[Question #7155] Oral exposure

6 months ago
Hi I received unprotected oral and analingus from a csw after 5 days I starting getting irritation on penis head im circumcised. But couple of days before that because my circumcision wasn't done properly I have excess skin which sometimes attaches to the penis head and with sometimes dripping urine might of caused like a skin infection. So I felt irritation and little irritation on meatus no discharge no pain on urination. Prior to the oral i asked her if she is clean and she said yes she gets tested every 3 months. So I messaged her after the irritation and explained what happen she decided to go for oral Swab a week later meanwhile I had azithromycin which I took 1g in the evening and next morning I took 500 mg and night 500mg. Few days later she got back to my and said she had throat chlamydia but gonorrhea clear. My question is would I be clear and should I go get tested or its not required as currently I feel slight sensations but could be anxiety related. Thank you. You guys do an amazing job on reassuring us anxious people.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
6 months ago
Welcome to the forum. Thanks for your confidence in our services and your kind comments about the forum.

Interesting that your CSW partner had oral chlamydia, which is quite uncommon -- so uncommon that routine testing for oral chlamydia isn't even recommended. However, oral gonorrhea is common -- and the standard gonorrhea test includes chlamydia automatically. Oral chlamydia also appears to be uncommonly transmitted to partners by oral sex, and your symptoms don't seem to fit with a chlamydial infection. The main symptom is urethral dsicharge, not skin irritation. That said, from your description I can't be certain whether you might have had urethral discharge or just the same dripping urine you apparently have quite frequently.

With or without symptoms, known contacts of someone with known chlamydia should routinely receive preventive treatment. I would have recommended against self treatment with azithromycin before you knew your partner's test result -- but as it turned out, in this case it was appropriate. In fact, you over-treated yourself:  the initial 1 g dose is all that's needed to cure or prevent chlamydia. I'm confident the "slight sensations" you are experiencing are not due to any infection. (Among other things, when someone suspects his or her own symptoms have a psychological origin, usually s/he is right.)

As for your penile skin irritation, I suspect you're right that it's likely related to the continuous moisture you describe and not to any infection from the oral sex event. As long as that irritation clears up, I'm confident you needn't worry about any STD. However, somewhere along the line you might consider consulting a urologist about the circumcision skin remnant and possible urine leak. It sounds like something that might increase your risk of infections and continuing irritation, and that might be easily correctible. But I don't see this as particularly urgent.

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

HHH, MD
---
---
6 months ago
Thanks for your response dr. In your opinion in the odd case it was gonorrhea but as I said she was tested. I never had discharge it definitely was urine as sometimes I wee and I dont finish all and as I walk i feel it coming out this is even before this encounter do you think the antibiotics I took would of cured gonorrhea as well and I don't feel the irritation when my mind is busy. Thanks again dr
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
6 months ago
Your symptoms are not consistent with gonorrhea, and your CSW partner's test result shows you were not exposed to it. Also, the dose o azithromycin you took would cure at least 90% of gonorrhea cases. There is no chance you have gonorrhea. ---
6 months ago
P.s when I said i walk after I pee I mean just as zip up after toilet. Apart from gonorrhea and chlamydia as there anything else I need to worry about thanks again and she has been around for a long time so I am sure she is not lying
6 months ago
Sorry I asked the last question at sand time as you were answering not sure if you got it my irritation is not an irritation as such is more of a sensation feeling 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
6 months ago
I already commented on the "sensations"; see my initial reply.

The main risks from oral sex are gonorrhea, herpes due to HSV1, and nongonococcal urethritis (NGU). As already discussed, gonorrhea isn't an issue. Herpes symptoms (blisters, sores) usually start within a week, so with no symptoms so far, it's unlikely. NGU is treated the same as chlamydia, so you've already taken care of that risk with the azithromycin. The risk of syphilis from a single such exposure is almost zero, and there is no risk of HIV either. However, some anxious persons decide to bne tested for both 6 weeks after the event; it's up to you. (But check with your CSW partner first. Whenever someone ist ested for chlamydia and gonorrhea, usually blood tests for HIV and syphilis are done routinely. If she was tested and those results negative, you'll know you were not exposed and definitely would not need testing.)

That completes the two follow-up exchanges included with each question and so ends this thread. I hope the discussion has been helpful. Best wishes and stay safe.
---
6 months ago
Thank you and keep up the good work
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
6 months ago
Thanks for the thanks. Take care.---