Persistent Sore Throat - 45 Days and Counting

[whathappened]

I’ve posted previously and hope that you will provide some more guidance.  I’m currently at the six week mark involving protected sex and unprotected cunnilingus and have had a sore throat for 45 days (2 days after event).  Dr H provided an assessment that it was unlikely that I had throat gonorrhea or clamydia, I tested via swab and he was correct.  I’ve never had a sore throat for more than two weeks and growing very concerned and tired from this ordeal.  My Dr thinks its acid reflux and has prescribed medication.  While I want to believe the diagnosis I find it difficult to accept since I never had reflux before the event.  I asked if stress could cause it and he did not think so, if so I would buy into it.   The latest issue is my tongue swelled up on Sunday and since has developed sores around the edges making it very difficult to eat and talk with tongue hitting teeth...hoping they are canker sores, described to my Dr over phone and he wants to do a blood test for HSV.  I read that herpes on tongue is relatively rare but how can I tell the difference between canker and herpes?
Tested negative for strep and mono…are there any tests that I should request that are STD or non STD related such as general throat culture to see what grows?
I do not take antibiotics lightly and do not want to be reckless with them but I wonder if it would be worth a try?
Lastly I would like to take a final HIV Duo test since I’m at six weeks but they did not have it available at Dr’s office.  Any suggestions in the Seattle area?

Thank you,

[whathappened]

Thank you for answering! I will seek a counselor to work through this...

[Edward W Hook, MD]

You are over reacting.  Work with the ENT regaring the source of your sore throat and try to get away from your unwarranted fears that your low risk oral exposure is behind this.  I woul likewise suggest you don't share your inappropriate fears with your partner.   If you cannot move forward without concern that this might be some sort of STD, I suggest you speak with a counselor who can help to deal with this.  

There will be no more answers from here. EWH

[whathappened]

I tried to pay for a new post but was deleted, also posted on user forum and Grace suggested asking on this post thread...

Sore throat continuing 9 weeks post exposure.  Took amoxicillan for 10 days, along with Zantac and Flonase but sore throat still present.  Referred to ENT, scoped and found sinus infection which I've never had before (in early 40's now) now taking Amox & Cav combo, Rhinocort Aqua, Zantac and nasal irrigation.  

Read article earlier this week that just came out about the increase in throat cancers from oral sex, that pointed out sore throat for more than two weeks was a sign along with unexpected weight loss which I have had recently.  I am also becoming more alarmed about HIV, when sore throat is searched HIV is often listed and sinus infections are common.  I understand risk is extremely low for oral sex transmission but the ongoing sore throat has been tough on the nerves.

I did test for HIV and STD's at 4 weeks which was negative which I recall reading that 90% would seroconvert by that time.    

My sore throat started two days after performing cunnilingus, does the sore throat that has continued for so long change your opinion?

ENT took a general swab and nothing grew, she said she would be able to see an HPV Cancer in throat but did not elaborate at all and she seemed uncomfortable discussing it.  How long does it typically take for cancer to develop?  If HPV cancerous type would a sore throat develop and then go away after a few weeks?

Want to contact parntner about HPV and HIV testing history, having difficulty figuring out how to ask without offending...when a pap is performed do they automatically test for cancerous types?

I have 12 week final STD & HIV testing scheduled for Oct 26th.  

Thank you,

[Edward W Hook, MD]

You may have an element of sinusitis or other respiratory tract infection as the source of your sore throat. This can certainly happen.  If so, it would be a coincidence.  I would not attribute it to the fact that you performed oral sex on a new partner.  EWH

[whathappened]

Thank you I appreciate the reassurance and I think you're correct that other things are going on...

This afternoon I think I discovered the culprit of my throat issues.  At 4 pm  I felt a sudden nose bleed coming on and went to wipe blood and discovered yellowish watery discharge dripping from nose, which has happened 2 more times since.  Brief search online points to reaction from recent colds and throat infections.  Not sure if you have seen such a thing before but if so any feedback would be appreciated as it's a bit scary at first sight.  I'm convinced I picked up a bacterial infection from the cunnilingus back on July 29th.  Although it may not be considered an STD I would appreciate any insight you may have, tests that you may recommend to identify organisms and lastly any medication suggestions.

Thanks again, I will not post any more questions or comments...promise!

[Edward W Hook, MD]

Welcome back to the Forum.  In preparing to respond I reviewed your earlier interchange with Dr. Handsfield and agree with all that he said.  Given the time course of your problems and your test results to date, I suspect that your extra-curricular sexual contact and your current symptoms are, in large part coincidence, perhaps amplified by guilt and anxiety.  Several comments on your points:

1.  Acid reflux can certainly cause a sore throat an anxiety can both precipitate and worsen reflux.  A therapeutic trial of anti-reflux measures is certainly reasonable.

2.  There is little chance that this is HSV, or entirely HSV.  HSV episodes, even when they first occur last 2 or, at most, 3 weeks, not 6.  

3.  Canker sores an oral HSV can sometimes be confuse for one another.  Herpes on the tongue is quite rare.

4. This illness is not suggestive of HIV.  Again, both the manifestations and time course do not fit. Further, there are no well substantiated cases in which HIV has been spread through oral sex.  If you feel you must have further evaluation for HIV, the Seattle clinic, where they can do additional tests to supplement the antibody test (which would detect over 90% of HIV at 6 weeks) is where I would start.

I hope these comments are helpful.  My guess is that there may be more than one thing going on. You may need to work systematically with your own doctor to get this completely sorted out.  EWH