Should I follow up about Syphilis?

[qaboutsyph]

Hi doctors,

About 5-6 months ago, I received unprotected oral sex from a CSW. 9 days later, I began to develop a large pimple-like bump on the base of my penis. I went to the doctor and I was tested for all STDs via a urine test (clamydia, gonnorrea, trich, HIV, Syphilis) and given oral azithromiocin. I tested negative for all of these. The doctors (3 of which ended up seeing the bump) said that it looked like foliculitis or some sort of incursion, and said that it didn't look like an STD. It eventually 'popped' like a pimple does. It seems really hard-to-explain to me that I've literally never had a bump like this until a week after exposure, but whatever - I eventually got over it and moved on, completely healthy.

So why am I here? I've had a persistent cough since about 8-9 weeks ago. I sometimes have chills/sweating at night during this period and feel very flush. I've been to the doctor 2-3 times, and they've suggested it may be a long-lasting viral infection that should clear itself up shortly (in a few days, but i've heard this 2-3 times now), or asthma (the inhaler I was given does not seem to be helping). I'm running out of explanations for why I've been sick for so long.

Looking back, my Syphilis test (blood test) was probably not accurate given that it was done 9 days after exposure. I've read that some of the symptoms for Syphilis in the later stages is sore throat, fever, chills, etc. Looking back, I worry that the bump on my penis was a misdiagnosed syphilis sore.

Question: are my symptoms worrisome with respect to undiagnosed Syphilis - do I need to follow up with additional testing?

Thank you!

[Edward W Hook, MD]

Welcome to the Forum. I'll be pleased to comment.  The exposure you describe was very, very low risk for syphilis and the lesion you describe is both in an unusual location for syphilis and does not sound like syphilis.  Syphilis is a rather rare disease and currently most syphilis occurs among men who have sex with other men., Further syphilis from oral sex is a medical rarity. Finally, your more recent symptoms are not  suggestive in any way of syphilis.

Taken together, I think syphilis is most unlikely.  If the concern is lingering however, syphilis tests are easily performed on a blood specimen and at this time would be completely accurate.  If you choose to test, I am confident the syphilis test will again be negative.

I hope this comment is helpful to you. EWH

[qaboutsyph]

Re-reading my description, it sounds like I am very sick - to clarify, I am not very sick, just mildly sick for a very long time - my cough is minor but persistent, I do not have a fever as measured by the doctor's office (although my skin is sometimes hot/flush), and my chills/sweating is intermittent. Just wanted to clarify that.