Long sore throat, STD?

[Superhernia]

First of all my congratulations for your work. In my professional life I also have to seek advice from leading academics and some are less available than even the pope

30 year old lawyer from Belgium here (Land of Peter Piot) but also from a stupid guy (me).

My history:

2005 had testicular cancer, two times chemo in the same year, got my last treatment in May of that year. Been healthy ever since although my urologist, who has become a friend, is not yet willing to say I’m 100% out of the clear (legal) but he has mumbled it.

Dec 2006 lost my wife, been a bit lost ever since.

10 may 2008: visited a CSW. Asked her if she had any STD’s, she said she didn’t think so.
I had unprotected oral sex with her, both receiving and giving but protected vaginal sex with correct condom use

1 June 2008: came down with severe sore throat, swallowing problems
By than I started to get a bit scared and searched the web for any STD’s and of course I found that sore throat was a big symptom in both STD’s and HIV.

2 June 2008: went to my doctor and because I have a history of sore throat she gave me Augmentin 825. Had an HIV DUO test at 3 weeks = negative

9 June 2008: no improvement, went to ENT who thought it were my tonsils.

15 June 2008: itchy sensation in the tip of my penise with an urge to urinate a lot. But definitely no discharge.

16 june 2008: went to see my urologist who gave me Ciproxin for six weeks because he thought it was prostatitis. He also took a swab of my throat, everything came back negative

22 july 2008: went to another ENT, who took blood (including HIV, antibody) and was also considering reflux. This was 10 weeks and 3 days ago. Result = negative

Until this day I still have a very sore throat and swallowing problems. I got medication for the reflux,  Omeprazole. It has been almost 16 weeks since my unprotected oral misstep. Could this be an STD? And I know this isn’t the right forum but could my Chemotherapy from 3 years ago alter the HIV results?

[Edward W Hook, MD]

Most gonococcal throat infections are asymtomatic.  When present the evidence suggests that most clear up without therapy.. EWH

[Superhernia]

Thanks again doctor for your answer

I forgot to mention that i had my urine examinated 5 weeks after my unprotected oral exposure and everything got back negative.

Last question: IF my sore throat happens to be caused by Gonorrhea, would it clear up by itself?

Regards

[Edward W Hook, MD]

The problem is that with the progressive development of antibiotic resistance by gonorrhea, the cure rate with either augmentin nor cipro would have cured somewhere in the neighborhood of 60 or 70% of cases.  While that is most, for most recommended therapies we expect about a 95% cure rate.  The same is tre for NGU where the recommended therapies would be either doxycycline or azithromycin.   I present this as fact but would also temper these astatemetns that, all things being equal, your risk fo infection from the exposure you describe is very, very low.  EWH

[Superhernia]

Thanks you for your answer doctor

If I would have NGU or Gonorrhea, would the Ciproxin 500 or Augmentin 825 already treated both?


Regards

[Edward W Hook, MD]

Let’s get the HIV question out of the way right away.  This far out from your chemotherapy the chance that it would have residual effect on your immune response is miniscule.   HIV tests will work the same for you as for anyone else.

Could you have gotten an STD. Unlikely.  The likelihood that your partner had STD is small, most exposures do not lead to transmission and the antibiotics you have received would have helped to cure many STDs.  I would not worry at all about having gotten an STD from your performing oral sex on her.  On the other hand, you could have gotten either NGU or gonorrhea from her performing it on you. The best way to assess this is with an examination and testing for gonorrhea or white blood cells in either your urine or in a swab from your penis.  To be honest, I think it is very unlikely that you got an STD of any sort from the exposure you describe.

Hope this helps.  EWH