[Question #4363] Syphilis and neurosyphilis symptoms?
 |
82 months ago
|
Ive done a lot of research and read all questions similar to mine. still worried sick. I know my risk was low from your responses to others. I got tested for all sti’s and HIV all negative. I didnt get a syphilis test. The Risk was with a female. We kissed and she gave me cunnilingus. 2 weeks after I had white coating on tongue. then severe sore throat, swollen tonsils, bad cough. diagnosed as strep throat. got better but had a continuous raspy voice and throat clearing for months. chronic runny nose, sneezing, oral ulcers. Got sick twice again with sore throat, fever and chills within 6mos. 10lbs weight loss.
Fiancé was also getting sick and had rash on torso that went away after a day or two. After 3 months fatigue, heart palpitations, migratory muscle pains, white tongue and leukoplakia patches,ringing in my ears Pain and hearing problems. Foliculitis rash on chest,dizziness, nauseous,foggy and lightheaded.Then migrating muscle twitching and pain, formication and tingling and numbness sensations all over. skin changes and muscle atrophy. I am still suffering with most all these symptoms plus now started with neck stiffness and cracking, brain fog,memory loss,confusion or forgetting words and weak muscles. I am terrified that I have tertiary or Neurosyphilis and infected my fiancé.Please help! I gave as much info I could with word allotment.
1. Do you think I could have been infected from this incident?
2.can white tongue be first sign of syphilis?
3. Is it common for neither of us to not notice a rash on hands or body or sores other than the ones I mentioned?
4.Does his torso rash 1 month later and my foliculitis I mentioned sound like syphilis rashes?
5.Could I have neurosyphilis or tertiary syphilis after 2 years causing the symptoms I described?
6.Does syphilis cause autoimmune diseases to activate?
7. Does it cause the symptoms I’ve mentioned and would they persist this way? Or does it always follow the typical pattern/stages?
 |
H. Hunter Handsfield, MD
82 months ago
|
Welcome to the forum. Thanks for your confidence in our services.
---
It would be helpful to know about the timing. Aside from the mouth and throat symptoms, please give more details about how long following the exposure your various symptoms began, and when were you tested. (You allude to some symptoms going on for 2 years, but when did they start?) Also, it's surprising that testing for "all STIs" didn't include a syphilis blood test. Are you sure?
Pending that information, based on what you say I'm not really concerned you have syphilis or any other STD from the exposure described. Certainly there is little or no risk from kissing or oral-vaginal contact. If your partner has genital herpes, conceivably your oral ulcers and sore throat could be from a new oral HSV infection, except that 2 weeks is too long; initial herpes symptoms typically start within a few days of catching the virus. Syphilis doesn't cause painful sores or sore throat. Your symptoms are very nonspecific, meaning they do not point to any particular infection and are consistent with innumerable health problems, both infectious and non-infectious. I cannot say syphilis would not cause some of them, but most don't fit well with syphilis or any other STD, or with HIV for that matter. Directly to your questions:
1) Very unlikely, based on what I know so far.
2) White tongue goes along with almost any infection or medical condition you can name, including strep throat. It would rarely if ever be the first symptom of syphilis.
3) No, this would be uncommon. Most people with syphilis would notice the symptoms you describe, as well as the initial sore (chancre) at the site of inoculation (i.e. your mouth or lips).
4) Syphilis rash is highly variable. However, it generally does not look at all like folliculitis.
5) Conceivably yes, but not on the basis of your symptoms. If you happen to have syphilis, neuro or otherwise, probably it is asymptomatic. In other words, whatever the cause of your symptoms, almost certainly it isn't syphilis.
6) I am unaware of any data on syphilis triggering or activating autoimmune diseases. In any case, your symptoms aren't typical for an autoimmune problem.
7) As your question suggests you know, syphilis symptoms usually would not be persistent for so long.
I look forward to hearing expanded information about timing of symptoms at your lab tests so far. In the meantime, I hope this information is helpful.
HHH, MD
------
|
82 months ago
|
Thank you so much for your response and I truly appreciate what you do here. I apologize on the short info. My original post was more detailed but too long to post. I had to omit a lot of words. I didn’t have tests until a year after as I waited a while because of nerves and afraid of ruining my relationship and I didn’t have all the tests at the same time. I asked for different tests from my doctor on separate occasions. Which is why I know I wasn’t tested for syphilis.
From the day of the risk I will run down symptoms. Sore throat, swollen tonsils, bad cough. Happened within a month and I got sick a few more times within a 3 month period with fever severe sore throat and swollen tonsils the raspiness and constant throat clearing lingered for about 6 months. Which is when I noticed I had been steadily losing weight. About 10lbs. The 2 or 3 oral ulcers were not at the same time but all within about 2-4 months.
