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Sore Throat (Strep) after kissing & oral sex
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The STD Forum 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.

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Sore Throat (Strep) after kissing & oral sex

Hi Doctor,

I'm a 32 year-old male.  Last weekend I had unprotected oral sex with two guys I met from craigslist on two separate occasions.  My encounters included performing and receiving oral sex.  In one instance, I ejaculated in my partner’s mouth.  However, I've never had an experience in which someone ejaculated in my mouth.  The only other contact included kissing and rubbing our bodies together.  

On Monday, I started experiencing a sore throat.  Yesterday (Friday), I was still experiencing a sore throat, was having difficulty swallowing and noticed a small white patch in my throat.  I decided to visit a Doctor and was diagnosed with Strep throat (positive from a swab test and visual throat exam).  My doctor prescribed Amoxicillin
(500mg 3x per day for 10days).

I've had a total of 4 oral sex encounters in my life prior to the two other experiences last weekend. I've never had any other type of sexual intercourse (e.g. Anal).

My questions:
1)What is the likelihood of the Strep infection being misdiagnosed and could I possibly have something else (such as an STD)?

2)What type of STD testing would you recommend and when should I be tested (keeping in mind I'm taking Amoxicillin for the next 8 days).

Thanks in advance for your professional advice and for providing this service.
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Straight to your questions:

1.  The rapid strep tests used in doctors' offices are very good.  There is no way that they would mix up strep with and STD.  My guess is that one of your partners had strep in his mouth and you got it from kissing.
2.  Odd are you got nothing.  Even if you did, there is an 80% chance that the amoxicillin would cure gonorrhea which is the major thing you need to be concerned about.  In my opinion, as long as you do not have urethral symptoms, you do not need testing at all.  If you experience urethral discharge or burning, a urine or swab test for gonorrhea and white blood cells (to diagnose nongonococal urethritis/NGU) is all that is needed.

Hope this helps.  EWH
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H. Hunter Handsfield, M.D.Blank
University of Washington
Seattle, WA
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