[Question #11063] Syphilis scare
17 months ago
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I am a 23 year old white male who had protected vaginal sex and unprotected oral sex with an older Asian sex worker in Dallas, TX about 6 and 1/2 weeks ago. I got a full std panel 2 weeks after possible exposure and everything came back negative. Today I noticed redness all around the shaft of my penis and started freaking out. My question is do I need to worry about syphilis and HSV 2?
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Edward W. Hook M.D.
17 months ago
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Welcome to the Forum. Thanks for your questions. I'll be glad to comment. FYI, I happened to be on the Forum when your question arrived so you are getting a response more quickly than if typical. Any follow-up responses may take longer.
The exposure you describe was very low risk. Most commercial sex workers do not have STIs and even when they do, most single exposures do not lead to infection. In addition you used a condom further reducing any risk for STI Condoms are highly protective against both syphilis and HSV-2 (which is virtually never acquired from receipt of oral sex).
---It is rather late for symptoms or signs of STIs such as syphilis of HSV to appear- typically if a person acquires HSV, lesions appear within 10 days of exposure while for syphilis lesions appear, on average, by about 3 weeks.
Technically your tests for syphilis 2 weeks following the exposure were taken too early to provide reliable results. OTOH, testing now would be conclusive.
Personally, given the low risk nature of your exposure, your initial negative test results and your lack of typical symptoms, I would have no concerns. OTOH, testing is often reassuring and a personal choice. I would not bother to test but if you choose to, I am confident the results will show that the redness you have noted is not due to HSV, syphilis, or any other STI. EWH
17 months ago
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Thank you for you answer. One more thing. Is it possible for syphilis to have a delayed response or is it possible to not have any symptoms? Do you know the statistics of getting syphilis from one encounter of unprotected oral sex?
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Edward W. Hook M.D.
17 months ago
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Persons who acquire syphilis, may sometimes miss the signs of infection however, asymptomatic acquisition of syphilis is uncommon. Overall the risk of acquiring Syphilis for receiving unprotected oral sex from a partner of odd status is a small fraction of one percent.
I continue to think that you are worrying unnecessarily. EWH
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17 months ago
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My final concern is that the lymph node on the right side of my leg is a little swollen but there isn’t any pain with it. I know swollen lymph nodes are a symptom of syphilis.
17 months ago
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Is there any concern for the swollen lymph node in my leg?
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Edward W. Hook M.D.
17 months ago
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No. Swollen lymph nodes are present in most people and are non-specific findings. If you are concerned about thius lymph node, you should discuss it with your doctor but I am confident that what you have noticed is not due to syphilis or any other STI.
As you know, we provide up to three responses to each client's questions. This is my 3rd response. Thus this thread will now be closed without further responses. Please don't worry. EWH
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17 months ago
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Thank you for your time