Fiancé rash on torso occurred about a month after. that went away after a day or two. But did very much resemble syphilis rash pictures I looked up.
Around 3 months after I developed severe fatigue, heart palpitations- heart beating fast or skipping at randomn times. migratory muscle pains, formication, white tongue persisted and then I developed leukoplakia patches on sides of tongue also started having ,ringing in my ears And felt like hearing would go out. dizziness, nauseous ,foggy and lightheadedness so severe some days and then would feel fine the next. About 4-5 months I started having migrating muscle twitching along with the muscle pain which persisted and lingered.
After about 8-12mos I did have times where I felt I was fine for a few weeks and then everything would come back. About 1.5 yrs. is when neck stiffness and cracking memory loss confusion severe brain fog began it would happen some days and then I would feel fine the next. The muscle twitches and pain and still white tongue are the most constant and persistent and happen everyday all day. While other symptoms come and go. I hope I cleared up the timeline.
You said
2) White tongue goes along with almost any infection or medical condition you can name, including strep throat. It would rarely if ever be the first symptom of syphilis. 1. Even if it is still persisting until this day? I never had a white tongue before it was always pink. Even with the leukoplakia patches?
3) No, this would be uncommon. Most people with syphilis would notice the symptoms you describe, as well as the initial sore (chancre) at the site of inoculation (i.e. your mouth or lips).
2. I received cunnilingus could I have missed the sore on my genitals?
3.if we kissed before she performed oral sex would the chancre have been in my mouth instead of my genitals? What if she had condylomata?
4.Also you said sore throat is not a symptom of syphilis can you explain this because I have read on multiple sites that it is and I am confused.
5.are the muscle pain and constant twitches symptoms of syphilis?
6.do you see any reason why I would have a positive syphilis test or can I be assured it will be negative and I can put my mind at ease?
|
H. Hunter Handsfield, MD
82 months ago
|
Thanks for the details. Happily, they reinforce my confidence you don't have syphilis or any other STD. Further, I am confident these symptoms are entirely unrelated to that exposure, except for the possibility that many of the symptoms are typical for the physical manifestations of stress, anxiety, or other psychological factors -- i.e. that you are experiencing minor symptoms or even normal body sensations that wouldn't be concerning or that might not even be noticed except for your anxieties over a sexual decision you may regret. Also, you are making the mistake of focusing on a single event when in fact you have undoubtedly had innumerable other potential exposures that in theory could cause various health problems. Over the months and years, both before and after the sexual event, you have had overt or unrecognized environmental exposure (fumes from industry, traffic, sewage plants, etc, etc), and you have interacted with innumerable people through hand shaking, social kissing, restaurant service or other commercial contacts, and so on. Since your symptoms are so nonspecific and really don't suggest syphilis or any other STD, there is no particular reason to suppose the sexual event is any more likely a source than all these others.
---
1) Long persisting white tongue doesn't go along with syphilis any more than a hundred other health conditions, and some people have white tongues all the time. Syphilis doesn't cause leukoplakia. (I'm inclined to doubt you have leukoplakia unless diagnosed by a knowledgeable health care provider. Other conditions cause white patches inside the mouth and can be confuse with leukoplakia. Google lichen planus for photos of one of the most common.)
2) This is the first I realized you received oral sex, rather than only performing it on your partner. Cunnilingus is oral-vaginal contact. Mouth-penis is called fellatio. In any case, it would be unlikely for you to miss a syphilitic chancre on your penis.
3) Kissing can transmit syphilis but does so very rarely. For either mouth or penis, it is hard to believe you would have missed an open, non-healing sore for the 3-4 weeks it typically lasts, typically up to the size of a dime. (Google it for typical photos.) Oral warts (condylomata) are rare, although you could have been exposed to genital warts by performing cunnilingus on her. (But because you were apparently confused about terminology, now I'm not sure you did that. Maybe fellatio on you was the only oral sex?) Gut warts at any location would not change any of this, and in any case you don't describe anything that suggests warts or other HPV infection.
4) Syphilis manifestations are very broad. Syphilis was described as "the great imitator" because it can mimic many other medical conditions. But I stand on my statement that syphilis rarely causes sore throat.
5) Muscle pain or twitching also do not fit with syphilis.
6) You definitely should have a syphilis blood test and for sure you can expect a negative result. (You should have done so when syphilis or other STDs first entered your mind.) In the off chance it is positive, it will not explain any of your current symptoms. It would mean you have asymptomatic syphilis, with a continuing need for further medical evaluation to determine the cause of your symptoms. OTOH, if many of your symptoms are psychological, as I believe they are, you may find they fade once you become convinced syphilis is not a problem. This is the main reasons you should be tested, not because there is any real likelihood you have it.
