STDs Expert Forum
Syphilis risk and advice
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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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Syphilis risk and advice

I had protected Vaginal intercourse with a CSW about 3 months ago. The condom functioned properly from what I could tell and there were no tears or leakages. The condom was provided by the CSW so I am unaware of what the expiry date was, but I assume she would have wanted to stay as safe as I did?

I also had unprotected oral from a different CSW about 2 weeks ago. I didn't notice any sores etc. on CSW.

Two days following the oral sex I noticed a small hard spot on the shaft of my penis. I could feel it hard when I ran my finger in one direction and not hard in the other direction. It was skin coloured at this point. I thought it must be an ingrown hair and did was everyone does and picked at it and squeezed it. It now looked a bit more red and I made a doctors appointment to get it checked. It was painless at first but then was slightly uncomfortable when touched after I picked at it or after masturbation.

The doctor took a look and asked if I picked at it. I said yes. He then said it could be one of three things. It could be Herpes. This is unlikely since it isn't painful. Then more likely it could be syphilis or just a spot. He then said since it had only been there for a week there is no point in testing for syphilis. He gave me a disinfectant ointment (betadine) to apply twice per day and if the spot is still there after a week to come back and do a blood test on me for syphilis.

My questions:

1) What is your opinion is my risk of having contracted an STD from the situations I described? If it is syphilis then I'm guessing it is unlikely that it was caused by the oral sex (ony two days for chancre to form?). In that case the infection would be from 3 months ago and a test would be okay.

2) If the doctor thought it MIGHT be syphilis. Then surely he should have given me a shot of Penicillin just to be safe?

Other symptoms I have are a very mild sore throat and some diarrhoea. Although this may be from fast food that I've been eating recently.

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Welcome to our Forum.  Your risk for any STD, and particularly syphilis from the exposures your describe is very, very low.  Few STDs are spread by oral sex and you used a condom for your vaginal exposure, reducing your risk in that situation.  Your condom was fine if it appeared intact upon completion of intercourse.  Condoms do not fail by leaking a little, they break wide open.  Thus, if the condom appeared intact, it was.

1.  Your risk for syphilis is extraordinarily low.  Had the lesion you described been syphilis it would not have appeared so soon following exposure and would have gone on to ulcerate with the sore last several weeks. Further, statistically, syphilis is VERY rare in North America.  This year there will be only about 10,000 cases of syphilis in our nation of over 350,000,000 and about two thirds of those will occur among men who had sex with men.  I have to disagree with the doctor who saw you however, a syphilis blood test likely would have been useful at the time you saw him.  Blood tests are typically positive within a few days of the appearance of a lesion.  Further, to address your question, a blood test at this time would certainly be reliable.

2.  See above, the probability of syphilis was low.  I doubt that he though syphilis was a realistic possibility.  I do not.

Diarrhea and sore throat are not suggestive of syphilis. they could arise from bad food or, most likely at this time of year, a flulike viral illness of the sort we all get from time to time.

I hope you find my comments useful.  EWH
4 Comments
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Avatar_m_tn
Thanks for your speedy reply Doctor.  Would it be safe to say I can have unprotected sex with someone of known 'clean' STI status in your opinion?

Or do you think I should wait until I get a definitive test.

Just to confirm that I'm in Western mainland Europe not the US (I ran out of characters to type in my initial post :) )

I can even send a picture of the spot if that's possible here?

Thanks again
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300980_tn?1194933000
Sorry, we have a policy not to look at pictures on this site.  Too many bad expereinces related to mis-interpretation.  Better to have your own doctor take a look.

I would not worry about syphilis if I were you and would not worry about the need to abstain.  EWH
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Avatar_m_tn
Thanks for your help
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H. Hunter Handsfield, M.D.Blank
University of Washington
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