[Question #5581] SYPHILIS

73 months ago

Thirty five days ago I had oral sex with another man unknown to me I performed oral on him to ejaculation. Three and a half weeks later I had a painful sore under the right side of my tongue. I couldn't see any bump or reason it hurt it was more like a canker feeling it lasted about 6 days. Before the sore tongue I did not see or feel a chancre before this time. What has me freaking out is at the same time I have developed a small rash on the side of my big left toe. Reading about it it fits the description of the Syphilis rash ie. painless ,scaly and rough. I took a Syphilis rapid test four[4] days ago which is 36 days from my last exposure and it was NEGATIVE. I also took an HIV test also NEGITIVE.

Another reason I am so concerned is I have grand kids and my 3 year old said while we we playing and talking that I got some spit on his face. I didn't think anything of it for we were laughing and playing. I did not think I did but his words are now implanted in my head and I am very worried. What should I do?

Thanks

H. Hunter Handsfield, MD

73 months ago

Welcome back to the forum. Thanks for your continued confidence in our services.

I agree that syphilis is a potential concern, in view of your exposure and the oral sore. However, the timing of that sore isn't a perfect fit -- most chancres appear sooner than 3 weeks. But it's possible. However, the skin rash cannot be due to syphilis: the rash of secondary syphilis rarely if ever appears sooner than 6 weeks after infection, and generally after the chancre has cleared up entirely. Your blood test also is reassuring, and makes it very unlikely you have syphilis: roughly 90% of people with syphilis develop positive blood tests within 1-2 weeks of onset of the chancre. To be completely certain, you should have one more blood test 6 weeks after exposure. You can expect a negative result, which will be 100% proof you don't have it.

Syphilis is never transmitted nonsexually in households, to young children or anyone else. Your saliva on your grandkid's face carries no risk for syphilis. Even if your final blood test should be positive -- as discussed, this is extremely unlikely -- there would be no worry about the child's risk for syphilis.

So stay relaxed until you have a final blood test in a few days. Feel free to return and let me know the test result. In the meantime, I hope these comments have been helpful.

HHH, MD

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73 months ago

Doctor I need some clarification. First I miss counted days from exposure to test it was 31 days does that make the test much less reliable?

Next am confused about the sore under my tongue. It was painful like a canker. I thought a chancre was painless so I didn't consider the tongue sore to be a chancre.

As for testing should I wait 6 weeks after symptoms or six weeks after exposure? If it is symptoms which first showed up 3 weeks after exposure I have a much longer wait than two weeks. I just want to do it right and be done with it.

One last point ,I took the Rapid test should I go get a more sophisticated test or is the rapid test good?

Thanks so much.

H. Hunter Handsfield, MD

73 months ago

31 days still is very reliable. Around 95% of newly infected people would have positive results by then. It takes 6 weeks to cover just the last 5%.

Indeed syphilitic chancres usually are painless, but not always.

Six weeks after exposure.

The rapid tests are equally valid as lab based tests.

You have just one more follow-up comment coming in this thread, so let's hold off on additional questions until you have the final test result. Stay mellow in the meantime; I'm confident it will be negative.

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73 months ago

Hi Doc.

Just took my six [6] weeks tests HIV and Syphilis both NEG as you predicted. Tester said HIV was 4th gen. and the Syphilis was new as of last year. Hope it is a good brand.. So having said this, is it over? Am I home free with testing times etc.? The stress of infection my Grand kids was horrible so now I can resume play time and enjoy a stress free life once again.

Thanks again, hope this is the last you here of me.

H. Hunter Handsfield, MD

73 months ago

All this is good and the results are conclusive. As implied above, you needn't have held off on play time with your grandchildren, and certainly you can resume it now.

Thanks for the thanks. I'm glad the discussion was helpful. Take care and stay safe.

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