STDs Expert Forum
syphilis or herpes
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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 or herpes

Hi Doctor. Thank you for your time.

Would syphilis chancre show up by day 10 of infection?
I have what appears to be a sore of sorts and do not know if its syphilis or HSV.
I performed fellatio on male.
I have a sore on my lip barely visible. I thought it was getting harder, but is flat, and has 3 holes in it.
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239123_tn?1267651214
Welcome to the forum.

According to your description, this sore isn't typical for any STD.  Ten days is typically too late for herpes, and initial herpes usually causes multiple painful sores that start 3-5 days after exposure.  And it's too warly for syphilis, which typically shows up at 2-3 weeks or later.

You don't say enough about the situation for me to judge the STD risk.  If you are also male, the chance of syphilis may be higher, since most syphllis in the US and other industriazed countries occurs among men having sex with men.  If you are a woman and your partner a heterosexual male, then syphilis is very unlikely.

My advice is that you see a health care provider promptly, preferably one experienced in STDs.  Your local health department STD clinic (or GUM clinic, if you happen to be in the UK) would be a good choice; or a dermatologist.  But my best guess is that this is not an STD and probably has nothing to do with the recent sexual encounter.  I will be interested to know the outcome after you have been professionally evaluated.

Regards--  HHH, MD
10 Comments
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Avatar_m_tn
I am male. My apologies for not being clearer, I typed my post in notepad and got them mixed. Here is a paste from the one I posted in the community forums (I intended to post this here):

On July 23 I performed fellatio on a male I didn't knew for about 3-4 minutes before stopping, no ejaculation. Would I show signs of a chancre by now? 7 days after, I have a bump/sore on my lips (plus I feel very tired). I have had cold sores in the past, but given the coincidence, I am confused.

Would I show syphilis symptoms at day 7 to 9 (today)? say 10 days to be sure?

The sore has a few pinhead size mini sores in there... no pain. Only a little burn when I applied abreva. In the past, if anything at all, I only feel a little irritation where the cold sore would be.
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Avatar_m_tn
Also, was I at risk for HIV?
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239123_tn?1267651214
Thanks for the clarifications.  However, they do not change my opinion or advice; both your description and timing are atypical for both herpes and syphilis.  I suggest you stop applying Abreva, which has little if any benefit against herpes (despite claims by the manufacturer) but could screw up the diagnosis if the problem persists and you seek care.

The most commonly cited HIV transmission risk estimate for penile to oral exposure, if the penile partner has HIV, is 1 in 10,000.  That's equvialent to giving BJs to infected men once daily for 27 years before transmission might be likely.  Without ejaculation your risk might be even lower.
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Avatar_m_tn
Thanks!

All I read is that typically 21 days / 3 weeks is common for syphilis. So having a bump/sore at 9-10 days (today is day 11) and worrying about this being syphilis is unwarranted?

Can I test at 2-3 weeks after exposure?

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239123_tn?1267651214
See a doctor or clinic in person and feel free to let me know what is found.  Until then I have no further advice.
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Avatar_m_tn
Hi Doctor.
I got a syphilis test ordered for reassurance (dr mentioned is up to me). Doctor seems to think that this is a cold-sore, which kinda looks like it, but not really and it looks like its drying now. Also, the sore has changed since initially posting here, and its now more crater-like. I don't think I caught anything on this exposure, as Ive had them before, but this one is in a different place, plus I feel very tired and it coinciding with the fellatio event, well...

It all seems to point syphilis is not the cause?
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239123_tn?1267651214
It would have been helpful if you had said from the start that the lesion was similar to past cold sores.  My initial reply would have been even more reassuring!  In any case, syphilis is now even less likely.  However, it takes 6 weeks for syphilis blood tests to become positive, so in light of your concerns about it, you might want to have another test at that time.

Take care.
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Avatar_m_tn
Is it safe to have sex during this time? can I assume that if this heals this week, definately not syphilis? (to hold me over until the test :) ) thanks.


(btw, the location was not the same, I usually get the 1-3 papercut type to the side of the mouth towards the inside (0-2 times a yr), and once got a nasty looking one (more towards the top side). This one was in the middle low lip, the area raised, nasty like the others, but not really visible to others unless they saw (it had the mini sores). The part outside the mouth today scabbed over and I accidentally removed (ouch) the scab. It bled. And I am beginning to not feel tired, just like past times I've got the oral ob. at this time, it looks like it is returning to normal. If there is a chancre, I don't think I differentiate.)
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Avatar_m_tn
Today, on August 8, 2011, all traces are gone.
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