Unprotected .. burning tip of penis, sore throat and swollen lymph nodes

[phatkickr]

Hi All,

   I have been goign to this massage place and seeing one particular girl for almost a year ... all these days I only got hand job. But suddenly last week Saturday (20Apr13) I went there and things escalated and I gave her unprotected oral and she gave me unprotected oral .. then tried unprotected penetration but only stroked about 7 times .. then we decided to end. Then the next day I had the tip of my penis burning (all the time) and also got sore throat. On 25Apr2013 I noticed my lymph nodes swollen just below the ears on both sides and the swelling is lil and when pressed ..feel a lil pain.  Please help me decide what this looks like .. I am a lil scared. I need to go see a doctor but don't have insurance. Do you know any STD clinics or med offices in San Francisco South Bay area (Milpitas, San Jose) or Bay area that I can visit for low cost. Thanks much

[phatkickr]

Thx much

[H. Hunter Handsfield, M.D.]

Minor lymph node enlargements in these locations can persist a long time and often are present in healthy people, due to past infections of various kinds.  And I think you're being too hard on your doctor.  I'm inclined to doubt he or she actually "diagnosed" you with chlamydia or syphilis.  Probably testing was recommended as a precaution; if s/he had really thought you were infected, s/he probably would have treated you without waiting for the test results.

Everybody should be immunized against hepatitis B, regardless of sexual risks.  But it's especially recommended for people with high risk sexual exposures like the ones you have had and are considering in the future.  

You'll have to be the one to judge whether you are the only client with whom your massage has had unprotected vaginal sex.  That doesn't seem likely to me.  I definitely do not recommend unprotected vaginal sex in this sort of situation.  If you have vaginal sex with her again, I strongly encourage you to use condoms.  Unprotected oral is lower risk than vaginal, but does carry some chance of an STD, especially gonorrhea, nongonoccal urethritis, and herpes due to HSV-1.

That should end this thread.  Take care.

[phatkickr]

Hi Doctor,

    I got my test results and the nurse who called said everything was normal (as you predicted but my doctor who saw me diagnosed me with mostly Shyphillis and secondary as Chlamydia .. that's why I don't trust many docs these days)  Anyway, the nurse also told me the doc recommended HepititisB immunization, is this needed or helpful.

A few more questions to you - I still have the lymph nodes swollen .. small bumps (a lil painful when pressed) under my ears and also I believe my lymph nodes in left thigh is a lil painful when pressed hard (not the same on right thigh) so prolly they are swollen as well as diagnosed by my doctor.  Last question is can I have sex (unprotected) with this massage girl who I know for 1 yr .. she claims she does not do it with every client (for others Hand job or only covered BJs)  .. if not atleast can I do unprotected oral. Lemme know. Thanks much

[H. Hunter Handsfield, M.D.]

It is true that many doctors are not as knowledgeable about STDs as would be ideal.  But many are very good.  And you can always seek out a local health department or Planned Parenthood clinic, where for the most part STD related services are excellent, as well as being sensitive to alternative sexual lifestyles and related issues.  In any case, a distant online forum cannot substitute for in-person health care.

[phatkickr]

   I have one issue with local medical care providers ... they all seem to be clueless about diagnosis.  My first STD issue (seen by 5 local doctors .. and all different diagnosis) but the right answer was here by you and Dr. Edward and obviously I had nothing (test results proved it).    I just get a feeling most doctors these days are only there to make money and rely solely on test results rather than knowledge and experience. I pay $80-$120 for the visit without insurance and they only see you for like max 10 mins and then they are off to the next patient.  Anyway, my point is I would come here and tell others about you (this site) for the most accurate diagnosis and interpretation of results.  You and your partner do an unbelievable job for the world, and ofcourse some great ppl on the community forums as well. Thanks you.

[H. Hunter Handsfield, M.D.]

I will be extraordinarily surprised if this turns out to be syphilis.  I expect any and all your STD tests to give negative results.  But better safe than sorry.

