Follow up testing window

[ALittlereckless]

Hi Doctor,

I had an encounter with a sex worker 11 days ago.  We engaged in protected oral, very brief (less than 10 seconds) of unprotected oral.  I know my risk is small but I got tested today just for peace of mind (results in 2-3 days).  As prophylactic measure, I'm going to start taking doxycycline - 100mg 2x a day for 2 weeks.

My question are as follows -

1) with the 11 day lag since the encounter is that enough time for most of the common stds to show up in these kinds of tests?

2) can I be confident that this will prescription knock out anything that I might have contracted from the encounter (mostly concerned about chlamydia, gonorrhea, and syphilis)?

3) again for peace of mind, how long should I wait before retesting after I've taken the meds to be sure I'm clean (i.e. how long will the doxy affect future testing?)

As much as I hate to admit it, I need to be sure because my wife is expecting and I don't want to risk passing anything on.

Thanks very much.

[Edward W Hook, MD]

For a wart to be  transmitted to the scrotum as a result of protected oral sex is most unlikely.   It is likely to be another benign process which has been present for some time and was just noticed.  At the same time, making a diagnosis over the internet without the chance to examine you is not in your best interest.  My adice is that you would be best served by having your doctor take a look at the spot at a time that is convenient to you.  This is almost certainly not an emergency..  EWH

[Edward W Hook, MD]

As you point out, your exposure was very low risk.  I would not recommend antibiotics in this situation but I suspect this recommendation will have little effect.  I hope you do not have side effects from the antibiotics.  As for your questions:

1.  Yes, it is plenty of time.  If the tests were taken before you started antibiotics, when the results come back negative you can be confident that you did not have an STD.

2.  The doxycycline, in the dose and for the duration that you plan to take it, would kill chlamydia and syphilis, as well as most but not all gonorrhea.

3.  Follow-up tests are not recommended or needed.  If you must, the doxycycline will be out of your system about 4-5 days after completing it.  A re-test at 5-7 days after therapy would be accurate.  EWH

[ALittlereckless]

Thanks very much Doctor.  I'm making an appointment to see someone tomorrow.

[ALittlereckless]

Hi Doctor,

If you'll allow me another question in this thread.  I was showering this morning and noticed a painless, small (roughly 2mm) raised nodule on my scrotum.  I'm wondering if it could be a genital wart.  Could I have somehow gotten this from my encounter (protected oral) - either from saliva dripping down or otherwise?

Thanks very much.

[ALittlereckless]

Thanks very much for your thoughts.  Can I assume then, that a negative test for Syphilis is reliable only 11 days after the incident?  I was concerned about the longer incubation period.