[Question #8375] Syphilis

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45 months ago
Hello I am a heterosexual male , i had a msm encounter with the same guy twice. one about 4.5 months ago and the other about 3 months.

He randomly messaged me and said he tested positive for syphilis and didn't know until he had a rash and what he called 10 to 15 bug bites on his torso and chest. he said he just found out he might have had it starting 6 months ago according to his test results.

the encounter we had both times were just him performing oral on me and him performing analingus on me. His penis did touch my anus once but not very long. He had no visible sores or chancre on his penis and he said he didn't think any in his mouth. He also didn't have any rash during both times either. Ive read just about every syphilis post on here and it sounds like this was a pretty low risk event for me. So i just wanted an opinion on it as well since some were only somewhat similar to mine.

i just found out 5 days ago and i haven't noticed any sores on my penis my anus and have not developed any type of rash or bug bite type of bumps anywhere. I feel like if i did develop a chancre anywhere i would have noticed for sure as i always inspect myself. 

1. Given the time frame wouldn't i have developed some kind of rash by now if i were infected? Since i didn't ever notice a sore/chancre?

2. How risky was this exposure for me honestly?

3. any chance i could have passed this to my female partner?

thank you, and thank you again for the many years of replies on this site as well as medhelp. I have browsed many topics throughout the years. Very helpful and i am really hoping for good news as i have been pretty anxious over this.


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Edward W. Hook M.D.
45 months ago
Welcome to our forum and thanks for your question. I’ll be glad to provide some information which I hope you will find helpful.

It was good of your partner to inform you that you had been exposed to Syphilis.  Not everyone would do that. 

Conventional wisdom indicates that person is exposed to sexual partners who have active syphilis acquire the infection 25 to 33% of the time. These data however are generated in large part based on persons with General exposure.  The likelihood of acquisition of Syphilis from receipt of oral sex is far lower.

Syphilis is known as the “great imitator” because of its highly variable clinical manifestations. While your exposure was certainly low risk and despite the absence of lesions now, 3-4 months since your exposures, it is important for you to test to be sure that you were not infected.  I would recommend that you seek hey Syphilis blood test.

In response to your specific questions:
1.  The absence of a rash or lesions is certainly a good sign. As I mentioned above your risk of infection is quite low but not zero.
2.  There are no specific figures to define your risk of infection although, as explained above, your risk from having received oral sex and analingus from an infected partner is quite low.
3.  The likelihood of having passed infection onto your partner is a function of the likelihood that you were infected which is low. The best way to be sure that you were not infected however is to have a syphilis blood test at this time. Results of a syphilis blood test taken at this time will provide conclusive results. 

I hope this information is helpful to you. If any part of my response is unclear please feel free to use your up to to follow ups for clarification. EWH
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45 months ago
Just received my test results and it came back non reactive  ... I'm in the clear

Just wanted to ask a couple more questions for my own knowledge on the subject.

Ive read that syphilis rarely occurs in the mouth, well an oral lesion/chancre even in higher risk msm exposures... why is that?

In syphilis is there really a window when someone is infectious and able to transmit the infection? When a primary syphilis chancre is present only?

And in secondary syphilis is it safe to say that a body rash  it causes cant really transmit the infection to another person?

Thank you again for your responses, relieved that my test was non reactive. 


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Edward W. Hook M.D.
45 months ago
There are no good explanations why syphilis occurs more rarely as oral infections. Some suggest that friction plays an important role in transmission and that the friction of oral sex may be less than for other sorts of penetrative exposure.  

Sexual transmission of syphilis occurs through direct lesion contact.  Hence the primary and secondary stages are when nearly all syphilis transmission occurs.  There are treponemes (the syphilis bacteria) present in syphilitic skin lesions and hence the skin rash is potentially infectious. There are many varieties of syphilis rashes. presumably the moist, more open rashes are love infectious than dry rashes.

Hope this helps.  EWH
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