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STDs (Expert Forum)
Second Opinion Required
Answered by
Edward W Hook, MD - HIV Prevention, stds
Welcome to the STD Forum, which is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.
Second Opinion Required
by warner1, Jul 08, 2009 11:01AM
Dear Doctor,
2 weeks ago i visited my doctor complaining of a sore throat and swollen glands, as well as a temperature. The doctor also noticed that i had an extremley white tongue.
I informed the Doctor that i had an encounter with a escort the previous week ( no vaginal intercourse, protected oral, deep kissing with exchange of saliva. Also intermingling of bare legs/genital area).
The doctor informed me that i may have caught oral gonnorhea or chlamydia from the kissing and advised me to get a shot. I complied with the advice and received a shot of ceftriaxone 250mg in my buttocks. He also said that there was a small chance of catching syphilis, hepatitis b and HIV.
He prescribed me penicillin which he advised me to take 3 days after the shot.
After reading through this site, i realise that my Dr may have overreacted slightly (especially with regards to HIV) and i now have a few questions, which i don't really feel comfortable asking him.
Although i now realise that the chances of me actually having oral gonorrhea and chlamydia is extremley low, would the shot have cured it if indeed had either infection (and would it also deal with oral nsu)?
i took the penicillin for 4 days before stopping the course due to travel- in the remote chance that i actually contracted syphillis would that be sufficient to cure it. As it is now a month past the encounter and i still have swollen glands and a cold, as well as a sore throat.
Finally- i informed my doctor that i have visited a dozen escorts over the last 2 years. He informed me that it is practically a certainty that i have HPV. He also told me that although it has been 4 months since my last sexual encouter, there is every chance that i could contract gential warts in the next few months due to my past encounters. Is this the case? I will be getting married in 2 months and my fiance is a virgin. Should i be informing her to get the Gartosil vaccine?
2 weeks ago i visited my doctor complaining of a sore throat and swollen glands, as well as a temperature. The doctor also noticed that i had an extremley white tongue.
I informed the Doctor that i had an encounter with a escort the previous week ( no vaginal intercourse, protected oral, deep kissing with exchange of saliva. Also intermingling of bare legs/genital area).
The doctor informed me that i may have caught oral gonnorhea or chlamydia from the kissing and advised me to get a shot. I complied with the advice and received a shot of ceftriaxone 250mg in my buttocks. He also said that there was a small chance of catching syphilis, hepatitis b and HIV.
He prescribed me penicillin which he advised me to take 3 days after the shot.
After reading through this site, i realise that my Dr may have overreacted slightly (especially with regards to HIV) and i now have a few questions, which i don't really feel comfortable asking him.
Although i now realise that the chances of me actually having oral gonorrhea and chlamydia is extremley low, would the shot have cured it if indeed had either infection (and would it also deal with oral nsu)?
i took the penicillin for 4 days before stopping the course due to travel- in the remote chance that i actually contracted syphillis would that be sufficient to cure it. As it is now a month past the encounter and i still have swollen glands and a cold, as well as a sore throat.
Finally- i informed my doctor that i have visited a dozen escorts over the last 2 years. He informed me that it is practically a certainty that i have HPV. He also told me that although it has been 4 months since my last sexual encouter, there is every chance that i could contract gential warts in the next few months due to my past encounters. Is this the case? I will be getting married in 2 months and my fiance is a virgin. Should i be informing her to get the Gartosil vaccine?
Doctor's Answer
by Edward W Hook, MD, Jul 08, 2009 10:07PM
, Jul 08, 2009 10:07PM
While I am sure that your doctor was doing his best to act in your interest, you did not need the treatment you received. Chlamydia does not cause oral infection and gonorrhea is not transmitted by kissing. NSU is a penile infection and has no oral counterpart.
The ceftriaxone would have certainly cured gonorrhea if you had it, as well as prevented development of syphilis. Your sore throat however, given your non-response to antibiotics and your history is far more likely to be a plain, every day viral sore throat than STD related.
As far as HPV is concerned. The topic of HPV and genital warts is a complex one. I will try to provide some facts. For addition information on this most common of STDs, I would suggest search for other HPV- and wart-related Q&A on this site, as well seeking addition information on sites such as the American Social health Association web-site (disclosure, Dr. Handsfield and I are both on the Board of ASHA).
For better or worse, at present HPV is a "fact of life" and most people have it or will have it at some point in the future. It would not be surprising if you had some form of HPV. Despite this fact, only a tiny minority of persons with HPV get the consequences of infection (primarily women and primarily cancer and pre-cancerous lesions). HPV is the most commonly acquired STD. Over 85% of sexually active women will have HPV infection at some time in their lives. The figure for men is less well studied but similar. In some HPV will cause genital warts, in others it will not cause warts but may lead to changes in PAP smears. In nearly everyone who gets HPV, warts or otherwise, the infections will resolve by themselves without therapy in 8-24 months. In a very small minority of women, HPV infection can persist and lead to the pre-cancerous lesions that PAP smears detect and which can then be treated. For men there is far less risk of any sort.
The HPV vaccine is recommended for all women and your fiancé should have it. In addition, if she has regular Pap smears as is recommended for women, she should not have trouble from HPV.
Hope these comments help. EWH
The ceftriaxone would have certainly cured gonorrhea if you had it, as well as prevented development of syphilis. Your sore throat however, given your non-response to antibiotics and your history is far more likely to be a plain, every day viral sore throat than STD related.
As far as HPV is concerned. The topic of HPV and genital warts is a complex one. I will try to provide some facts. For addition information on this most common of STDs, I would suggest search for other HPV- and wart-related Q&A on this site, as well seeking addition information on sites such as the American Social health Association web-site (disclosure, Dr. Handsfield and I are both on the Board of ASHA).
For better or worse, at present HPV is a "fact of life" and most people have it or will have it at some point in the future. It would not be surprising if you had some form of HPV. Despite this fact, only a tiny minority of persons with HPV get the consequences of infection (primarily women and primarily cancer and pre-cancerous lesions). HPV is the most commonly acquired STD. Over 85% of sexually active women will have HPV infection at some time in their lives. The figure for men is less well studied but similar. In some HPV will cause genital warts, in others it will not cause warts but may lead to changes in PAP smears. In nearly everyone who gets HPV, warts or otherwise, the infections will resolve by themselves without therapy in 8-24 months. In a very small minority of women, HPV infection can persist and lead to the pre-cancerous lesions that PAP smears detect and which can then be treated. For men there is far less risk of any sort.
The HPV vaccine is recommended for all women and your fiancé should have it. In addition, if she has regular Pap smears as is recommended for women, she should not have trouble from HPV.
Hope these comments help. EWH
I have a follow up appointment with my doctor tomorrow and shall politely inform him that i didn't finish the penicillin course as my own research showed that the ceftriaxone would have cured any syphillis which may have been developing.
I perused the ASHA website as well as previous threads regarding HPV. From previous replies from Dr HHH and yourself, am i correct in thinking that it is very rare for warts to occur months after a protected exposure and that warts usually develop after a few weeks?