[Question #4261] Follow-up procedure after recieving oral unprotected

29 months ago
Hello,

Last night I recieved oral sex from a sex worker at a strip club. What should I do from here? Last time this happened I had epididimytis symptoms a few days after. I went to an urgent care and they diagnosed it as gonorrhea and/or chlamydia and treated it accordingly. My symptoms went away, but reflared later. Testing proved that the same symptoms were not G or C or Trich. One of the doctors here (one of the male doctors) claimed it was likely a UTI of some variety and to not worry about it since it resolved both times with a standard dose of Doxycycline. 

Do I need testing if I do not experience symptoms in the days to come? How long should I wait for testing and/or preventitive treatment? My primary concern is not passing something to my regular partner. 

Thanks in advance
Edward W. Hook M.D.
Edward W. Hook M.D.
29 months ago
Welcome to our Forum.  I'll be glad to comment.  Technically, you had contact with a commercial sex worker, dancer or not.  the good news is that most commercial sex workers do not have STIs and oral sex only relatively rarely leads to infection.  When it does, the most common problems are either gonorrhea of non-gonococcal urethritis NGU) caused by mouth organisms introduced in to the urethra during sex.  Chlamydia occurs very rarely.  when these infections occur they are typically symptomatic within a week after contact so if you do not have symptoms, I would not worry and see no need for testing.

Also, there is no risk for HIV from receipt of oral sex and the risk for syphilis is very, very low unless she had a sore on/in her mouth which, again, is most unlikely.

I hope this comment is helpful.  EWH 
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28 months ago
Dr. Hook,

One week after the incident I had no symptoms and felt clear. In the last 5 days symptoms have started to develop that mirror symptoms of the testicular pain I experienced earlier this year. I suspect that it may be triggered by anxiety, as I recently ran a marathon. I went to an urgent care and asked for a shot of cetrofloxacin and a week dose of doxycycline as this treatment got rid of my symptoms quickly the last time. Symptoms mow are not as severe as last time (and a time before that last year). I now have slight testicular pain but not a tender epididymis. Not red and warm like last time. Thoughts? 


Thank you.
Edward W. Hook M.D.
Edward W. Hook M.D.
28 months ago
Testicular pain without other signs of urethral infection (penile discharge or burning on urination).  Further, the recurrent nature of your symptoms makes it all the more unlikely that this is an STI.  I obviously have not examined you but while testing might be a good idea, unless there is something more obvious, I probably would not treat.  You are correct, anxiety could certainly be a contributor.  EWH
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