[Question #2645] i have three questions about syphilis.

41 months ago


in thinking about exposures for me they would have been once 10 months ago, once 1.5 yrs ago, and 2-3 times over 2 years ago each being receiving unprotected oral sex from various commercial female sex workers in the usa.

my questions are

1 -- since i never developed a chancre on my penis and i was looking closely can i assume i never got syphilis

2 -- twice during the last 2.5 years i have been prescribed amoxicillin 500mg tablets 3x/day for 7 days each time.  if i had been infected, would this have cured it

3 -- given that occurence of syphilis in females is low and getting it via oral is low and that not having a chancre seems rare, what are the chances that maybe i have it ?
Edward W. Hook M.D.
Edward W. Hook M.D.
41 months ago
Welcome to our Forum.

1 -- since i never developed a chancre on my penis and i was looking closely can i assume i never got syphilis.
Syphilis following receipt of oral sex is very uncommon and the few cases which occur typically occur among men who have other men as their sex partners..  Syphilis lesions are typically painless and can go unnoticed but when this occurs, the lesions are typically at sites which may not be seen/inspected on a daily basis such as the rectum or, in women, within the vagina.  The best way to be 100% sure you have not acquired syphilis, as for other STIs which can be asymptomatic, is by screening which refers to the practice of testing in the absence of obvious signs or symptoms.  For syphilis this is a simple, easily done blood test. 

2 -- twice during the last 2.5 years i have been prescribed amoxicillin 500mg tablets 3x/day for 7 days each time.  if i had been infected, would this have cured it
Probably.  The minimum amount of penicillin needed to cure syphilis is unknown.  Recommended regimens typically prescribe medication that will be in the system for 10 days or more. 

3 -- given that occurence of syphilis in females is low and getting it via oral is low and that not having a chancre seems rare, what are the chances that maybe i have it ?
Very, very low.  Were I you, given the information you have provided, I would probably not be worried. 

Hope these responses are helpful to you.  EWH
---
41 months ago
thank you for the replies.  a few follow up questions please.

1 -- i thought that acquiring syphilis would necessarily include a chancre on the penis (if that is the site of exposure, as in my cases).   so my thinking that never having had one i could not have acquired syphilis? 

2 -- interesting, so if i had it, it is likely gone?

3 -- would you agree there is no medical need to test for it now?

and 4 -- i am married, and if i never had a chancre, if i had it, i could not have transmitted it, correct?

thank you.
Edward W. Hook M.D.
Edward W. Hook M.D.
41 months ago
I am not sure why your concern is syphilis.  Answers to your follow-up questions:

1 -- i thought that acquiring syphilis would necessarily include a chancre on the penis (if that is the site of exposure, as in my cases).   so my thinking that never having had one i could not have acquired syphilis? 
You are correct but they are sometimes missed.  For instance in uncircumcised men.  I tried to provide a general answer. 

2 -- interesting, so if i had it, it is likely gone?
Yes

3 -- would you agree there is no medical need to test for it now?
Yes

and 4 -- i am married, and if i never had a chancre, if i had it, i could not have transmitted it, correct?
Sypilis is only transmitted by direct lesion contact.  If you did not have a lesion/chancre, you would not transmit infection.  EWH
---
41 months ago
thank you.  

i think after this 10 month period since exposure to unprotected oral the guilt over the encounter is masking scientific realities of possible infection.   syphilis concerned me as it is life lasting.  and i would hate to think i was infected and could have passed it along 

in your expert opinion given that i was inspecting myself in weeks after exposure and given the activity of female to male unprotected oral and the fact i have had two amoxicillin regiments since would you say there is any chance i am a carrier of syphilis?

lastly, i have read it is actually more rare than hiv?  is that correct?  if so, it seems that i schools not be worried in the least?

would you agree?

thank you again. 
Edward W. Hook M.D.
Edward W. Hook M.D.
41 months ago
As you likely know, we permit up to three replies to any question.  Thus this will have to be my final reply and this thread will be closed later today.

In reply/response to your questions:

Syphilis is NOT "life long"- it is absolutely curable!

Give the facts that you did inspect yourself, the exposures you mention, and your two amoxicillin treatments, there is realistically virtually no chance that you are a syphilis carrier.

Yes, in the US, there are more new cases of HIV occurring each year than there are syphilis at present.  further, picking up on a theme that you have already mentioned, syphilis is CURABLE and NOT lifelong while HIV is not curable and is lifelong (and no one has ever been proven to have gotten HIV from receipt of oral sex)

I hope this interaction has been helpful.  there will be no further comments as part of this thread from me and the thread will be closed in a few hours.  Take care.   EWH
---