[Question #7570] Possibility of Herpes, Syphilis, or Chancroid Infection from Protected Sex

55 months ago

Hello Doctors. Thank you for taking my question. Several weeks ago, I had several sexual encounters with a female csw in the Dominican Republic. I had protected oral sex and protected vaginal sex during the first encounter. I had protected anal sex during the second encounter. During the first encounter, I noticed that the condom did not cover the lower half of my penis shaft during vaginal sex. I tried to clean and disinfect myself after every sexual encounter. Three days ago, I noticed a bump on the uncovered lower shaft of my penis. I have had ingrown hairs before and, I believe at least once, zits on my penis. I squeezed the bump and pus and blood came out like a pimple or ingrown hair. Thereafter, the area has been irritated and I have squeezed it a good deal. Mostly clear fluid (like an ingrown hair or zit that has been repeatedly squeezed) has come out of it. It has now become flat and looks like a tiny crater or ulcer and is slightly red with a pencil size circle in the middle. I have become worried and have been looking at pictures of herpes and syphilis online. It really doesn't look like most of the herpes pictures but it does look somewhat like a chancre but it is irritated from my squeezing it. At this time, it is mildly sore when I get sexually aroused. Could this be herpes, syphilis, or chancroid and should I get tested?

Edward W. Hook M.D.

55 months ago

Welcome to our forum. Thank you for your question. I’ll be glad to comment. The encounters you describe were low risk encounters. Most commercial sex workers do not have STI’s and when they do, the infections they most often have are infection such as gonorrhea or chlamydia. Further, even among commercial sex workers, diseases such as syphilis and HIV are very rare. In addition, most exposures to infected partners, even without condoms, do not lead to infection. In your case, when condoms are used, they are are highly effective for prevention of acquisition of nearly all STI ‘s. As long as the condom covers the tip of your penis there is virtually no risk for acquisition of STI’s such as gonorrhea, chlamydia, or HIV.

I would recommend that you have a trained clinician take a look at the lesion you describe. I doubt however that it is an STI. The lesion that you described certainly does not sound like typical herpes. Typically, herpes lesions are multiple clustered lesions. This is also a bit early for a syphilis lesion to occur. Syphilis lesions typically occur about three weeks following an exposure. My suspicion is that indeed this was an ingrown hair which is become irritated by your squeezing and manipulations. If you wish to have the lesion tested, the preferred test is a swab specimen a for herpes PCR test. If this test is negative that is further very strong evidence that this is not herpes. On the other hand, if this is Syphilis and the lesion has been present for more than two or three days a blood test for Syphilis should be positive.

I would also strongly suggest that you stop manipulating the lesion. Self examination of the sort you describe can be irritating and distort the lesion. Gentle cleansing with soap and water and keeping the lesion dry will suffice and, I suspect, lead to healing in just a few days.

I hope this information is helpful to you. If there are any questions please feel free to use Europe to follow up questions for clarification. EWH

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55 months ago

Thank you very much Doctor. I shall follow your advice.

55 months ago

Is it possible it is chancroid?

Edward W. Hook M.D.

55 months ago

This does not sound at all like Chancroid. Chancroid is extraordinarily rare. EWH ---