Testing/symptoms

[thh4455]

Hi.  For background please review my previous posts.

After a low risk exposure in november 2010 started having diffuse symptoms. Possibly not STD related at all but I would still like your opinion regarding symptoms and testresults:
Receipt protected oral with csw in november. Took Azitromax + Doxylin (without testing). Was prescribed Cipro 14d by urologist january for possible prostatitis.
Symptoms: discomfort urethra, neuropathic like pain (arms, legs, torso) since december. Small ulcerations on penis 15 weeks post exp., PCR HSV  - negative.
Last tests 20 weeks: negative (hsv1+2,syf,hiv)

Borrelia test april + ktr after 3 weeks: IgM - pos, IgG - neg. Waiting for Western blot.
Saw my GP today and was refrerred to neurologicst. We agreed on no new testing.

Question: Could the antibiotics have delayed the course of syfilis, causing late outbreak (15 weeks) and false negative serology at 15 and 20 weeks ,the positive borrelia beeing a crossreaction to treponema?

Also , I had a planned vasectomy in december. Knowing that this initiates production of anti-bodies angainst semen - could this cause a crossreaction ?
Other comments ?

Thanks

[Edward W Hook, MD]

Welcome to this Forum.  I have reviewed your earlier posts under this pseudonym and will be pleased to make some comments.  It is clear that your exposure to the CSW last year was most worrisome for you and that in response you have taken a number of actions, not all of which are advisable.  That said, the fact is that there is NO evidence whatsoever that you got an STD of any sort through this encounter.

STDs following oral sex are rather uncommon.

Your tests have all be negative.

The antibiotics you took without a diagnosis would have killed/cured syphilis had it been present, something that was most unlikely.

I should also point out that sometimes after an exposure that, in retrospect, one wishes they had not had, persons tend to examine themselves and be far more attuned to genital and other sensations than in periods when they are not concerned.  This in turn leads to noticing what turn out to be normal sensations that might have been not noticed or ignored at other times.  Perhaps this was a contributor to your situation.  Never underestimate the power of the mind.

I would advise you to work through this with your doctor.  Perhaps some other health issue has come up coincidental to the exposure you mentioned.  there is no reason to be worried about STDs of any sort and to continue to focus on them may delay paying attention to other possible causes.  Hope this helps.  EWH

[thh4455]

CMV  IgG pos. EBV IgG pos. HSV combo + HSV 2 - neg. Borrelia IgM pos, IgG neg.
No need for follow up from you!

[thh4455]

Just an update: neurology examination normal. Could be Lymes. Neurologist suggests to do a spinal tap. Treponema serology-neg. She also ordered ebv, cmv and Hsv serology. One question on Hsv : if by any chance the lesions at 15 weeks PE was due to Hsv , would a negative Hsv 1 and 2 at 22 weeks PE be accurate? Or would this be defined as 7 weeks post OB thus possibly to early for a definitive result? Sorry for the adfitional question .. Thanks

[thh4455]

Ok, std-lead closed!
Borrelia IgM titer from 100 to 128 in 3 weeks, IgG neg. Maybe Lymes, maybe not...hopefully neurology assessment can clear things up.

[Edward W Hook, MD]

No, these tests are highly reliable.  You can relax and move forward.  EWH

[thh4455]

last questions :  can false negative treponema serology occur 20 weeks PE?
How early after exposure can symptoms of neurosyphilis occur?
Sorry, just for Peace of mind..

[thh4455]

Thanks for your reply.  The timelines, lightning Pain symptoms, ulcerations and positive Borrelia IgM is the reason why I have not been able to put this at rest. But I do trust your expert opinion; the negative test results triumphs symptoms. I have an appontment with an neurologist sms still wait for Borrelia western blot