubt you had an STD or any infection acquired from the oral sex event.  Most likely the pain was going to improve on its own and didn't get better because of the Levaquin.

However, if you want a guarantee you weren't infected and that your second partner is not at risk, I cannot give it.  Since you seem to be convinced you had something, regardless of my judgment, it seems to me you are ethically obligated to discuss it with partner no. 2.

I can't help further.  Do whatever your conscience dictates.