First, sorry for my english, it’s not my first language. I(M) had sex with a female sex worker 3 weeks ago. I live in Vietnam and sex work is illegal here so most of them don’t do health check, I guess so. I did protected oral sex and protected vaginal sex using two different condoms. I also did some deep kissing sessions with 10s-20s each and I also put my finger into her vaginal. Day 10, I did pcr oral swab and negative for chla and gor. Day 14 I did pcr urine test, rpr + tpha+ syphilis rapid test, all came negative. Day 20, I saw a white painless bump on my gum. So I did another rpr and tpha, hiv combo, results came out negative. I am really scare of syphilis and the anxiety is killing me. Not just because of this but also having many problems in life. I was not sure if there is any sore in the sex worker’s mouth because I did not check. She said no when I asked and told me she did test 3-6 months (dont know what kind of test and not sure if she told the truth). From week 2, I usually have chills and shiver when sleeping. I read that these are symptoms of anxiety but not sure if relates to any sti. 

1. I know the risk is small. But I want to how many case getting syphilis from deep kissing were reported?

2. From my exposure, how long should I wait to get the confirmative test?(only tpha, rpr, syphilis and syphilis rapid test available in local)

3. The white painless bump on my gum. Does getting neg result on the same day show that the bump is not from syphilis?

4. Does neg result on day 20 have any meaning? How many percent I don’t have syphilis from this result?

5. Do you see any risk of other sti from my exposure? Hiv? 

1. I know the risk is small. But I want to how many case getting syphilis from deep kissing were reported?

Syphilis is relatively rare and syphilis of the mouth is very rare.  While there are not specific figure, I would estimate that it represents less than 2% of all syphilis.  Transmission of syphilis through deep kissing is even rarer.

Many thanks for your response. It helps me release my stress. The white bump appear on my gum on Thursday, today is Sunday and I did Syphilis CMIA TP test and TPHA test, the results are NEG 0.04 S/CO and NEG. After a few days of "monitoring", I see that the white bump is not yet "broken" into sore or something and it only become more "white" in the middle. I do smoke cigarrete more recently so I think it somehow affect my oral health. So here are my follow up question.

1. Can the results this morning confirm that the white bump on my gum is not syphilis? I did consume a bit weed last night for my anxiety. Will it affect the test results?

2. Can a canker sore first is painless bump and then become painfull when broken? My bump looks a bit like canker sore but I not painfull yet so it make me confused.

3. I found that you have done many researches and also some book chapters about syphilis. Have you ever seen actual case of getting syphilis from deep kissing? If you be in my situation, would you concern about the risk and get test?

4.  With negative result of CMIA and TPHA on day 23, how many percent that I don't have syphilis from this encounter?

5. Is CMIA a good method for primary syphilis detection, on day 23? With RPR, TPHA and CMIA, which method I should do for the 4th weeks and 6th weeks test? If my 6th week test is negtive, is it conclusive or I have to retest after 3 months?

Best regards

2. yes, canker sores can be painful

3.  No, I have never seen a case of syphilis acquired through deep kissing.  

4.  Your 23 day test result, if you relied on only that, would have detected somewhere in the neighborhood of 2/3 of recently acquired syphilis

5.  The CMIA is a good test but like the RPR, TPHA it is dependent on development of antibodies to the syphilis bacteria.  Results at 30 days are close to (well over 90%) conclusive and tests at 6 weeks will provide conclusive results.

Please don't continue to worry about syphilis. EWH

Many thanks for your replies.

I will try to not worry about syphilis. Here will be my last question:

I’m using Gentrisone cream for my skin issue, maybe 2 or 3 times a week. It includes 10mg of Gentamicin, 6,4mg of Betamethasone  dipropionate and 100mg of Clotrimazole. Can it affect my hiv, syphilis or any sti test result? Because it has corticoid so I don’t know if it affects my immune system and “not create enough antibodies to be detected on test”.

Since this is my last follow up question. Just want to thank you for your support and information which help to release my stress. I will get syphilis test after 30 days, 6 weeks and maybe 3 months(just to totally sure). And hope that I will not have to ask you any question in the future. 

Best regards

The medications you have taken will not impact the accuracy of your syphilis tests.  The steroid you are taking is used topically specifically so that it will not effect you systemically.  If you had syphilis, your body would produce antibodies in the normal fashion.  Please try not to worry. I am confident you do not have syphilis.  

Thanks for your thanks.  I'm pleased I could help.  This will complete this thread.  TAke care and please don't worry.  EWH