Since you're now in medical care for these issues, that's where you should direct any further questions about it.  Best wishes.

[phatkickr]

I saw a doctor at North East Medical Services in South Bay.  Anyway, the doc told me there was some redness in my throat and the Swollen lymph nodes below the ears are very little and the doc also said the left groin area lymph nodes are swollen (but I do not feel any pain or discomfort).  One more thing, I was diagonsed with Candidiasis (on penis head .. redness) in March 2012 after a one time nude sliding massage with a different female,  and it was not cured until like jan 2013 .. it would go away when I applied the cream (1 week) .. then return when I thought it was almost gone. But in Jan 2013 I thought it was gone completely because I applied the cream everyday twice/thrice for almost 2 months.   But yesterday the doctor pulled my foreskin and found redness on the penis head and said its mostly candida, but said my current infection could be shyphillis (the burning at tip and sore throat with swollen lymph nodes). I will go to lab tomorrow for the tests and prolly get my results next week.  Doc did not prescribe anything at the moment.

My last complete panel tests were in December 2012 and all negative.

Thanks much

[H. Hunter Handsfield, M.D.]

Adenovirus is not possible from the sexual exposure in the massage parlor.  If this is what you have, you probably caught it 3-7 days before your symptoms started -- in which case you may have already exposed your wife, either in day to day contact (as with any cold) or sexually.  There is no chronic carrier state for adenovirus; once your symptoms clear up (probably 1-2 weeks), you would no longer be infectious, sexually or otherwise.  Adenovirus in this context shouldn't be looked at as an STD.  

I stress I'm not at all certain you have adenovirus. It conceivably explains the combination of both upper respiratory symptoms with urethral irritation, but it's only a slight possibility.

[phatkickr]

By "Can't trust anyone" I didn't mean to blame the girl but I meant I need to be responsible and have my guard up all the time ... Thanks much for advice

[phatkickr]

   Just curious is adenovirus transmitted thru sexual acts I described.  I read the virus could be shedded for a very long time ..so can I transmit to my partner. Thanks much

[H. Hunter Handsfield, M.D.]

I'm not sure I follow your "can't trust anyone" comment.  It takes two to tango; your massage partner is no more responsible for escalation of your sexual practices than you are.  Most people don't lie about STD status and testing when asked directly.  And as far as she knows, the greater danger was hers:  women in general, and sex workers as well, are generally at higher STD risk from their male partners than the other way around.

But in any case, I'll still be interested to hear the outcome after your doctor visit.

[phatkickr]

Thanks for your response doctor.  This girl had claimed she does not do it with all of them and told me she gets STD testing done 6 months ... also since for a year I only got like hand job .. I thought I could trust her.  But I know can't trust anyone ....
I will keep you posted after my visit to doctor and testing.

Kind regards

[H. Hunter Handsfield, M.D.]

Welcome to the forum.

This was obviously a high risk exposure.  Since your massage parlor partner had unprotected sex (including vaginal) with you, it's a fair bet she does so with other men as well.  On that basis, STD testing would make sense.

However, your symptoms probably are not due to any STD from that event.  In general, no symptoms of any infection can not start within 24 hours; 2-3 days is the minimum for both STDs and common colds, which is probably the cause of your sore throat and possible lymph node inflammation.  I wonder whether you have an infection due to adenovirus; some types of that virus can simultaneously infect the upper respiratory tract and genitals, perhaps causing the penile burning as well as sore throat.  It's also possible your penile burning has a physical or chemical cause -- e.g. from vigorous manual stimulation, a lubricant, vaginal perfume, contraceptivve foam, etc.

In any case, I agree it is a good idea for you to be professionally evaluated.  When you do, I expect no STD will be found, but better safe than sorry.  I can't recommend any specific clinics in the south bay area, but I would expect San Jose city or Santa Clara County have a health department clinic that provides low cost or free STD services.  If not, the San Francisco city health dept STD clinic is one of the best in the nation.

I hope this has helped.  Please return with a comment to let me know the outcome after your clinic visit.

Regards--  HHH, MD