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Odds of needing testing??
Hi Doc,
Nice to see a fellow physician providing a very valuable service. I commend you on your honesty and have found your forum to be extremely useful. I will undoubtedly refer patients to it. I am an emergency medicine physician, but used to practice FM and have a reasonable amount of STD knowledge (nothing like yours obviously). So that is my background. Now here is my situation.
I was in Sin City 3 weeks ago for a conference and I was not with my wife. I found the lure of the young prostitute in the casino too difficult to avoid unfortunately, and took a young 20ish Hispanic, healthy looking woman back to my room. I performed oral sex on her for approximately 5 minutes and she was not at all aroused during the process....ie did not ***, and did not get a lot of vaginal secretions flowing.
Then I used one of her condoms and had intercourse for some 10 minutes or so. She only had the "magnum" larged sized condoms and it was slightly looser than a normal condom. But I felt it was snug enough.After the encounter, I immediately took a shower where I urinated several times, and bathed all over for about 15 minutes. I also gargeled and brushed my teeth throroughly.About 3 days later, I noticed a small area under my right glans on the shaft to be a dry linear streak about 10mm long. I ignored it and thought nothing of it because I had done a lot of masturbating during my trip with ****-poor lotions and thus I assumed it was an abrasion. But just a couple of days ago, I noticed that the dry lesion had formed sort of a pseudocircular lesion with slightly raised edges, sort of like a pityriasis rosea or a tinea corporis lesion (for the non medical people, ringworm or non STD rash). The center was rather clear and ther entire circle was about 12mm in diameter. It was absolutely painless, and I talked myself into believing I also had some right inguinal lymph nodes non-tender but swollen.
Being the typical physician, I conjured a way to get 2 Bicillin LA (1.2mu each) injections from the pharmacy and had a nurse buddy give them to me in the thigh (enough punishment for this folley in my opinion!!!). In the last 3 days since I took it, the lesion is clearing. But of course were it from an abrasion from my biking spandex, or something else, it also could have cleared at the same rate I realize. I have never felt ill, never had a rash, never had a fever or decreased energy.
So now to my question/s.
1) In your expert opinion, do you think this could possible have actually been a chancre and been syphilis?
2) My wife knows about the encounter because we have a very open relationship (this does not mean we are cheating spouses, as it simply means in previous years we have done some occasional swinging). We had sex one time about 2 weeks ago when the initial "scrape" was there, so should she get tested?
3) Lastly, should I get an HIV test in about 4 weeks or just forget about it, and would you get an RPR now that the PCN is onboard or forget it too?
Nice to see a fellow physician providing a very valuable service. I commend you on your honesty and have found your forum to be extremely useful. I will undoubtedly refer patients to it. I am an emergency medicine physician, but used to practice FM and have a reasonable amount of STD knowledge (nothing like yours obviously). So that is my background. Now here is my situation.
I was in Sin City 3 weeks ago for a conference and I was not with my wife. I found the lure of the young prostitute in the casino too difficult to avoid unfortunately, and took a young 20ish Hispanic, healthy looking woman back to my room. I performed oral sex on her for approximately 5 minutes and she was not at all aroused during the process....ie did not ***, and did not get a lot of vaginal secretions flowing.
Then I used one of her condoms and had intercourse for some 10 minutes or so. She only had the "magnum" larged sized condoms and it was slightly looser than a normal condom. But I felt it was snug enough.After the encounter, I immediately took a shower where I urinated several times, and bathed all over for about 15 minutes. I also gargeled and brushed my teeth throroughly.About 3 days later, I noticed a small area under my right glans on the shaft to be a dry linear streak about 10mm long. I ignored it and thought nothing of it because I had done a lot of masturbating during my trip with ****-poor lotions and thus I assumed it was an abrasion. But just a couple of days ago, I noticed that the dry lesion had formed sort of a pseudocircular lesion with slightly raised edges, sort of like a pityriasis rosea or a tinea corporis lesion (for the non medical people, ringworm or non STD rash). The center was rather clear and ther entire circle was about 12mm in diameter. It was absolutely painless, and I talked myself into believing I also had some right inguinal lymph nodes non-tender but swollen.
Being the typical physician, I conjured a way to get 2 Bicillin LA (1.2mu each) injections from the pharmacy and had a nurse buddy give them to me in the thigh (enough punishment for this folley in my opinion!!!). In the last 3 days since I took it, the lesion is clearing. But of course were it from an abrasion from my biking spandex, or something else, it also could have cleared at the same rate I realize. I have never felt ill, never had a rash, never had a fever or decreased energy.
So now to my question/s.
1) In your expert opinion, do you think this could possible have actually been a chancre and been syphilis?
2) My wife knows about the encounter because we have a very open relationship (this does not mean we are cheating spouses, as it simply means in previous years we have done some occasional swinging). We had sex one time about 2 weeks ago when the initial "scrape" was there, so should she get tested?
3) Lastly, should I get an HIV test in about 4 weeks or just forget about it, and would you get an RPR now that the PCN is onboard or forget it too?
A related discussion, What are the odds of transmission was started.
MEDICAL PROFESSIONAL
Syphilis currently is very rare in most heterosexual populations in most geographic areas of the US; you used a condom, which undoubtedly was highly protective regardless of the loose fit; and the lesion you describe doesn't sound particularly like a chancre or other syphilitic lesion. Thus, my responses are:
1) The chance you had syphilis is extremely low, probably zero or close to it.
2) I see no reason for your wife to be tested on account of this particular event. However, in view of your sexual lifestyles, clearly you both ought to be getting routinely for common STDs (chlamydia, gonorrhea, HIV and syphilis) from time to time, such as once a year. If your wife hasn't had such testing recently, this probably is a good time since it's on your mind.
3) Same response as no. 2, i.e. have an HIV and syphilis test if not done in the past year, but not because of this particular event.
Regards-- HHH, MD
1) The chance you had syphilis is extremely low, probably zero or close to it.
2) I see no reason for your wife to be tested on account of this particular event. However, in view of your sexual lifestyles, clearly you both ought to be getting routinely for common STDs (chlamydia, gonorrhea, HIV and syphilis) from time to time, such as once a year. If your wife hasn't had such testing recently, this probably is a good time since it's on your mind.
3) Same response as no. 2, i.e. have an HIV and syphilis test if not done in the past year, but not because of this particular event.
Regards-- HHH, MD
He'll likely tell you that you did not need the PCN. You had condom protected sex. You don't need an RPR, or an HIV test. An exception is that if you are not in a mutually exclusive relationship, an HIV test once a year or so is not a bad idea.
You should know better than to treat yourself. You would never have advised a patient to do what you did, would you?
Of course not.
You should know better than to treat yourself. You would never have advised a patient to do what you did, would you?
Of course not.
My treatment of myself is not the issue here, and it certainly is not a violation of any state or federal statute in my jurisdiction. The only thing that is not allowed in my state is that physicians may not self prescribe controlled substances. My taking penicillin made me feel comfortable based on what I felt the lesion perhaps was. I have seen chancres, condyloma lata, and even diagnosed patients with neurosyphilis. I felt based on the characteristics of the lesion that there was a significant probability that the lesion was a chancre. I suppose I could have waited 2 more weeks to see if it would ulcerate, but when an injection of Bicillin is so benign (I have had it before for other reasons and knew it was safe for me), why not use it? It costs a few bucks only. Please don't lecture someone or speculate on what the forum physician is going to say. I think I paid the 15.00 for his expertise, not yours. It seems you are more likely to be offering medical advice inappropriately than I am.
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.
