[Question #2858] Follow up #2744

40 months ago
Hi Doctor
I am still under 6 weeks (which will be next week). I did a 4th Gen on day 30 and it came back negative. Will repeat next week for conclusive results. Although the doctor I went to for this exposure said I don't need any testing and refused to hear any sp

Reading through comments, my concern is from a unprotected  Oral sex exposure I had with a CSW at a FKK club in Germany in May16. Not about HIV because I got tested 2 times after that for a surgery and they were alp negative including the recent one. My concern is about Syphilis and the others. At that time I wasn't so aware of the other STDs (sorry for my ignorance but I have always been monogamous except for these 2 situations. I am 37) and have might not have realised any sores or other symptoms and I don't remember now either. Next week I will test for  all STDs. However, I have a H Pylori bacteria issue and I get treated with antibiotics every year. I got treated in July 16.( 1.5 months after exposure) The course is a 7 day course which has 6 tablets every day consisting a. 2 tablets each of Amoxycilin 500mg b) 2 Tinidazole 500 mg c) 2 Omeprazole 20mg.

My questions:
A. Would I have got Syphilis and others with that single exposure? The girl told me they were tested regularly
B. If yes, would the above antibiotics have cured it?
C. If no, I am now almost 1.5 years from that exposure and not sure what impact it would have.  I am getting tested for VDRL next week so if anything comes up, I will start treatment but worried about any impact it would have already done.

I will update next week on my results.

Thanks doctor.

Rgds
40 months ago
Sorry Amoxicillin is 750mg. I am based in India. First paragraph...Doctor refused to hear any symptoms. He said, he is more than 100% sure I did not contact anything from the kissing and masturbation incident. If I still wanted to test, my decision. 
Edward W. Hook M.D.
Edward W. Hook M.D.
40 months ago
Welcome back to the Forum.  I am sorry that you continue to worry about your virtually no risk exposure.  I agree with your doctor that there is no medical reason to continue to worry about the exposure you described to me in your original post.  I provide a little more information to your specific questions below:

A. Would I have got Syphilis and others with that single exposure? The girl told me they were tested regularly.
Syphilis is not transmitted through receipt of masturbation or kissing unless you have direct contact with an infectious lesion, something that is very, very rare.  You would have seen or felt a lesion if there had been one.

B. If yes, would the above antibiotics have cured it?
Amoxicillin is highly active against the bacteria that cause syphilis.  while not the recommended therapy for syphilis a week of the medication would likely cure syphilis, had you acquired it.

C. If no, I am now almost 1.5 years from that exposure and not sure what impact it would have.  I am getting tested for VDRL next week so if anything comes up, I will start treatment but worried about any impact it would have already done.
I am confident your tests will show that you did not acquire syphilis.

I hope these clarifications are helpful to your continuing concerns.  EWH
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40 months ago
Thanks for the reassurance doctor.

However I think I might have confused you. My questions regarding Syphilis and the other STD was from the Unprotected Oral Sex I had last year in May 2016 and not from the kissing and masturbation recently (Sep 2017). For Sep 2017 I am clear on your comments.

It was after May 2016  exposure that I had the amoxicillin course for some other condition.

Hope it clarifies and look forward to your advise.

Sorry for the confusion. 
Rgds
Edward W. Hook M.D.
Edward W. Hook M.D.
40 months ago
Thanks for the clarification on the timing of your possible exposures.  This however does not change my assessment.  There is nothing you report to suggest that you have or have ever had syphilis.  I anticipate that your upcoming tests for syphilis will show that you do not have syphilis and need not be concerned.  When the tests are negative, I urge you to believe them.  EWH
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40 months ago
Hi Doctor
Hopefully these are my last question and my last time on this forum.

I have received by VDRL which was Non Reactive 43 days from last exposure. hIV is expected tomorrow. It is a 4th Generation and I understand it's conclusive at 43 days? 

Now some last questions.

1.  I have been monogamous for 9 years since my marrige but before that I had a fair bit of sexual encounters mostly Oral sex (Just once it was a Oral sex from a male when I was drunk. All others were women)  I always tested for HIV only but never Syphilis - never as I never knew about it. Since VDRL only picks up latest once. Is there any test to identify if I have latent Syphilis? I really don't remember any symptoms or I must have ignored them . Will TPHA identify?

2. I was treated with antibiotics (Amoxicillin 750mg 2x7days)  last year for other condition but my wife never was. so I plan to get VdRL done for her as well as may be I infected her before treatment of my hpylori bacteria. however she was on antibiotics last 5 days for a throat infection (Amoxicillin 500 mg 1x5 days). Will this interfere with the VdRl test? Again since we are together for 10years, my last part of the 1st question applier for her too.

3. should we both rest for Gonorrhea?

I am just concerned about latent Syphilis for me and my wife. 

Thanks very much Doctor for all your help. Both of you are doing a wonderful job and I can't explain how much of help this forum has been for me in my anxious moments! I could not have passed those moments without yours and doctor Hansfields (to other's questions) valuable and considerate responses.

big thanks from India. 
Edward W. Hook M.D.
Edward W. Hook M.D.
40 months ago
I anticipate that both your HIV test and your VDRL will be negative.  These results will provide conclusive evidence that you did not acquire either infection during your recent exposure and that you do not have untreated Syphilis.  The VDRL would be positive if you had untreated latent Syphilis as well.  A TPHA would prove that you have never had Syphilis of any sort.  As for your specific questions:

1.  See comments above.  Your risk for syphilis is exceedingly low.  A negative TPHA would prove that you do not have syphilis and never had.

2.  I think you are worrying entirely too much about syphilis and this question is a bit repetitive.  Her recent antibiotics should not effect test results.

3.  I see neason for concern about Gonorrhea.  If you want to be sure, you can test.  If your test is negative, as I expect it will be, there is no need to test your wife.

Thanks for the thanks.  This is my third and, as per Forum guidelines, last reply to this set of questions.  The thread will be closed later today.  Tske care and please try not to worry.  EWH
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40 months ago
Thanks Doctor. Sorry just to reconfirm

a) VDRL detects Syphliis at all stages if uncured? In which case I am not interested in TPHA as long as I don't have it now.

b) both HIV and Syphliis negative are conclusive at 43 days?

Thanks v much. Keep up the best work!


Edward W. Hook M.D.
Edward W. Hook M.D.
40 months ago
Repetitive question.  Yes, correct.  Results are definitive.

This thread is now closed.  EWH
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