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Syphillis vs. Herpes

Here is my quick story...

I have had herpes for about 5 years.

I had sex with a CSW (with Condom) in Eastern Europe.  At a about 6 1/2 weeks after incident...I noticed two open sores on the base of my penis (around where a condom would just sit). Both are small and semi-circular with one being much smaller than the other.  It currently looks like a scab that is starting to heal. The sores are not firm or raised.  There is limited irritation (but I have limited irritation with Herpes).   At first I just thought this was a normal Herpes outbreak but now I am worried that it might be Syhpilis.  (I did not notice the lesion prior to it becoming open_

I am traveling (internationally) now and it is hard to get to a Dr.  Any advice on how seriously I should treat this suspicous sore?  

Any insight into the prevalence of Syphilis in Eastern Europe?  

I know that Syphilis is the "great imitator" but is there anything that would help me distingiush a hepres outbreak from a syphilis chancre?  

Thanks




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239123 tn?1267647614
MEDICAL PROFESSIONAL
You probably are the best judge whether your current penile lesions are due to herpes or something else.  Recurrent genital herpes usually occurs in pretty much the same spot each time, within an inch or so; and each outbreak tends to otherwise be similar to the previous one.  If this episode is typical for your previous outbreaks, I see no reason to be suspicious of anything other than herpes.

As to whether syphilis is possible, it seems unlikely.  The "great imitator" aspects of syphilis apply more to later stages of the disease than to the initial lesion.  The typical initial sore of herpes (the chancre) usually is a single, not very painful sore, often quite firm in consistency, i.e. rubbery or quite hard.  It would be unlikely to start to heal before 2-3 weeks.  Often there are enlarged, inflamed lymph nodes in the groin.  Also, the chancre usually shows 2-3 weeks after exposure; 6+ weeks might be possible, but unlikely.

Syphilis is more common in Eastern Europe than in the US, but still highly variable from one country to another -- and from region to region within countries.  The highest rates are in parts of Russia and other former Soviet states.

All things considered, it is very unlikely you have syphilis.  But the way to know is to have a blood test.  Probably not necessary, but better safe than sorry.  Enough time has passed, so that a negative test will be definitive.  You could have it done either by your personal health care provider or your local health department STD clinic, or its equivalent in other countries.

Best wishes--  HHH, MD
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Avatar universal
A related discussion, herpes and chancre was started.
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Thank you for your response.

A follow-up question.  The lesion completed resolved itself in about one week.  It was not exactly like previous herpes outbreaks but was in a similar location.  

Now (7+ weeks post potential exposure and 1 week after noticing the lesion) I am having a sore throat, swollen lymp nodes (neck) and pain in my kidney area.  No noticible rash and no noticible swollen lymph nodes in the groin area.  

Is pain in the lower back / kidney area at all suggestive of secondary sypilis?  

I have another two weeks before I can get to a Dr.  So would appreciate your thoughts.  

Thank you.



Is Kidney pain at all associated with Secondary Syphilis
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