3 months in went to a clinic & was presumptively prescribed 2xCefixime 400mg & 4xAzithromycin 250mg with no change. Had a scrotal ultrasound at 4 months. Went to urology at month 7 and tested for uti & ureaplasma (negative). They suggested it might be pelvic floor disfunction. This and stretching helped the pain a lot but still had mild pain/burning. Then had a white film start on my tongue with tongue swelling and mouth pain with very short lived (<24 hr) ulcers if irritated. Continues to now. White film is intermittent. Discovered swollen sore lymph nodes in groin and 1 armpit. Concerned that I missed something.

Test History

Month 1: Chlamydia NAAT, Gonorrhea NAAT, Hep A/B/C, Herp I/II, HIV RNA, Syph RPR, Trich

Month 3 & 7: Same except HIV 4th Gen

Month 8: Syph TPA

Month 10 Syph TPA & HIV RNA (Different lab)

Every time I think this is done something else happens. I did read on a couple medical websites (not reddit) that sometimes syph antibodies aren't produced. Is that true? I did have a suspicious pimple on my thigh 3 months in but dismissed it since I'd tested negative already. I am done testing unless there is something else you would suggest. Please help.

You clearly have no STD from the event described and never did. I cannot be entirely certain about the reasons for your symptoms, except for sure they were no STD; most likely they have been at least partly the result of anxieties over the event -- magnifying minor symptoms or even normal body sensations that otherwise would not be bothersome and maybe not even noticed. This also fits with "pelvic floor dysfunction", which often (usually?) has a psychological basis. You might google "chronic pelvic pain syndrome", which is similar if not the same thing -- sometimes called nonspecific prostatitis, but probably not originating in the prostate. The Wikipedia article is good. I think you'll see many similarities to your own symptoms. As for your non genital symptoms (tongue, mouth, etc) you don't describe anything that isn't common from time to time in entirely healthy persons.

All the lab tests you mention are highly reliable and the results are conclusive. In addition, you really couldn't have acquired any of the listed infections during a single episode of condom protected vaginal sex. It is not plausible that the condom broke without your notice.

As for syphilis being active but without detectable antibodies, that's nonsense. No such thing occurs. And in any case, your symptoms also don't fit syphilis -- or any other STD. And no STD would show up as a pimple on the thigh (or anywhere else). You need to guard against attributing every itch, tingle, or other unexplained symptom as somehow related to the sexual event.

So I'm very glad to hear you are "done testing"! I am truly confident you have no infection of any kind from the event eleven months ago; and that once you accept and understand that (at a gut/emotional level, not just intellectually) that most of your symptoms will fade away.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

Chancres can occur at any sexually exposed site. Other than the genitals and anal area, the mouth is most common. In distant past history, dentists occasionally acquired syphilis with chancres on fingers which likely had been injured during dental procedures. Other non-genital sites probably usually followed injury, e.g. from teeth, and nipples have been involved although very rarely.