I have two final bits of advice as you go forward with your life. First, don't test yourself for STDs or anything else without doctor advice. And when you see doctors, don't just request particular tests. Address your symptoms broadly then follow the doctor's advice. It is of course OK to mention that you have had a worrisome sexual exposure or that you're concerned about syphilis (or HIV, or whatever) -- but let the doc select the best approach, without insisting on particular tests.
Second, get over the notion of not being tested (for syphilis or anything else) for fear it will be positive. People die all the time of undiagnosed conditions because of such delay (think of colonoscopy for colon cancer, women not having mammograms for fear they will show cancer, delayed HIV testing that results in earlier death, and so on). In addition, both clinical experience and research show that when someone delays testing for fear of the result, anxiety and stress decline when the test is finally done. The stress of worrying about it is always greater than comes even with a positive result. Clearing the air is very liberating!
Each question includes two follow-up comments and replies, so you have one coming. I suggest holding off until you have had a syphilis blood test, then return and tell me the result for any final comments or suggestions I might have.
|
82 months ago
|
Thank you so much Doctor for your reassuring words.I understand this is my last post or question chance. I would have liked to save it for after I get testing to come back and post my results and be able to reassure others going through this same experience. Maybe it could save them the years or months of worry that I went through. but I felt there was still some confusion I needed to clear up and A few things I forgot to mention and ask.
First sorry for the confusion but I am a woman and the risk was with another woman. My fiancé is a man. I had never been with a woman before this. That is why I said cunnilingus and was worried about missing chancre in my vagina. My relationship with my fiancé was commited up until this point and both of us had been tested prior to this engagement. So I know we were free of stds before this point.
Second I had to take a strong antibiotic for an infection a few months back My neurological symptoms intensified severely after 2 days on the medication which the doctor said wasn’t normal side effects of the meds but i had to quit taking them. Could it have been a syphilis Herx? I know only penicillin cures syphilis so would another strong antibiotic cause that reaction or only penicillin would affect and kill off the bacteria to cause a Herx?
Lastly I forgot to elaborate on the auto immune disease. I was diagnosed with morphea on my skin. These symptoms started 6 months after the risk and was diagnosed about 8 months after. Does syphilis cause skin lesions like morphea or similar to occur?
Third I do agree with you that some of my symptoms maybe caused from anxiety as I have lost sleep over this for years and maybe some other environmental factors. But some are also hard to dismiss and were not there before. I was very healthy up until this event. Also unfortunately due to the information on the internet even the cdc website has caused me much worry. After this I am getting tested and will stop googling my symptoms.
I want to thank you for your responses I really appreciate it and I hope that maybe you could leave the thread open to post my test results once I am tested which I will be doing very soon. I will not comment any further until I do so. Again thank you!
|
H. Hunter Handsfield, MD
82 months ago
|
Thanks for the further clarification. I should have not made a knee-jerk heterosexual assumption -- apologies! I didn't mean for my summary of the definitions of oral sex to be condescending. But if anything, it still further lowers any concern about syphilis. No data have been reported on syphilis in women who have sex with women in the US (sexual orientation or sex of partners is not routinely collected among women in public health settings -- even for males, it's only a recent change in STD reporting). However, the available data and broad consensus is that syphilis is very infrequent in lesbians, far less common than in either gay men or straight men and women. (This comment assumes your female partner mostly has sex with other women, i.e. not a one-off event as it apparently was for you.)
It would be unusual for a chancre acquired during oral sex to be inside the vagina. Syphilis bacteria generally enter tissues through microscopic abrasions, i.e. at the sites of direct contact and maximum friction during sex. Hence usual locations like penile shaft in men and the vaginal opening, labia, or anus; or rarely the mouth. Inside the vagina certainly can occur from vaginal-penile sex, but I cannot imagine it from cunnlingus, barring an unusually prehensile tongue!
---Some antibiotics, including many that would be considered "strong", have absolutely no effect on syphilis and cannot cause Jarish-Herxheimer reactions. Others are active and could do so. In any case, J-H reactions generally are systemic fever, headache, etc, not exacerbation of the quasi-neurological symptoms you have described. Also, these reactions start within 8 hours of the initial dose, not 2 days later. (That said, J-H reactions only occur with curative treatment. So in the exceedingly unlikely chance you had syphilis and J-H reaction, it would have meant you were then cured of syphilis.)
I know nothing about morphea, except that it's a localized form of scleroderma. I can't say anything about it except to reiterate that syphilis isn't known to exacerbate autoimmune conditions.
I'll make an exception and leave the thread open, so you can tell me your syphilis test result and the antibiotic treatment. At that time, let me know what antibiotic you took. But I won't have any further comments on all this until then.