[Question #11936] Concerns with symptoms

11 months ago

I had unprotected vaginal sex with a Mexican, who is a well educated school teacher. Her vaginal fluid also went in my mouth from my fingers. I then had unprotected sex with my long term partner (F) the following day.

A few days later I developed a sore throat and felt achey and needed to pee frequently. About 2-3 weeks post exposure, the sore throat, achey limbs returned. I also developed mild oral thrush and had a couple of sores in my mouth. Accompanied by mild back, abdominal and testicular pain and a phlegmy cough. Also have occasional tingling over my body. No discharge, fever or painful urination. Still have issues with urge to pee, though it is less severe than before.

Tested negative for HIV 5th Gen (UK) on day 10, 24 and 32. As well as for Chlamydia, Gonn, Trich, Ureaplasma, Mycoplasma and Syphillis. Mexican girl tested negative for HIV and Syphillis on day 25. No symptoms. My partner has no symptoms but we are not sleeping together due to the fact I cheated and want to identify what I have.

Still very concerned including for Hep B, which I will test for soon.

Looking for some reassurance or advice. I have not been sleeping or eating well since this exposure.

11 months ago

I should add that I am now 5 weeks post exposure and I will retest after day 45 for HIV, Syphillis and Hep B.

Remaining symptoms is a slightly uncomfortable throat with slight ear pain in my left ear and occasionally achey limbs. Occasional lower back and testicular pain. I still need to pee more frequently than I did prior to the exposure and is worst when I am standing. I don’t need to pee during the night when in bed. Until recently my mouth also felt sore, almost as if it had been burnt but this pain has now effectively gone.

I’m at a loss. Doctor’s don’t seem to think it’s STI related. Urine and blood tests have come back clear so far.

H. Hunter Handsfield, MD

11 months ago

Welcome to the forum. Thank you for your confidence in our services.

You describe a nearly zero risk sexual exposure, having used a condom; getting vaginal fluid in your mouth carries little or no risk. And you describe a partner who seems to be at very low risk -- on top of which she tested negative.

Even if you had not stated your and your partner's test results, I would have guaranteed you that your symptoms were not due to any STD. You caught a cold, that's all. Or maybe covid or influenza. And onset after "a few days" could mean you caught it from your sex partner. However, no STD causes sore throat, body aching, or cough. HIV also is a less likely cause of such symptoms than you might assume from lots of online information, and does not cause cough. In addition, symptoms of HIV ALWAYS are accompanied by positive test results. And none of the other STDs for which you were tested are known to cause the sorts of symptoms you had. In other words, I agree exactly with the advice you have had from your own doctor(s).

The chance of a hepatitis B virus (HBV) in this situation is zero for all practical purpose -- even if you were not vaccinated in childhood. (Were you?) I see no reason to be tested for it.

As for your continuing symptoms at this time, I think they are no more than anxiety over the situation, magnifying minor symptoms or even normal body sensations that you would otherwise ignore and maybe not even notice. You might discuss this possibility with your doctors. My strong advice is to have no further tests, including HBV (which is not a possible cause of your symptoms) and that you resume sex with your regular partner with 100% confidence that you have no STD of any kind.

I hope this information is helpful. Let me know if anything isn't clear.

HHH, MD

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11 months ago

Thank you for your reply Dr Handsfield.

I understand this is my final question, so just to clarify a couple of things.

The sex was unprotected. First with with the Mexican girl (we cheated), then with my long term partner as usual the following day. The symptoms then followed 2-3 days after.

My main concerns:

I don’t recall ever suffering from oral thrush/having sores in my mouth from flu. The doctor treated this with anti-fungals, which largely cleared it up though an uncomfortable throat remains.

One thing I neglected to mention was for a couple of weeks, alongside the frequent urination, I had a slight pinching feeling in the urethra. This stopped two weeks ago now and the doctor swabbed but couldn’t find any issues. I do still feel a slight weakness in my limbs, particularly knees and upper arms. This still concerns me.

Hep B vaccinations in the UK only became standard for children a few years ago, so I am unvaccinated. The Mexican girl isn’t clear on whether she has received the vaccination. She is trying to check. She visits a gynaecologist twice a year and is generally very sensible with her health. We both just made a mistake. She has no symtoms for anything since the sex. Likewise with my long-term partner.

H. Hunter Handsfield, MD

11 months ago

I understood the sequence of sexual events if not the exact timing.

True that flu doesn't usually cause oral sores, but some common cold viruses do so (e.g. adenovirus). As for thrush, it's common in entirely healthy people without immune system problems. Your test results prove you do not have HIV.

Your urinary symptoms, weakness, etc fit nicely with anxiety.

Regardless of vaccination status, the risk of HBV from this event is near zero. In my 50 year in the STD business, I've never seen or heard of anyone who acquired it heterosexually.

In short, this information does not alter my opinions and advice.

Each question comes with two follow-up exchanges -- so you have one more coming (but only for clarification of the same issues, not to raise new ones).

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11 months ago

Thank you again doctor. I feel much more reassured regarding HIV and HBV in that case.

I guess this leaves me with HSV-2, as most other things have already been ruled out/tested negative for. Do you have any views on the reliability of a blood test? I have had HSV-1 since a child.

I understand it’s quite transmissible even if asymptomatic? She had no visible sores/symptoms, but do you know if it’s prevalent in Mexico? My relevant symptom is strange, but sporadic nerve sensations (wrist, fingers, shoulders, legs). No visible lesions on my genitals, however. Thanks again - you provide an invaluable service!

H. Hunter Handsfield, MD

11 months ago

The HSV blood tests are inherently unreliable in some ways. but negative HSV2 results generally are reliable.

I'm not sure how you came up with HSV2 being "quite transmissible". The best data are that when a known infected person has unprotected vaginal sex with an uninfected one, the infection is transmitted an average of once for every 1,000 exposures. I can't say the prevalence of HSV2 in Mexican women, but probably well under a 50% chance your partner was infected.

Don't believe "Dr. Google" or "Dr. Reddit" in assessing HSV symptoms. The things you report DO NOT OCCUR in people with genital herpes; definitely no "sporadic nerve sensations" (whatever that means) outside the genital or anal area. Never. There isn't the slightest reason for you be worried about HSV2 in this situation.

That completes the two follow-up exchanges included with each question and so ends this thread. Thanks for the thanks -- I'm glad the discussion seems to have been helpful. Best wishes and stay safe.

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