Risks and Transmission

[Northernmistake]

Good Afternoon,

I have asked a similar question on HIV, but things have changed somewhat! Please advise.

9 weeks ago I had protected sex with a stripper in London (I was informed by friend she was from Argentina living full time in UK). This involved a very small amount of unprotected oral sex both ways, more me on her to be honest, maybe a little (accidental) rimming as I was very drunk. I was a mistake and I feel terrible. Two weeks later I break out in ulcerated red spotty gums in one area of the mouth (around the tooth before wisdom tooth top left, with a couple of tiny spot further up), two weeks later than this I get stomach ache with some Diarrhoea which lasted a week, although it was loose rather than any more regular than usual (now normal). From this another mouth ulcer came with red spots and groin/neck/general muscle pain (I still get some neck pain at top of spine/base of skull). I cannot feel any raised bumps. Behind the ears and at the sides of the neck have been 'pulsing' sometimes. I also had a sore throat for a few days 4/5 weeks after and now mouth feels dry. When I calmed down all symptoms went away.

Now at 9 weeks I feel fine, no issues with me at all. However, a girl I have been seeing has complained of a problem on her anus it is bluish, small (4mm), sometimes uncomfortable, itchy in the shower, she thinks it is a pile. She has not had one before though. The last time I went down on her was 7 weeks ago, and I did have the problem in my mouth (I thought it was something to do with tooth).

I am worried about Syphilis and Herpes. What are the chances the thing in my mouth was a chancre? I know there are only 1400 cases in UK of Syphilis, how often is it passed from cunnilingus? Would Herpes present itself as spotty inflammed painful gum?  

Thank you for your time,

[Edward W Hook, MD]

For starters, not only syphilis rare int he UK but it is also far and away much more common among men who have sex with other men than among heterosexuals.  You have virtually nothing to worry about syphilis-wise.

As for herpes, it could certainly be acquired by oral sex however in your case I'd bet against it.  When oral herpes is acquired this way, it most often involves the lips and perhaps the tongue, not the gums.  In addition, it does not involve diarrhea.  It is far more likely that you acquired some other virus in your community (not necessarily through sex) which may have caused this.  Should the ulcerations re-appear, there is no harm whatsoever in getting such lesions cultured.  Beyond that, I would not pursue this further.  A blood test for herpes will be of no help in sorting this out.

Finally, we often get "if I got this, could I have passed it on to may regular partner" questions.  It just does not happen with any appreciable frequency.  Why, because first of all, most of the people who raise such questions on this site in fact do not have the disease they are concerned about.  A second contributor is that even if a person has an STD of one sort or another, most exposures do not lead to transmission.

My assessment- you have little to worry about.  I would not recommend further testing at this time.  EWH

[Northernmistake]

Brilliant. Thanks for the advice.

I have read the spotty/ulcerated gum nearer the back of the mouth is not consistent with Syphilis anyway, is this correct? I do worry a lot at times, especially when I get a call like I did regarding my partners problem!

We all do the odd stupid thing, and then feel the guilt for a long time.

Your reassurance has made me feel at ease, I appreciate it. I hope the girls problem clears up soon too.

Best Regards

[Edward W Hook, MD]

Syphilitic lesions of the mouth are so rare that there is no "typical" location, not that it should be a concern for you.  EWH

[Northernmistake]

Right, thanks. I hope you are right! Crossing my fingers the partners problem is not related!

Best Regards

[Northernmistake]

Good Afternoon, one last clarification please before end of thread...

I am of the understanding the fact that I made contact with partner in the place she now has a sore/bruise/blister (she has never had before, 7 weeks after contact) when I had the problems in my mouth still does not change things? And that to worry about a small chance of Syphilis is irrational, White male UK, with low number of sexual partners one stupid incident? Generally impossible to catch orally and then pass orally in my case?

Thank you, your service is a god-send to many people!

Regards

[Edward W Hook, MD]

No change in my assessment.  EWH

[Northernmistake]

I did have a look at her 'problem', which was a strange thing to do for me! She now does not feel it, it is small blister like and grey/white. It is right on the anus opening. No pain at all.

No change in assessment?

Thanks

Regards

[Northernmistake]

This is certainly the last message on the thread.

Thank you for your help.

Best regards

[Edward W Hook, MD]

No change in my assessment.  But you are re right, this thread must end.  Further questions will be deleted.  EWH