[Question #3931] Recent Encounter -too early for Syphilis?

34 months ago
Hello,

I'll try to keep this short and to the point.  Three days ago I had aex with a male/female couple I met online.   Both are middle class,in their late 50s, white male and Hispanic female, from a coastal state in the American Southeast.    Both said they were tested recently and practiced safe sex for penetration, but not oral.  I performed unprotected oral on them both, and they both performed unprotected oral on me.  They male did not ejaculate in my mouth, but I did get his semen in my mouth via a kiss from the female.  The male performed protected insertive anal sex on me but did not ejaculate and I confirmed the condom was intact after he was done.  I performed protected intercourse with the female and the condom was intact at completion.  While I believe I practiced safer sex, this afternoon I noticed a sore about half way up my penis.   It was painless, pliable and soft and appeared to be already scabbing over.  My question is, could this be a syphilis chancre after only 3 days?  My research says it probably is too early, I just wanted an expert's advice.  Thank you.
Edward W. Hook M.D.
Edward W. Hook M.D.
34 months ago
 Welcome to the forum. I congratulate you on your commitment to safe sex. Thanks as well for the detailed description of your recent exposures.   For an STI to cause lesions of the sort you describe so soon after sex would be most unusual. For Syphilis it takes an average of 21 days following exposure for syphilitic ulcers to appear at the site of contact.   It is also a bit early for lesions of HSV to appear. Further the sorts of exposures you describe would put you at risk only for HSV-1. If you already get cold sores or have HSV one this should not be a concern   Further this is a bit early for HSV-1 to cause lesions as well and, had this been an initial episode of herpes it would be unusual for the lesions to already be beginning to heal. I doubt that this is an STI.   The most likely cause of the sort of lesion you are describing would be the trauma of your recent sexual activity.   If the lesion you describe is the result of your recent sexual activity it should heal quickly and not progress. 

 I hope that these comments are helpful to you. If they are not you may use your up two to follow up questions to seek clarification.  EWH
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34 months ago
Thank you for your quick reply.  You seem to confirm what I was thinking about it being trauma from the sex.  My understanding is that a chancre will take longer than normal to heal (approx 3-6 weeks).  If my wound heals quicker than that, should I just consider it a normal scrape and move on?  Would there be any benefit to seeking an antibiotic treatment immediately just in case?  I don't even know if a doctor would prescribe the medicine without the confirmation of a test, but I have read it can take six weeks for the most accurate test results.  Any advice you can offer will be appreciated.
Edward W. Hook M.D.
Edward W. Hook M.D.
34 months ago
 I agree with your assessment. The most likely cause of the reasons you described, given its appearance and timing is that it is related to your recent sexual activity and not an STI.   Abrasions of this sort typically heal on their own in a few days and without anabiotic treatment. Nothing you have described suggest a need for antibiotics unless it becomes red or increasingly painful. If it has not shown signs of improvement  in 3 to 4 days it may be appropriate to have a healthcare provider take a look.   In the unlikely situation that this is Syphilis, a blood test would be positive within a few days after the appearance of the lesion. As I have already said I think this is most unlikely.  

 As a matter of general good sexual health practice, we do recommend that all persons with multiple partners periodically have screening tests for HIV and other STI ( gonorrhea, chlamydia, syphilis primarily).. The frequency of such screening depends on the person's sexual activity but  typically we would suggest such screening annually or every six months.   EWH
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34 months ago
Thanks for the good info.  The abarasion has already healed so looks like nothing related to n STI.  I guess I'll use my last follow up question to ask about future STI testing.  Was there anything in the encounter I described given the activities and demographics of those involved which would require me to get tested any earlier than 6 months from now?  By my research, the riskiest activity for me was getting the man's semen in my mouth.  Any last advice will be appreciated.
Edward W. Hook M.D.
Edward W. Hook M.D.
34 months ago
 I agree that the encounter you describe represents safe, low risk sex. Receipt of unprotected oral sex has a very low risk of acquisition of gonorrhea or nongonococcal urethritis however these problems are typically symptomatic. Thus if you have not developed symptoms I see no reason for specific testing related to this encounter . I would however, as you have suggested suggest periodic STI screening as a matter of good sexual health practice as long as you continue to have multiple sexual partners going forward.   Unless you develop symptoms in the meanwhile, waiting six months would be fine. 

 Thanks again for your confidence in our advice. As you know this is my third reply to your questions and therefore as per forum guidelines this thread will be closed in a few hours. Take care. EWH 
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34 months ago
I just wanted to clarify, I didn't see a specific answer to one part of my follow up question about getting the man's semen in my mouth.  If this counts as an additional question or violation of the rules, please disregard.  Thanks.
Edward W. Hook M.D.
Edward W. Hook M.D.
34 months ago
I understand that you likely got genital secretions from each of your partners into your mouth and thought that my answer had covered it.  The likelihood that this exposure led to your penile lesion or causes and STI is very, very low and I would not worry about it. 

This will complete this thread and there will be no further answers. I urge you not to worry further and to move forward without concern.  EWH 
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