[Question #12483] Can this be Syphilis?

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7 months ago

25 (male). 7 weeks ago, I had an exposure with a CSW. Received protected oral for 4-5 minutes and kissed the breasts, nothing else. From what I’ve read, this is all low risk, but 2 weeks later, my wisdom tooth became inflamed, which is partially covered by the gum. My dentist prescribed 1 week of Amoxicillin 875 mg + Clavulanic Acid 125 mg two times a day for 1 week. After finishing the antibiotics, by the 4th week, a 5-6 mm red, round, painless spot appeared on the inner part of my lower lip which slowly became slightly raised but still doesn’t hurt. Its surface is almost flat, and it looks like it has very small red dots or radial lines in it, with a color similar to the rest of the lip, but it feels slightly firmer to touch and has 1-2 whitish areas at the border. On the upper lip I have a small 1-2mm mucocele i think. Now it’s the 7th week, and it’s still present but has slightly retracted. There is no ulceration, but from the whitish area, I think I see a small transparent fluid drop (oozing?). I did a rapid test after the antibiotic treatment and again at the beginning of the 7th week, and both were negative, no palpable lymph node. My question is whether the antibiotic treatment could cause a negative result and later turn positive (delay?), when should I retest, and whether this bump could be more likely related to the tooth inflammation and antibiotic therapy rather than syphilis.

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Edward W. Hook M.D.
7 months ago
Welcome to the Forum.  Thanks for your questions,  I agree with you assessment.  You indicate that the only oral contact you had with your casual partner was kissing her breasts and you do not mention any lesions there.  Thus this was a no risk activity for developing oral syphilis.  In addition, a week of amoxicillin-clavulanic acid would have completely prevented, not delay development of a syphilis lesion.  I am confident that the lesion you describe is not syphilis.  I presume the rapid test you did was for syphilis.  If not, while I see no need for testing, should you feel the need to prove this to yourself, you can test and that result will provide further proof that this is not syphilis.  

I do not what the lesion you describe is but it is not syphilis.  I suggest that you see your own doctor to sort this.  In doing so, I would have no concerns about the possibility of syphilis.  EWH
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7 months ago

No, there was no lesion. Yes, the rapid test was for syphilis, and it was negative 7 weeks after. I just have one last question to clarify. Are there doses of antibiotics that can delay the test from becoming positive ? I read that sometimes you need to wait 3 months after taking antibiotics, or did I misunderstood? Thank you for your response!

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Edward W. Hook M.D.
6 months ago
There is no need to wait three months to test.  You can test at any time now and get reliable results.  Please don’t worry.  EWH---