Re-test for syphilis?

[shaned1]

3 weeks ago, I received unprotected oral sex from a stripper at a bachelor party. Afterwards I noticed she had lump under her lip - I'm not sure if it was a pimple or a cold sore or something else.

I became worried so I went to an STI clinic the next day and was tested. My blood tests came back negative (they came back within 5 days), but the doctor gave me Zithromax to take as a precaution.

Fast forward two weeks - I was feeling fatigued, my glands on my neck were slightly sore, and I had a really sore throat. I went to my regular doctor and he gave me a 5 day course of amoxicillin to clear my throat. It worked fine.

Now, I have just found out that the stripper works as a prostitute. I am really worried now - she is a sex worker, and may have had some type of sore on her mouth.

Is it possible that the first blood test failed to detect an STI that is in the beginning stages?
I googled Zithromax and found that it may not treat things like syphilis - I am from Ireland so a study like this has made me more worried

http://news.healingwell.com/index.php?p=news1&id=519982

Apparently zithromax was not successful in some trials in Ireland.

Can you clarify things for me?
Should I get another test?
What are the chances of contracting syphilis?

I should mention that I am getting back with my ex-girlfriend and I am worried that I may pass something on to her.

[Edward W Hook, MD]

The description of your rash is not suggestive of syphilis and if you had gotten syphilis, at 3 weeks following exposure you would be likely to have a genital lesion, not a rash.  If your rash was syphilis (and I cam confident that it is not, your blood test for syphilis would be postive at that time. The two go together.  EWH

[Edward W Hook, MD]

You really need not worry about syphilis.  You do not say where your exposure occurred but if it was in the U.S. let's start by looking at your risk. There are over 350 million people in the U.S, of whom 6-8,000 will contract syphilis.  Further, over half of syphilis which is acquired will occur among men who have sex with men. Finally, oral transmission of syphilis, while describe is very, very rare.  Putting all of this together, you really need not worry about syphilis.  If the exposure was in Ireland the figures are similar and the risk is no greater and probably less

You are right that the data on use of azithromycin for syphilis prevention is worrisome however penicillin (or amoxicillin) is highly active and if you had been exposure to syphilis 5 days of amoxicillin would have cured it.  

Bottom line, there is no reason to worry aobut syphilis and no need for further testing.  EWH

[shaned1]

Thanks for the quick response Dr.

Shane.

[shaned1]

Thank you for the response doctor, it was very reassuring.

I should have clarified that my exposure was in Ireland, not the US.

I have two more things that I forgot to ask in my original post.

In the last two weeks, I have developed a small rash on my stomach. It is about 15 millimetres in length and width. It feels dry and scaly. A part of it is red. It is not raised up, it is flat.

1) Does this sound like anything associated with an STD?

2) As you have said, it is highly unlikely that I have syphilis. However, out of interest, if I did contract syphilis, would the lesion only appear on the site of exposure (ie the penis) or could it appear on any part of my body (eg my stomach)?

I'd be very grateful if you could answer those two questions.

Thanks again doctor, I hope you had a happy 4th of July!!

Regards,
Shane.