[Question #11301] syphilis HIV worry

15 months ago

I have been receiving massage from a girl from Eastern Europe, we engaged in deep french kissing, oral sex with a condom, along with body to body massages. Afterwards, I was using a mouthwash, I had noticed that my tongue had a thick white residue with a possibly raised painless lump. I am worried that it may be a chancre,

I continued rinsing my mouth with salted water, the sore would bleed with heavy contact. Unsure if the bleeding is due wiping of the residue or something more serious. I am concerned about this being syphilis or another STD/STI or the risk of HIV, unsure if it was bleeding before. I also have swollen glands in my neck, a mild sore throat, unsure if significant or coincidental. What would you suggest.

Edward W. Hook M.D.

15 months ago

Welcome to our Forum. Thanks for your questions. I'll be glad to comment. The exposures you describe- deep french kissing, receipt of condom protected oral sex and vigorous frottage are not exposures associated with risk for STIs, including HIV. You do not provide information regarding how recently these activities occurred however my sense is that the encounter was within the past day or two- if that is the case, the onset of your symptoms is too soon for your oral symptoms to be related to an STI. For instance, the average time to the appearance of a syphilis lesion (the chancre) is 3 weeks. The white coating that you describe immediately after the encounter does not sound like an STI either.

It certainly does sound like you have an oral infection of some sort however I suspect it is not an STI and it is certainly not HIV (HIV is not acquired from receipt of oral sex, kissing, or frottage. I would encourage you to see a health care provider to get evaluation including a throat culture..

If you wish to provide more information regarding timing, perhaps I can provide more information regarding your STI risk but I doubt that this is an STI of any sort. EWH

---

15 months ago

Thank you Dr for your reply, I will add a little more context. I have just started to go for massages the past 6 weeks. I had noticed my tongue after the last session 2 days ago. It may have been there before.

Since yesterday, I have been feeling quite fatigued and have developed a sore throat with an inconsistent mild cough. I have been very run down lately that’s why I had started to go.

However the white coating seems to be going and the raised lumps seems to have flattened leaving a speck of red since I have been using salted water the past day. Would a chancre react this way, Also would the bleeding on my tongue when I had scraped it be a concern. I am not to sure if it was bleeding before, would this be a transmission for an STI / STD / HIV. I read that oral thrush if scraped could cause bleeding.

Do you think this may be syphilis or another STD or if I was bleeding lead to HIV as it may have started a few weeks ago without me realising on my tongue.

Or possibly things are self resolving or should I get checked and if I should when would you suggest as I am not to sure when or it may have occurred due to my encounter. Thank you again Dr.

Edward W. Hook M.D.

15 months ago

Thanks for the additional information. That this follows repeated encounters makes it a bit more difficult to determine whether your tongue sore might be related however, for all of the reasons already mentioned, it is unlikely. Further, lesions like the one you describe on the tongue which now bleeds (apparently when manipulated) would still be uncharacteristic for any STI. Since you asked, syphilis lesions do not typically bleed and are most unusual on the tongue. Nor would a chancre behave in the way you describe, flattening and possibly even improving.

Oral thrush is typically not limited to the tongue.

Unless it shows dramatic improvement I would still suggest getting seen. Lesions of the sort you describe are sufficiently unusual that I would recommend being seen by an Ear, Nose and Throat (ENT) specialist. You can, of course do a syphilis blood test out of caution but I would be most surprised if a syphilis blood test were positive. If the lesion were due to syphilis, i would expect the syphilis blood test to be positive.

Thanks again for the additional information. I hope my comments are helpful. I remain confident that this is not an STI, including HIV. EWH

---

15 months ago

Thank you Dr