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Delayed Syphilis Symptoms
Dr. Handsfield,
In late March of this year I stupidly had a brief period of protected vaginal sex (5 minutes) and a number of unprotected episodes of oral sex, both giving and receiving with a Thai CSW in Hong Kong. I live in a conservative SE Asian country where testing is difficult, so, after taking medical advice from the UK I took the following:
(1) Doxycycline - 2*100mg/day for 7 days, from 3rd day post exposure
(2) Ciprofloxacin - single oral dose (500mg) 4th day
(3) Azithromycin - single oral dose (1000mg) 5th day
(4) Cefuroxime - single oral dose (1000mg) 9th day
I followed up with a 4th gen Ab/Ag HIV test at 30 days, negative. I had no symptoms & felt free of anxiety.
Now, 4 months later I developed a blind spot on the underside (since 5 days ago) of my penis where the penis & testicles join. I thought if was a pimple/infected hair follicle (like an enlarged Fordyce Spot) and squeezed it, but it didn't pop & only some clear fluid emerged. I treated it with antiseptic fluid. It is now inflamed and red, and feels solid, but has scabbed and is dry (circular, 3-4mm across). I am now filled with anxiety!
(1) Does this sound like a syphilis chancre?
(2) Could incubating syphilis have survive the antibiotic regimen that I took very early post exposure?
(3) Could the antibiotic regimen have prolonged the incubation period by only partially treating the infection?
(4) Have you ever seen symptoms developing so late post exposure (125 days)
Many thanks for your help.
G.
In late March of this year I stupidly had a brief period of protected vaginal sex (5 minutes) and a number of unprotected episodes of oral sex, both giving and receiving with a Thai CSW in Hong Kong. I live in a conservative SE Asian country where testing is difficult, so, after taking medical advice from the UK I took the following:
(1) Doxycycline - 2*100mg/day for 7 days, from 3rd day post exposure
(2) Ciprofloxacin - single oral dose (500mg) 4th day
(3) Azithromycin - single oral dose (1000mg) 5th day
(4) Cefuroxime - single oral dose (1000mg) 9th day
I followed up with a 4th gen Ab/Ag HIV test at 30 days, negative. I had no symptoms & felt free of anxiety.
Now, 4 months later I developed a blind spot on the underside (since 5 days ago) of my penis where the penis & testicles join. I thought if was a pimple/infected hair follicle (like an enlarged Fordyce Spot) and squeezed it, but it didn't pop & only some clear fluid emerged. I treated it with antiseptic fluid. It is now inflamed and red, and feels solid, but has scabbed and is dry (circular, 3-4mm across). I am now filled with anxiety!
(1) Does this sound like a syphilis chancre?
(2) Could incubating syphilis have survive the antibiotic regimen that I took very early post exposure?
(3) Could the antibiotic regimen have prolonged the incubation period by only partially treating the infection?
(4) Have you ever seen symptoms developing so late post exposure (125 days)
Many thanks for your help.
G.
hi! I had a low stage of syphilis and I got treated and I'm not in a committed relationship.. Now about 6 mnths later I had unprotected sex with him can he get syphilis even if I got treated?
MEDICAL PROFESSIONAL
I am not familiar withthis test. That does not mean that it is not a good test. As I said, you really have no reason to worry about syphilis. Take care. EWH
Dr. Hook,
Just to follow up - I just did a rapid Syphilis antibody test (a product called EZ-TP Home Test Kit by a Singaporean biotech company called CS Innovation - have you heard of them or of the test?), as you predicted this was negative.
I will get a VDRL screen in my upcoming company medical, but now shouldn't have to worry about the results. I assume it's safe to resume sexual relations with my wife with out any fear of infecting her.
Many thanks for your help.
G.
Just to follow up - I just did a rapid Syphilis antibody test (a product called EZ-TP Home Test Kit by a Singaporean biotech company called CS Innovation - have you heard of them or of the test?), as you predicted this was negative.
I will get a VDRL screen in my upcoming company medical, but now shouldn't have to worry about the results. I assume it's safe to resume sexual relations with my wife with out any fear of infecting her.
Many thanks for your help.
