[Question #557] Sore throat the next morning

39 months ago

I'm male in his 40s. I have had a sexual encounter with a male escort the day before yesterday. The next morning to the encounter, I woke up with a strong soreness in my throat. (I doubted also it could be not my throat but a recurring inflammation of the esophagus; a condition that I have had a couple to times before, though in the previous evening I did not eat heavy meal or so. But on the same morning I had once a burping with a feeling of fluid from my stomach coming up my throat). The soreness continues for the 2nd day now, with a feeling sometimes of some pain when swallowing. I also had some mucus from my throat this morning. The fact that this happened the next morning caused me to worry.

I wonder I this soreness could be related to STDs/STIs.  The sexual contact that took place involved receiving oral sex (his mouth/my penis), a brief touching of the two penises, rimming (my mouth/his anus), and contact between my mouth and his feet and toes.  

What STDs/STIs, if any, might be actually transmitted via such practices, and if I wanna do some tests for STDs/STIs, how long should I wait after the encounter to do so?
Edward W. Hook M.D.
Edward W. Hook M.D.
39 months ago

Welcome to our Forum. I'm pleased to address your question,.  It is unlikely that the symptoms you describe are related to any STI you might have acquired through the contact you describe.  STIs almost never cause symptoms within 24 hours of exposure and most oral STIs are asymptomatic.  Increased burping, sore through or regurgitation of stomach contents are not STI symptoms but may reflect some other GI problem, particularly since you have had such problems in the past. I suspect the symptoms you are experiencing are due to some other cause. 

The major STIs acquired through he receipt of oral sex (his mouth, your penis) are penile infections such as gonorrhea or NGU, both of which are typically symptomatic, causing a penile discharge or burning on urination..  Unless he had sores in those locations, rubbing penises or oral contact with his feet and toes is not associated with STI risk.  Rimming may lead to ingestion of bacteria present in and around his rectum rarely leads to infection unless he has a GI infection.

Bottom line, I doubt that these symptoms are related to the sexual contact you have described.  EWH

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39 months ago
Thank you Dr Hook for your reply. It brings much reassurance. As I try to get tested for STIs once or twice a year, I wanted to know, if possible, how long I should wait before my next test to take into account the incubation period of STIs that might have been transmitted in this encounter (assuming worst case scenario), or any encounter in general.
Also, is my understanding correct that for rimming, there is hardly any risk of STIs?
Edward W. Hook M.D.
Edward W. Hook M.D.
39 months ago

Congratulations on your practice of regular screening for STIs.  This is a practice that will keep you healthy and we applaud it.  If, related to this exposure, and presuming you remain asymptomatic, you decide to be tested, be sure you are tested at appropriate sites, i.e. your mouth and penis.  As far as incubation times, for the most common STIS (gonorrhea, chlamydia)  tests would be positive within 3 -4 days of exposure.  In contrast, for rarer STIs, it may take longer-at least three weeks for syphilis and 4 weeks (28 days for HIV) for tests to reliably be positive.  As I told you however, I would not be worried and do not feel strongly that timely testing is critical.

In terms of risk, rimming is rather low risk.  Perhaps the major risk is if your partner had an enteric, gastrointestinal infection there might be risk for infections which typically cause diarrhea such as salmonella, shigella, and ambebiasis but this is uncommon.  Transmission of typical STIs like gonorrhea or chlamydia from the rectum to the mouth is biologically inefficient and the risk is low.  Finally, unless lesions were present, the risk of syphilis or herpes is very, very low and should not concern you.  I have tried to be comprehensive n this response but, again, would say that your risk is very, very low and would not be particularly worried, if I were you.  EWH

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39 months ago
Thanks again, Dr Hook, for your detailed answer. One thing caught my attention though in your response: your recommendation that if tested, it should be at the appropriate sites (mouth and penis). Actually I had in mind only blood and/or urine analysis, as these are the only tests for STIs  that I know about, and I don't remember being tested otherwise for STIs (I'm not in USA by the way). Were you referring to a specific kind of test, or just an examination by a generalist doctor or dermatologist?
Edward W. Hook M.D.
Edward W. Hook M.D.
39 months ago
Sorry for the delayed response.  I missed your followup question.

If your mouth did not touch his penis or rectum, there is no need for oral testing.  Were you to have oral exposure and wanted to rule out infection, it would be necessary to have a swab taken from your throat for testing.  Following rimming your risk, as I said, is quite low but if you are nervous, a throat swab for gonorrhea testing is appropriate.

This will complete this thread (Forum guidelines call for up to three responses per question). EWH
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