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Dear Doctor
this is a follow on for a previous question, so will ask anyway. I am currently in romania. Couple of months ago i performed oral sex on a male escort. I didn't see anything on his penis but it was a dark room (stupid, i know). Soon after i developed a small spot in my mouth that soon developed into a very painful and large chancre. My lymph nodes in my neck also were slightly swollen. The pain went away after around 7 days and the spot cleared up after around 4 weeks. I think, but am not sure, that i have a developed a rash on my chest and arms - small brown dots but they could be just part of my normal skin but i am not sure and obviously am in a slightly paranoid state.
I went to a local romanian clinic, described my symptoms and she dismissed syphilis but ordered a general blood test and hiv test (yet to be done). I also took 2g of azithromycin. Do you think i am likely to have syphilis and would the azithromycin be effective?
Thank you for your time.
Best regards
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239123 tn?1267651214
Welcome back to the forum.

I can confirm the accurate information you had from Dr. Gonzalez-Garcia on the STD international forum a few days ago.  The initial oral sore still does not sound like syphilis, and a rash you can't even be certain you had also is not likely to be due to syphilis -- and it sounds like your clinic doctor agrees.  I would not have recommended azithromycin, but if you did have syphilis, it would probably be effective.  Some syphilis strains are resistant to azithromycin, however.

Most likely the clinic is doing a syphilis blood test, in addition to HIV and a "general" blood test.  Please clarify it with the clinic.  If not, you should insist on syphilis testing.  For the reasons above, I still doubt you have syphilis, but the blood test should be done to make certain.  If the result is negative, you can cease all concern and worry about it.

Feel free to return with a comment to tell me your syphilis and HIV test results.  Until then I won't be able to provide any other comments or advice.

Regards--  HHH, MD
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