G.
MEDICAL PROFESSIONAL
The chance that this is syphilis remains near, if not at, zero. If this were syphilis from an exposure 4 months ago however, the syphilis blood test would almost certainly be positive at this time. I am confident that your syphilis test will be negative at this time
EWH
EWH
Dr. Hook,
Thanks for the response - it's reassuring. I wasn't concerned with the oral sex as the lesion is in the wrong place, but was more concerned with the condom protected vaginal exposure - the lesion is just at the place where the condom doesn't cover!
There is something weird with this lesion - it was damp whenI awoke this morning and then scabbed over again. After I took a bath this evening the scab washed off & it was moist and bled a little when I dabbed it with a tissue, so I am still concerned.
I have to have a work related medical for my work permit & visa (I'm an expat). If I had been exposed, but had cleared the infection with antibiotics, would I still test positive on an antibody test for syphilis?
I can get a home, rapid test kit here, is it worth me testing to help my anxiety?
Once again, many thanks.
G.
Thanks for the response - it's reassuring. I wasn't concerned with the oral sex as the lesion is in the wrong place, but was more concerned with the condom protected vaginal exposure - the lesion is just at the place where the condom doesn't cover!
There is something weird with this lesion - it was damp whenI awoke this morning and then scabbed over again. After I took a bath this evening the scab washed off & it was moist and bled a little when I dabbed it with a tissue, so I am still concerned.
I have to have a work related medical for my work permit & visa (I'm an expat). If I had been exposed, but had cleared the infection with antibiotics, would I still test positive on an antibody test for syphilis?
I can get a home, rapid test kit here, is it worth me testing to help my anxiety?
Once again, many thanks.
G.
MEDICAL PROFESSIONAL
Welcome back to our Forum. As you know, Dr. Handsfield and I share the forum. You got me. FYI, the reason we share the forum is because we have worked together for nearly 30 years and while our verbiage styles vary, we have never disagreed on management strategies or advice to clients.
Syphilis is a very uncommon STD, is prevented by correct condom use, and is only very, very rarely transmitted by oral sex with the cases which have been reported primarily being in men who have sex with other men. Furthermore, of the antibiotics you took, the doxycycline, the cefuroxime and the azithromycin each would have probably prevented the development of syphilis. Considering the 3 in combination, even in the very unlikely circumstance that your partner had syphilis, the infection would have been prevented with the antibiotics you took. In other words, the lesion you have noted is not syphilis related to the exposure you mention - for sure. The current irritation and reaction you describe is just the reason that we do not recommend that person scratch or squeeze skin lesions of this sort - it can lead to infection and irritation. Hopefully that is not what is going on with you but, if the irritation gets worse over the next day or so, you should seek medical evaluation, not for STDs but for a possible infection due to squeezing the lesion.
In answer to your specific questions:
1. No, not al all.
2. No syphilis would not have persisted following these antibiotics.
3. No, see above. You can only kill bacteria once.
4. Not from syphilis.
Hope this helps. this is not syphilis or, for that matter, any other STD. EWH
Syphilis is a very uncommon STD, is prevented by correct condom use, and is only very, very rarely transmitted by oral sex with the cases which have been reported primarily being in men who have sex with other men. Furthermore, of the antibiotics you took, the doxycycline, the cefuroxime and the azithromycin each would have probably prevented the development of syphilis. Considering the 3 in combination, even in the very unlikely circumstance that your partner had syphilis, the infection would have been prevented with the antibiotics you took. In other words, the lesion you have noted is not syphilis related to the exposure you mention - for sure. The current irritation and reaction you describe is just the reason that we do not recommend that person scratch or squeeze skin lesions of this sort - it can lead to infection and irritation. Hopefully that is not what is going on with you but, if the irritation gets worse over the next day or so, you should seek medical evaluation, not for STDs but for a possible infection due to squeezing the lesion.
In answer to your specific questions:
1. No, not al all.
2. No syphilis would not have persisted following these antibiotics.
3. No, see above. You can only kill bacteria once.
4. Not from syphilis.
Hope this helps. this is not syphilis or, for that matter, any other STD. EWH
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
