[Question #13751] kissing and protected sex - syphillis risk?

27 days ago

I am from Christchurch New Zealand. On the 3rd of January I met with a 53 year old woman who i have met occasionally before. She probably has the odd casual partner but not heaps. We had protected sex - I was very careful with the condom and it was intact and didnt come off. I also deep kissed a bit. 13 days after, I tested for chlamydia and gonnorhea and had blood work done for syphilis and hiv. I know this is a bit early for syphilis and gonno. Since about the time I met with her I feel like I have had raised lymph nodes, a bit of a stiff neck, and my ears feel blocked. I am worried I may have got syphilis from kissing. I also have a pimple on the outside of my thigh halfway between hip and my knee. I dont have any lesions in my mouth. My questions are as follows:

1) Is it likely I would have got syphilis from kissing?

2) Is the pimple on the outside of my thigh worrisome?

3) were my chlamydia and gonnorhea tests accurate at 13 days?

4) is further testing warranted?

5) are my lymph nodes and blocked ears indicative of syphilis?

Thanks so much for your help!

Edward W. Hook M.D.

27 days ago

Welcome to the Forum. Thanks for your questions. I'll be glad to comment. From the sound of things your casual partner was low risk and the activities you engaged in would make it unlikely that you would get any STI. Syphilis is a relatively rare STI and is only very occasionally spread through kissing. Your risk is low. Further, the symptoms you describe are non-specific and are far more suggestive of one of the all too common community acquired viral upper respiratory illnesses we all get from time to time than syphilis or any other STI. You are correct that your testing was a bit early for syphilis and HIV but your results of gonorrhea and chlamydial testing are conclusive and should be believed. In response to your specific questions:

1. Quite unlikely. She was low risk and syphilis is rarely transmitted through kissing

2. No. The location you describe is a common area for the occurrence of folliculitis but not for STIs

3. Yes, your results are reliable and should be believed.

4. Personally, I would not test further however testing is always a personal choice. Should you choose to test, I see no need for further gonorrhea or chlamydia testing. Blood tests for syphilis and HIV will be conclusive any time more than 6 weeks after your encounter.

5. Absolutely not. Far more likely to be a respiratory tract infection

I hope this information is helpful. You really have virtually nothing to worry about at this time. EWH

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27 days ago

Hi Dr.

Thanks for your answers. I wonder if I could ask you to elaborate slightly on a couple of points.

1) You stipulate that she is low risk - why do you believe this? I have queried her and she assures me she is clean but sometimes my mind gets carried away.

2) Why is kissing low risk. Have you come across many people that have contracted syphilis through tongue kissing?

Thanks in advance for your answer.

Edward W. Hook M.D.

27 days ago

1. She is in an age range where STIs tend to be uncommon and she states she has had a limited number of partners. Epidemiologically this is low risk.

2. Syphilis is primarily transmitted through direct contact with a lesion during genital or ano-genital contact. As I said, above, our experience, and that of other experts is that syphilis is rarely transmitted though kissing.

One follow up remaining. EWH

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26 days ago

Thanks for clarifying.

1) I dont have any lesions in my mouth at all that I can notice. I am assuming given they are caused by contact with a partner that these would mostly likely be on my tongue or lips given kissing was involved. Would a chancre usually be quite noticeable?

2)Based on my exposure, do you think its reasonable that I can resume sex with my wife?

Edward W. Hook M.D.

26 days ago

Final Responses:

1. Yes, a chancre would be quite obvious.

2. Yes, it is entirely reasonable to resume unprotected sex with your wife

It's time to move forward without concern. This completes this thread. Take care, EWH

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