STD concern receptive oral sex

[falus]

Hi, i would really appreciate a professional answer on this matter ...
3 days ago i made a terrible mistake under the influence of alcohol with a bunch of friends and ended up on a massage parlor on the fort lauderdale area, really cheese ugly place.
All in all at the end of the day I ended up receiving oral sex ( im a male ) and this girl did not placed a condom on me, of course at the time It sounded like a good idea but at the end realizing the place I was i literally was in shock an panic.

The ******* overall time was 5 minutes, im circumsized, no scratches or bruises, i got really really concerned when this girl ( who was naked ) placed my hands on her vagina and i realized her vagina had a fowl smell like dead fish wish make me think immediately that she might have an std or some kind of illness producing such a discusting odor.

I left the place feeling so bad and discusted with myself, but thats a different topic.

Im so afraid of an STD by receving oral! , next day as a precaution I was able to get a hold of 2mg of Zithromax ( from Pfizer ) and took 2 pills on day and 2 more pills yesterday.

My question is this, what are the chances of contracting chlamydia from receiving oral sex (unprotected) ?
Same question about gonorrhea or similars?

Will the zithromax I took as a preventive measure be effective ? , i mean was it ok to be taken one day after such event assuming any illness takes certain time to manifest ?

Please, im so nervous, any feedback is greatly appreciated

[Scaredguy360]

A related discussion, Herpes from Oral Sex was started.

[falus]

I really appreciate the responses, i love this site :)

Thanks a lot Dr.

[H. Hunter Handsfield, M.D.]

Azithromycin can cause cramping and loose stools or even overt diarrhea for a day or two, and alcohol might make it worse.  But no harm will be done by a couple of beers, and the drug will remain effective.

[falus]

By the way, I have a quick question about zithromax, i have a BBQ on saturday , is it safe if i drink 1 or 2 beers even though im under the zithromax ?

Thanks a lot

[falus]

I really appreciate the fast response, btw the treatment i took is (2) 500mg pills one day, and then 2 more the next day, total of 2000mg treatment.

Thank you very much, im happy to learn that the zithromax could be of help in any case.

Best Regards
Falus

[H. Hunter Handsfield, M.D.]

I'll try to help. The bottom line is that the STD risk was very low and you probably reduced it still further by taking azithromycin (Zithromax).  Such self-treatment really wan't necessary and isn't recommended as a general principle, but undoubtedly caused no harm.  I'm not sure the dose you took -- clearly it was grams, not milligrams (mg); you took either 1 g or 2 g each time, but any of these would prevent or cure incubating gonorrhea, syphilis, or nongonococcal urethritis (NGU).  It also would eradicate chlamydia, but that wasn't an issue.

Let's look at each possibility one by one:

Gonorrhea:  Definite but very low risk.

Chlamydia:  Rarely infects the throat and rarely if ever transmitted by oral sex.  Some health education sites state oral sex as a risk, but they are unaware of the latest research about it.

Syphilis:  Theoretically possible but rare by oral sex. Equally importnat, syphilis is a rare STD in the US and almost nonexistant except in gay/bi men and in commercial sex workers in limited geographic areas (e.g., southeastern inner cities and among latinos in the southwest).

Nongonococcal urethritis (NGU):  This might be the highest risk from fellatio, sometimes perhaps due to normal oral bacteria and not a standard STD.  But nonchlamydial NGU is not a serious STD, with no known complications or serious outcomes -- so really not a big deal.

Herpes:  This is the last possibility and the only one that would not be prevented by azithromycin.  Genital herpes due to HSV-1, the usual oral herpes strain, can happen but is rare after any single exposure.  And the odds are good you are immune to it anywya, since half of all adults have HSV-1, generally dating back to an oral infection in childhood.

Bottom line:   If in the next 2 weeks you develop no symptoms (penile sores, abnormal discharge of mucus or pus from the penis), you have no worries and will not need examination or testing.  Of course see a provider if such symptoms appear.

Best regards--  HHH, MD