Sore Throat and tongue after a cunnilingus

[zelec]

Hi,
I performed an unprotected cunnilingus on an escort girl 3 weeks ago (protected fellatio and protected intercourse)
My tongue hurt a few hours later, then had a sore throat and ended with geographic tongue now (two painless round spots on my tongue, they were gone 2 days ago and I have a new one today)

Can this be an STD (HIV/Syphilis)?

I softly brushed my teeth 3 hours before the incounter and only drunk water.
3 days after the incounter, my spit smelled like vagina.
I have genital herpes but I take Valtrex daily and had no outbreak during the incounter.

Thanks in advance

[H. Hunter Handsfield, M.D.]

Welcome to the forum and thanks for your question.

I doubt your symtoms are due to any STD.  First, cunnilingus is low risk for STDs, both for the exposed woman and the oral partner.  Second, no STD can cause tongue irritation (or any other symptoms) sooner than 2-3 days after exposure.  Onset within hours has to be some sort of physical or chemical irritation, or allergy.  Third, no STD is a likely cause of sore throat or geographic tongue. Gonorrhea can cause sore throat, but usually does not; most oral gonorrhea is entirely without symptoms.  I can't comment on a "vaginal" odor to your mouth or breath, except that any bacterial overgrowth can cause similar odors, and that's the source of most female genital odors.

Syphilis can cause pink patches on the tongue, but only in the secondary stage, which typically doesn't begin until 2-3 months after the primary infection.  And primary syphilis (the initial infection) can't cause a sore tongue within hours.  Finally, syphilis is very rare in escorts (expensive female sex workers by appointment).  For what it's worth, herpes wouldn't behave this way, and in any case you already have HSV-2 and can't catch it again, and you were further protected by your valacylovir treatment.

A non STD possibility is that you have an oral yeast infection (thrush).  I have seen such cases following cunnilingus on women with vaginal yeast infections and I think it's a reasonable possibility for you.  As suggested above, the tongue irritation started sooner than I would expect, but I think it's still a possibility.

Finallly, you might just have a garden variety upper respiratory infection -- coincident in timing with the sexual exposure, but not caused by it.  Sore throats due to common viruses often are accompanied by geographic tongue and sometimes pink patches on the tongue.

I reccommend you see your primary care doctor or other clinic, in particular to check out the possibility of a yeast infection and perhaps treatment for it.  To be entirely safe, probably STD testing would make sense, in particular for oral gonorrhea and a syphilis blood test.  But I expect them to be negative.

I'll be interested to hear the outcome if you would like to return with a follow-up comment after you have been professionally evaluated.

Best wishes--  HHH, MD

[H. Hunter Handsfield, M.D.]

I have no further comments or advice.

[zelec]

A little bit about my background...

Hi,
as you might have noticed, I'm not new to STDs :(

2.5 years ago, I had fully protected sex (kissing, condom for vaginal and oral sex, no cunnilingus) with a low risk girl. I contracted HSV2 genitally (on pubic area around the shaft, not covered by condoms). Took valtrex episodically when I have outbreaks, and didn't seem very effective. For a year, I tried all kind of supplements (zinc, olive leaf extracts, tea tree oil...) with not a lot of success. My outbreaks were non-stop  and some times impressive (That's how my ID doctor described them when I showed him the pictures later)
After that year, I went to my ID specialist who prescribed daily Valtrex and an immunity check (completely normal). It was much better, but my skin was often red and fluid secretions are alway present. I saw my doctor's assistant who told me that virus is present in the fluid which means that I'm constantly infectious. I didn't have any sexual life for over 2 years and went through a depression.
I consulted my doctor again lately, and told me that if there are no blisters, there is no contagion., he even took a swab that was negative a few days later. that's when I called the escort girl and practiced cunnilingus (after 2.5 years of abstinence)
I was also worried about catching HIV my doctor told no risk for that unless I have open sores but I heard about a study showing that asymptomatic HSV shedding increases HIV acquisition risks (Dr. Larry Corey)
http://www.youtube.com/watch?v=GkE_d5YWjFY

My disproportionate worries come probably from the fact that despite my low risk practice (fully protected, no sores on the girl), not only I caught herpes but was also part of the minority of carriers that develop a strong reaction when infected!

My tongue is better, but seems to get irritated after food, I even saw a few red dots but don't last enough so I can see my doctor. Hope it's nothing major.

Thanks again Dr Handsfield

[H. Hunter Handsfield, M.D.]

Glad to hear the problem is clearing up.  I doubt your symptoms will return.  You can stop worrying about this.

[zelec]

Hi,
I just got back from the doctor's.
Unfortunatly, the red spots on my tongue were gone when I saw him, he told me not to worry and to run to his office if the red spots are back so he can perform a culture. I forgot to ask what kind of culture he'd like to do.
He didn't suggest any other test.
On a side note he seemed to recommend against unprotected oral: when I asked him how risky unprotected oral was, he told me "you can get anything from oral sex"
I feel more relaxed as I have no more symptoms and my risk taking was  low.

Thanks again. I'll keep you updated if there is anything new.

[H. Hunter Handsfield, M.D.]

HIV has never been known to be transmitted by cunnilingus, in either direction.

[zelec]

Hi,
I took an appointment Monday with my doctor (an ID specialist that follows me for my HSV infection).
I just forgot to mention that I also got a painless red spot on the side of my neck about one week after the encounter. it disappeared the next day.
You didn't mention any HIV link, surely not because you forgot it :) I guess it is improbable

Thanks

[zelec]

Thanks again :)
very informative!

[H. Hunter Handsfield, M.D.]

Actually, genital yeast infections in women are odor-free.  The most common causes of an unpleasant (often fishy) odor are bacterial vaginosis and trichomnoniasis -- although the identical odor sometimes is present in any woman who hasn't showered or bathed in a day or two. But yeast infections don't smell bad. It's a common misconception, both by women and their partners.

[zelec]

Dr. Hansfield,
Thank you very much for your fast, detailed and relieving response.
I will see my doctor next week.

I would only add that the vaginal odor was a 'good' natural vaginal odor, I've already had a partner with yeast infection and know it's typical odor.

Thanks again