First and most important, transmission of STDs by cunningus is rare, and fingering and kissing are risk free for all practical purposes. Your negative throat swab for gonorrhea and chlamydia confirms you acquired neither of these, and the chance of any other STD was even lower than those. Having an oral STD cannot lead to penile or other genital infection; those symptoms are not due to any STD or other infection from this event. The same is true for your "shooting pains" or pubic area itching. If your penile or genital symptoms continue, see a doctor -- but they have nothing to do with the exposure you have described. (Except that some of your symptoms sound psychological. In that sense, they could be related, given your apparent anxiety about the event.)

In the US, the majority of syphilis currently is happening in men who have sex with other men; the chance of syphilis from this event is near zero. That said, I don't know what to make of your syphilis test result:  I am unaware of any "early detection" test for syphilis. Some of the newer tests can indeed be positive sooner than older ones, but all tests, both new and old, require 6 weeks for conclusive results. Without an oral sore (chancre) to suggest newly acquired syphilis, there is almost no chance you have it. But since you've started down the syphilis testing path, I suggest you follow it to completion -- i.e. have another blood test 6 weeks after the event.

As for HSV2, oral infections in this circumstance are very rare. As for other STDs, they cannot show up genitally; if you were infected, it would be oral with obvious symptoms. And your genital symptoms do not even hint at herpes. I recommend you not be tested for HSV:  the blood tests are not perfect, and the chance of a false or misleading result is a lot higher than the chance you caught HSV2. In theory, there was a risk of HPV, but oral HPV infections generally are harmless, and no more risky from this event than any other sexual exposures in your life that involved cunnilingus. (HPV is no more common in sex workers than in any other sexually active person, or only by a little bit.)

The last issue to think about is HIV. Oral exposure to HIV is generally safe, and there has never been even one case documented to have been acquired by perfomring cunnilingus on an HIV infected woman. OTOH, HIV testing usually is routine whenever anyone is evaluated for STDs, and it would therefore make sense for you to have an HIV test when you have the follow-up syphilis test in a few weeks. You definitely can expect a negative result.

I hope these comments are helpful and reassuring. Let me know if anything isn't clear.

HHH, MD

1) It sounds like symptoms to the genitals/urethral opening would not be tied to transmission occurring at the mouth with any sti's (including hpv). Is that correct? Genital clamyd/gonorreah should be entirely ruled out, correct? Does that mean transmission to somebody else could only occur from my mouth to their mouth or genitals if by some chance i was infected with something? Or would I be contagious in penis to vaginal sex? Penis to oral?

2) Would having a cold at the time of my oral swab have any potential impact on a false negative? It seems I should be confident in those negative results per your note. 

3) Interesting on the early detection syph test. It was e7 health in Chicago and they charge $30 more and say "Trepsure testing is useful if it has been 2-4 weeks since a possible exposure" in the info about it.

 

2) Having a cold would not affect lab test results for any STD. No worries there.

3) TrepSure indeed is one of the tests that can be positive by 2-3 weeks after exposure, but not consistently. It can take 4 and probably sometimes up to 6 weeks.

4) HPV doesn't cause genital bumps (warts) sooner than 6-8 weeks after exposure. This symptom cannot have anything to do with the exposure event you have described. And no, HPV also cannot be acquired orally and show up genitally. No STD can do that:  period, no exceptions.