STD or Something Else

[adlowery1]

Hi

I am a 31 year old gay male living in the UK.

I was diagnosed with Scarlet Fever two weeks ago and prescribed penicillin for 10 days to clear it. I had a high fever, major sore throat with white puss on, a rash on my body and arms and now peeling hands, arms and feet.

I am wondering how I contracted this. I have met a new partner three weeks ago and all we have done is kiss (alot) and mutually masturbate. My Partner though was diagnosed with Tonsillitis in March and was hospitalised for it. They made a full recovery with penicillin.

Prior to this partner I had one other where it was only mutually masturbating and body rubbing - no kissing, no oral and no anal. I was tested for all STDs in April and was clear. I have never gave or received anal intercourse.

I completed the course of penicillin and had to return to the Doctors to test kidneys to make sure no complications following the fever but my throat still hurt. I have now been diagnosed with tonsillitis and am on another 10 day course of antibiotics. A throat swab has been taken this time to analyse what it is.

I am asking whether I could get this from my partner they show no signs at all but in the last week their hands have started to peel in exactly the same way mine are following the scarlet fever rash.

I am worried that this may not be scarlet fever but something more, is there any std that comes across this way. My Doctor has said that is highly unlikely I was infected from my partner following their treatment or that I was reinfected from them following my antibiotics course.

We have agreed to get a full STD test at our GUM clinic before moving forward. I would be interested to find out if I have an STD issue here or is it just coincidence that both our hands are heeling and that my strain of scarlet fever is taking longer to cure than normal.

Thanks for your help

Alan

[H. Hunter Handsfield, M.D.]

You're welcome; glad to be of help.

Finish the penicillin as directed by your doctor.  In addition to the antibiotic, your own immune system has kicked in by now to resolve your infection.  You are now highly resistant and you're not likely to be reinfected with strep any time soon, either from another person or the environment.

[adlowery1]

Hi

Thank you for your response and the info provided it has explained a lot to me and that STDs is not an issue here.

I was concerned about completing the penicillin course for the second time and being reinfected from my partner thinking that he maybe a carrier but your explanation is saying it could be anything in the environment or that I may have had it some time.

Ill make sure they check out his hands at GUM when we go for a full STD checkup as it looks identical to my peeling hands but he's showing no other symptoms.

Thanks for your time.

Alan

[H. Hunter Handsfield, M.D.]

Welcome to the STD forum.

Scarlet fever is just strep throat plus a skin rash, caused by group A Streptococcus bacteria.  Inflamed kidneys are a rare but potentially serious side effect of any group A strep infection, so your doctor's caution in checking that out doesn't mean anything special.  Your description of your symptoms is textbook-classical and your doctor's diagnosis undoubtedly is correct.

Many people carry strep in the nose and on the skin, and it also can be left behind in the environment, on everything from doorknobs to phones to table surfaces.  But most cases probably are acquired by personal contact like handshaking, social kissing, etc, and usually the exact source of infection is never known.  However, certainly any bacteria on the skin or in the mouth or nose can easily be transmitted between sex partners.  It is also possible you have been carrying group A strep for a long time.  Strep throat can be triggered in carriers by garden variety colds or other respiratory infections.

That he apparently has a similar rash is of interest and could indicate he has had a mild infection himself.  It would be a good idea for him to see his primary care provider for testing for strep and possibly for antibiotic treatment -- or they might be able to take care of this at a GUM clinic (see below).

Presence or absence of STD would not affect the time for the rash to clear up.  The rash is due to a toxin released by strep, not the direct result of infection -- and it clears up on its own schedule, usually 2-3 weeks.

So this clearly is not an STD in any sense.  On the other hand, STD testing is recommended from time to time among most sexually active persons, especially MSM; and mutual testing makes sense when a new relationship starts.  On that basis, you might go ahead with your plan for screening at a GUM clinic -- with understanding that the penicillin treatment will have cleared up many possible STDs, like gonorrhea or syphilis.  But this advice is entirely unrelated to your strep infection.

In case you are interested, here is a great website with excellent photos of scarlet fever rash:  http://www.lib.uiowa.edu/HARDIN/md/dermnet/scarlet4.html

Best wishes--  HHH, MD