I had an encounter with a high-end CSW. I performed cunnilingus on her for just a few seconds before I decided to stop. 

After that, I had protected intercourse for a few minutes. The condom seemed intact when I removed it but was covering something like 60-70% of my penis.

A couple of days ago I started feeling a bump on the back left side of my tongue and the papillae seemed a little enlarged upon inspection. This is after almost 30 days from the encounter,

Can this be from an STD? Syphilis? Any other risks?

Thanks

It is exceedingly unlikely that this is syphilis, which would not cause a "bump" on the tongue. Although this is well outside my STI expertise, I'm pretty sure the most common cause of such bumps is exactly what you state yourself -- minor inflammation of a tongue papilla, perhaps from something you ate. In addition, 30 days is too long for onset of a chancre, the initial sore of syphilis, and the location doesn't fit: chancres occur at the site of inoculation, generally places subject to friction during sex. Other cases against syphilis is its extreme rarity in escorts (assuming we agree that means expensive female sex workers by appointment), who typically are aware of STI risks, use condoms, have low risk clients (men like you), and get tested frequently. And acquiring syphilis or any STI by cunnilingus (oral-vaginal contact) is very rare. As for the condom covering only part of the penis, that's entirely normal; protection is concerned complete as long as the head of the penis and meatus (urethral opening) are covered.

I really wouldn't worry about this. From a medical/risk perspective, I would not even recommend testing for any STI. However, if you remain concerned you could be tested for reassurance. If you do that, I would advise a throat swab for gonorrhea, which would be valid now, and blood tests for syphilis and HIV 6 weeks after the exposure. If you decide to be tested, you definitely should expect negative results.

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

HHH, MD

Very clear and reassuring. 

I made the mistake of Googling enlarged papillae and found some info that syphillis, among many other things, could be one of the causes. Maybe I am overthinking this, but probably this would be later stages of the disease correct? And not something to happen with the first month?

Thanks