drunken fool frozen with anxiety

[badperson123]

Dear Doctors,

I recently performed unprotected oral sex for a very short period of time with no ejaculation with a man who fingered me (unprotected) after he ejaculated.  Before the encounter he said he had no stds but after the encounter he admitted he had never been tested but only has low risk sex, i.e. never anal sex of any kind and only recieves oral sex.
  
Five days later, I went to a clinic and was treated with 1 g oral of zithromax and an intramuscular shot of Rocephin (125 mg).  I also had a syphilis test which came back negative.  I have previously been tested negative for all relevant STDs.

I understand from the various forums that my risk of catching HIV is about 1 in 10,000 or one-tenth of one percent and that syphilis is rarely transmitted via oral sex without an obvious lesion (which I understand touching the lesion is the only way to transmit).  I did not see any obvious lesions of any kind.  I also understand from the forums that the only real risk from oral sex is gonorreah.  I have an HIV test tomorrow (5 weeks and 4 days after exposure) and had a follow-up syphilis test on friday (5 weeks after exposure).  

About two weeks after the exposure I developed a mildly irritated throat which has not gone away.  I am so anxious about this that I have lost 10 lbs, can't sleep, so I thought the sore throat might be due to anxiety.  I  worried that I might infect my family.  My wife is pregnant.  We did not have sex for 13 days after the antibiotic treatment.  I kiss my daughters (and wife for that matter) all the time and worry that if there is a pharyngeal gonorreah I could transmit it to them via kissing or sharing food/utensils.  

HEre are my questions:

1) would my antibiotic treatment have killed any gonorreah I could have had?
2) can gonorreah move from the throat to other parts of the body?
3) did i wait long enough for the blood tests?  
4) am i likely to transmit these horrible diseases to my family?
5) finger risk (maybe semen exposure?)

[H. Hunter Handsfield, M.D.]

This sounds like a very low risk eent.  There are no data, but with such a brief exposure and no ejaculation in your mouth, the chance of transmission probably was close to zero.  To the specific questions::

1) Your treatment would have cured any gonorrhea, chlamydia, or syphilis, if you were infected.

2) Gonorrhea doesn't travel through the body from one site to another.

3) It takes 4-6 weeks for syphilis blood tests to become positive.  The negative result tells that you were not infected previously, but gives no infromation about an exposure 5 days earlier.  However, you don't need retesting, because the treatment would have cured you and also prevent the test from turning positive.

4) Your wife is not at risk. Children in the household never are at risk for any STD from an infected adult (assuming no sexual abuse, of course).

5) No STDs are transmitted by fingering.

Bottom line:  You have no significant worries here; you probably were not infected; if you were, you were cured; and your wife and family are not at risk.

Best wishes--  HHH, MD

[badperson123]

Thank you for your very quick response doctor.  I want to be sure I am understand you clearly.  

I am not aware of any other symptoms than my sore throat which I am sure is aggravated by my anxiety.  My temp has remained normal since exposure and i have not rashes or other unexplained phenomena.  Thus, my sore throat is likely caused by anxiety and/or non-std causes.  

Based on my exposure, you are not recommending further testing or treatment for me or my family.  If I was infected with a bacteria my treatment would have cured it - including syphilis - and my retest for syphilis will likely be negative.  Did my treatment make it possible for the syphilis test to render a false negative?

My treatment would have killed any gonorreah (or NGU) in my throat and I cannot transmit it (if it were there) via normal contact with my family.  Is it at all likely that the treatment failed to kill the Gonorreah or Syphilis?  

And finally, does gonorreah of the throat clear up on its own or must it be treated?  

Thanks again doctor for your quick responses.  

[badperson123]

Sorry for the split comment -

Is there a transmission risk of pharyngeal gonorreah via cunnilingus?  

[H. Hunter Handsfield, M.D.]

"...my sore throat is likely caused by anxiety and/or non-std causes."  I agree.  It is not due to an STD from the event you describe.  

"Based on my exposure, you are not recommending further testing or treatment for me or my family.  If I was infected with a bacteria my treatment would have cured it - including syphilis - and my retest for syphilis will likely be negative."  Correct.  There is no reason to be tested again.

"Did my treatment make it possible for the syphilis test to render a false negative?" No.

"My treatment would have killed any gonorreah (or NGU) in my throat and I cannot transmit it (if it were there) via normal contact with my family.  Is it at all likely that the treatment failed to kill the Gonorreah or Syphilis?"  No.  

"...does gonorreah of the throat clear up on its own or must it be treated?"  Irrelvant, since you don't have it. But yes, gonorrhea of the throat usually clears up on its own within a few weeks, without treatment.

"Is there a transmission risk of pharyngeal gonorreah via cunnilingus?" No transmission risk, but this is also an irrelevant question, since there is no chance you have it.  

[badperson123]

Thank you so much for your answers and for providing this service.  You have been of great help to me and others who might read this post.