Syphilis and Candida

[vick936]

Dear Doctors, I'm writing you from Italy
10 Days ago i had a oral and vaginal intercourse with a sex worker here in Italy. Both oral (passive) and vaginal were PROTECTED with condom.
Soon after the vaginal intercourse i noticed a small pink papule on her pubis (just some centimeters above her vaginas) surrounded from a red area. She took a finger on it and didn't want to let me see better.

Obviously i started freaking about syphilis and in 72 hrs i was to an hospital talking about it with a doctor and asking for a preventive treatment for the eventually incubating syphilis.

He prescribed me Ceftriaxone (Rocefin) 1g IM daily x 8 days and said me to test in 3 months for safety.
I did the cure witch i finished 2 days ago.
The only thing that happened till now is that, after the first 3 injections, my gland start to become red and covered with a lot of little small red point.
I supposed it was Candida Albicans, the same thing happened to me last time i took antibiotics (Amoxycillina), and started a cure, the same as a doctor gave me last time, with fluconazolo (Diflucan - 100 mg a day orally) that i'm still doing. All the red and small points are now gone away after few pills.

Here my question:

1) Could the Ceftriaxone prescription the doctor gave me be really effective on my supposed incubating syphilis? Do i really need to get tested in 3 months? Can i come back having intercourse with my wife or there is any risk?

2) Is it something normal that anytime i took an antibiotic i have an outbreak of Candida? I'm thinking about having a latent infection of Candida resistant to fluconazolo. Is it possible? What i have to do?

Thanks so much.
Vick

[Edward W Hook, MD]

I do agree, there is no need for the azithromycin.  You will be fine. EWH

[vick936]

Thank you Doctor.
I could not see well what she really had on his pubis. Could also be a simple mosquito bite.. i don't really know. And it is difficult to explain what i have poorly seen in a language different from mine.
Anyway.
I was uncertain to take also a 1g dose of Azytromicine, but at this point, also according to your opinion about the effectiveness of Cefiaxtrone, i think i'm not going to to do it.
And i think you'll agree with that.

Thanks again.
Vick

[Edward W Hook, MD]

This was a low risk exposure with little meaningful risk for syphilis.  The lesions you describe is in an unusual place for syphilis and the brief description you provide does not sound like syphilis either.  Even if the lesion you saw was syphilis, the ceftriaxone you took would have reliably cured syphilis (as well as gonorrhea)

Thus in answer to your specific questions:
1) Could the Ceftriaxone prescription the doctor gave me be really effective on my supposed incubating syphilis? Do i really need to get tested in 3 months? Can i come back having intercourse with my wife or there is any risk?

See above.  The ceftriaxone would be curative in the unlikely circumstance that you were exposed.  There is really no medical need for follow-up testing and no reason to abstain from sex with your wife related to this exposure.

2) Is it something normal that anytime i took an antibiotic i have an outbreak of Candida? I'm thinking about having a latent infection of Candida resistant to fluconazolo. Is it possible? What i have to do?

Most people have Candida and other yeasts on their body and when they take powerful antibiotics like ceftriaxone, it is typical for the yeasts to overgrow.  What occurred is not unusual, particularly among person who take antibiotics they do not need.  I would not worry and would just treat the yeast.  EWH