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Infection from oral sex?


8 weeks ago, I had an oral encounter with an acquaintance.    I was probably down on her for a total of 3-4 mins. (one of my concerns is that she was just at the end of her period and removed her tampon, though I did not taste any blood as it was nearly over) There was also some mutual masturbation.

Immediately after the event I was overcome with guilt as I am married. Within 3-4 days of the encounter, I felt a funny sensation in the left side of my throat.  It didn't hurt (though it was slightly raw here and there, though tthis was minimal and did not last)  but when I would swallow saliva, it felt as though it was swollen as the saliva would not go down the left side. Swabbed - no Strep. At this point I told my wife.  It was stressful though after seeing what torment I was in she forgave me quite quickly.  Still I continue to suffer from extreme anxiety at the prospect of having brought something home to her as a result of this encounter.  The doctor gave me some sleeping pills, and I've arranged to see a counsellor to help deal with my guilt and fears. I've been on antibiotics 4 days, no result.

The ENT  looked in my mouth and said it looked assymetrical (a little more tissue on the left side). A scope revealed that there was a fair bit of mucous in my throat and some inflammation.  She said I have some kind of viral infection.  I asked her if it could be HPV, and she said "it could be".  I said that should I come back if I still have this infection in a month, and she said it was up to me.

1  My question therefore, do any of the HPV's (16, 18 or otherwise) present symptoms like this? The infection seemed to start within the first 3-4 days after the encouter)

2 my skin has been tingling on various parts of my body during the last day and a half .  There is no rash or indication thereof.  

3  I know you have said the odds of cathing HIV are minimal through oral sex, but given the fact there was a bit of blood, what are those odds?  .
  

6 Responses
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300980 tn?1194929400
MEDICAL PROFESSIONAL
You've been through a lot in terms of your relationship and your own guilt for the exposure you describe.  You chances of having gotten an STD from the expsoure you describe are quite low.  You may have gotten a community acquired virus at some point in the not too distant past which can give you these sorts of symptoms.  The chance that this is an STD however is miniscule.  Interestingly, nearly all STDs acquired in teh throat are asymptomatic. As for your specific questions:

1.  HPV infections virtually never cause symptoms.  When acquired they progress very slowly.  If you have HPV in your throat, I doubt that it came from the exposure you describe and I promise it is not causing your sore throat.

2.  Not an STD symptom.  Lots of other possible causes however - allergies, exposures, dry skin or anxiety being among the common ones.

3.  For you in the setting you describe - close to zero.

Please do not worry.  This is not an STD.  Hope this helps.  EWH
Helpful - 2
300980 tn?1194929400
MEDICAL PROFESSIONAL
Thank you for the comments and follow up.  Take care.  EWH
Helpful - 0
Avatar universal
Dr. Hook,

First of all, thank you for taking the time to write such a detailed response to my concerns.  I realize that you must be a busy individual, and for you to take the time to address all of my concerns (some of which probably seem ridiculous) is quite appreciated.  

If you are wondering if you've helped my anxiety, the answer is yes - for the most part.  After realizing that I had indeed developed a throat infection of some sort I obviously became quite concerned (my wife is pregnant and I did not want her getting infected, which is why I told her so soon after the encounter).  After a couple of weeks, she reminded me of how one of our friends was diagnosed with a throat cancer a few years ago, something which I had completely forgotten.  He was a non-smoker/ non-drinker and 31 years old.  After speaking with him, he told us how his oncologist thought it was HPV related.  It lead me to do some research and that's when I happened upon Maura Gillison studies on the link between HPV and oral cancer.  Apparently, HPV has been discovered in 40-60% of tumors. (gee, I really hope her data is wrong)

It just led me to wonder... were my extremely mild symptoms indicative of an HPV infection?  Could a virus that cause cells to change induce an inflammatory response that the ENT observed?  As the throat symptoms began within a week of the encounter, I couldn't help but link the two.  Plus, I've never had throat symptoms last so long.  I was actually hoping my throat would hurt - at least that symptom would be a bit more familiar.  

What I was especially seeking from you was knowledge, and you gave it to me.  The information on how HPV works was most helpful, and did help ease my concerns.  You reminding me that throat cancer mainly strikes people older than 50 also helped.

Thanks again for taking the time to write a thoughtful response.  It was thoroughly appreciated.  
(In case you are wondering, I have been talking to a counsellor once a week on the phone to deal with my issues of guilt, anxiety and stress.  What I need more than anything though is for this virus to go away)

Helpful - 0
300980 tn?1194929400
MEDICAL PROFESSIONAL
What the ENT confirmed is that you could have a viral infection of some sort, not that you have HPV.  You have taken that statement and gotten yourself quire worked out over things.  Let me make several statements which may help:

1.  Yes, HPV can infect the throat and it may be related to cancer of the throat (not the mouth) HOWEVER, the risks for these cancers appear to be influenced far, far more by previously described risk factor such as smoking (this is the biggest one) and heavy drinking.  The contribution of HPV to cancer of the throat remains unquantified and is at most only a small fraction of the cotribution due to smoking and heavy drinking.
2.  When HPV infections occur, as I said before, they hardly ever cause symptoms.  The problems you perceive are not likely to be related to HPV even if you do have the infection.
3.  Cancer of the throat is almost never seen in persons under that age of 50 or 60.   Worrying about symptoms before then is a waste of time.

Now on to your questions:

1.  For HPV infection to take hold and become apparent takes weeks
2.  See above. The likelihood that your symptoms are due to HPV is minimal. If you have HPV in your throat it is likely to be coincidence, not the reason fro your symptoms.
3.  HPV does not cause symptoms anywhere.  It is not a cytotoxic virus which kill s cells but a virus which invades the cells and causes them to grow abnormally.  The viruses that cause symptoms are cytotoxic.

Comment.  You may have symptoms due to a virus.  The likelihood that the virus causing your symptoms, if anything is miniscule.  If you have HPV it is most likely that your body will control and eliminate the infection with no adverse effect to you.  I worry that your guilt and anxiety is contributing to this.  That in turn concerns me because it could lead to unneeded therapy and procedures.  Please don't worry about HPV causing you problems in your throat.  EWH
Helpful - 0
Avatar universal
(oh I should add....the fact the virus is still present 8 weeks after the encounter (lots of mucous in my throat and back of the throat still inflammed, yet with no pain)
Helpful - 0
Avatar universal
Hi Dr.,
You responded to my previous question about my concerns about HPV in the mouth after an oral encouter.  Sorry but I didn't know how to respond directly to your response.  (your respose was on Aug 25 to kaylen1972.

I appreciate you taking the time to answer my question and make me feel assured.
Since my symptoms persist, unfortunately I'm still a bit concerned so I do have a couple of follow up questions and comments.

What concerns me most about this condition is that it is so mild that many people might have missed it, whereas of course I was so in tune with my body at the time that I am very aware of the symptoms. Perhaps other people have gone through this but just ignored it or got the similar "virus" response from doctors that I have. Now that an ENT has confirmed I have an infection keeps me concerned.   And the fact it started only days after the encounter just seems too coincidental.

1 So, what is the typical incubation of the HPV viruses?
2. Since diagnosing viruses in the mouth seems impossible, and that it is now known that HPV does invade the mouth/throat, is it not possible that this has occurred?
3. Why does HPV not typically cause symptoms in the throat?  Don't most viruses trigger some sort of immune response, such as the one I am having now?

What concerns me the most, of course, is that the longer this virus stays in my mouth (if it's HPV) the longer it could potentially cause cancer later on.

Thank you once again for your help. Your insight is truly appreciated.
Helpful - 0

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