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Avatar universal

questions about STDs and testing

Dr HHH or Dr Hook

this link can serve as a preface to my questions


i now have questions about syphilis.

10-11 weeks ago protected sex with csws in s america. very drunk but want to believe i remember everything and sex was protected. no oral as far as i can remember. 3-4 weeks later a very small pinkish red bump on middle of penile shaft surfaced. had tiny dip in middle where a scab formed. i picked tiny scab. rescabbed. i applied neosporen. seemed as if hair was growing thrw bump sideways. ingrown? bump remained about 2 weeks. MAYBE 3. wasnt sure of syphilis symptoms at time. 4-5 weeks after return from s america had unprotected sex with 2 females seperated by 3 days. denver, co. oral was performed as well.

took amoxicillan 1-2 weeks after return from SA. 10 day cycle. then again 6 weeks after SA sex incident. had full STD check including DNA PCR at 18 days post exposure of 2nd female in denver. 8 weeks post SA sex. i now have ANOTHER canker in mouth. inside left cheek. lasting a week now

1. will antibiotics interfere with syphilis testing window. since amox is not preferred. if it doesnt cure or prevent will it delay onset of syph until a later date? is my 8 week RPR negative good to go? or no because of the amox

2. is mouth ulcer a sign of syphilis since oral was performed (now at about 30+ days)

3. i have 3-4 tiny scabs on low ankle surrounded by a few more even tinyer barely visable scabs. friends say look like bug bites. sign of secondary syph? 10-11 weeks post SA encounter

4. my tongue was a little white and dry about 5 days post SA incident. got worse and VERY dry. entire mouth dry. from then till now it got better slightly then worse. now remains in the worse category. dry and coated. could this be STD or syph related. diarrhea for just as long. sore throat for about a 3-4 weeks. feeling some relief now. thoughts?

6 Responses
239123 tn?1267651214
Thanks for the compressed version.  I cannot comment on the risk of syphilis or other STDs from the South American events.  Oral sex with women in Denver is very low risk for all STDs and close to zero risk for syphilis.   Directly to your questions:

1.  If you had been exposed to syphilis and if an infection were getting started, the amoxicillin would cure it before symptoms ever began and your blood test would never turn positive.  Most likely you were not infected, but you will never be able to know for sure.

2-4. For the same reason, it is not possible that any of your symptoms are due to syphilis, including the mouth ulcers, the "pinkish red bump" on your penis, the ankle scabs, the tongue changes, nor the diarrhea.  Except for the penile "bump", none of these symptoms suggests any STD, and neither does sore throat.

If the penile thing persists, it would make sense for you to visit the Denver STD clinic and get it checked out, and also follow their advice about evaluation for other STDs in view of your symptoms and exposures.  Most likely they will agree with my views -- but if different, follow their advice, since direct examination by a professional always is preferable to distant online advice, no matter how expert.  (And anyway, the Denver public health STD clinic is widely regarded as one of the best in the nation, if not the world.  Their expertise is every bit as great as Dr. Hook's and mine.)

Avatar universal
Thanks Doc. Sorry for the stuff before.

1. Why can't you comment on SA event?

2. The penile bump on shaft was gone in about 2-3 weeks. I think picking that tiny scab kept it their longer and it did seem there was a hair growing underneath the bump. Growing horizonatally (as it would have to be under the skin). The pink/redish bump was very small but definitely a bump. Raised off surface slightly but enough to realize "its a bump". I've had stuff like that before but have never been diagnosed with anything other than herpes 1. But to mention again. The bump is gone and appeared before the encounter with 2 women in denver.

3. I saw an ID specialist in denver last week because of mainly hiv anxiety, as I told him. I mentioned the 18 day negative dna pcr. he checked for nodes and took oral swab of my mouth but its labor day weekend and no results today. Understanding your comment saying the tongue is not a symptom I'm still nervous but I will try to relax. The id specialist seemed confident it wasn't hiv especially with my neg dna pcr but I failed to mention the penile bump. Forgot since there was so many other issues and at that moment I didn't know syphilis symptoms at that time.

I guess other than question #1 all else is just added info especially info about penile bump since you might think its still there. It was there about 3-4 weeks after SA trip and gone in 2-3 weeks.

Thanks for your time especially during a holiday. And hope you can reply to my follow-up. Sorry once again for previous threads in other forum
Avatar universal
I had regular unprotected intercourse as well as oral with denver women. Thanks
239123 tn?1267651214
1) Pardon the misstatement that I had no comment; I meant that only with respect to HIV.  I did indeed comment on the SA events in regard to syphilis, which is the only STD you asked about.

2) The bump obviously isn't anything to worry about if it is gone.

3) As I said, this forum isn't for HIV issues.  In any case you have both laboratory proof and an ID specialist's opinion you don't have HIV.  The ID doc probably knows as much or more about acute HIV infection than I do.  There is nothing more for me to say.

I didn't understand unprotected vaginal as well as oral with your Denver partners.  Syphilis is virtually nonexistant in heterosexual women in the US aside from African Americans in the southeast and Latinas along the Mexican border (probably mostly illegal immigrants); assuming this doesn't describe your Denver partner(s), syphilis is not a signifcant risk.  HSV is generally too low a risk to warrant testing after just a couple of exposures, in the absence of symptoms that suggest herpes. HPV is always possible but generally asymptomtic and no way to test for it.  Asymptomatic chlamydia (and to a lesser extent gonorrhea) always are possible following unprotected vaginal sex and both are common in the Denver area.

So if you remain concerned, I suggest you take advantage of the world class expertise available at the Denver STD clinic.  It's on Bannock St.

Final advice:  Start using condoms.  It's rather silly, don't you think, to not take that basic precaution -- and then come to this or any other expert site for advice about how to make up for it?

That will be all for this thread.  Try to get safe.

Avatar universal
Thanks doc. I certainly agree with your last statement. Anyway I did in fact test for all stds at the same time I had the DNA PCR test. 18 days post exposure of the last encounter and 21 or 22 days from the other exposure. All negative. Is that sufficient for a few of them? I know its too early for the RPR to be reliable but as you said none of the encounters fall in the category you mention. Both caucasian women mid/early 20s. So is syph is too low to worry about, hiv dna pcr test good to go, all I should be concerned about is ghonorea and chlamydia. Both were negative at 18 days as well as hsv2 (that's herpes roght?). I've had hsv1 so no question about that. Is the negative chlamadyia/ghonorea at 18 days ok
239123 tn?1267651214
All your negative test results are valid.  Time to move on.  That's all for this thread; I won't have any further advice.
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