[Question #8526] Follow-up question #8476

43 months ago

Hello Doctors.

Just a follow up on my previous question #8476.

Summarizing my previous event: After noticing some lesions which I didn’t know if it was caused by friction on the sex or a STD from previous sex, I was afraid of syphilis and others STD, so I took 2g of azytromicin, 200mg doxycline daily for 14 days and I also took 500mg of ceftrexione.

Few days after start those antibiotics the lesions started getting better and cured.

The thing is that one week after the end of those antibiotics 2 strange lesions appeared.

My question is, is there any chance these new lesions be from Syphilis? All those antibiotics wouldn’t kill it? Would it appear just one week after treatment? I went to doctor and he told me to wait and see how these lesions will evolve (because they are small for now) but he is pretty confidant it is not syphilis. He told me that syphilis lesions don’t keep reappearing… they go away in 1 week and after several weeks syphilis gives other symptoms. I’m just afraid the antibiotics I took just suppressed syphilis and after some time it reappeared (could this happen?)

When I took the antibiotics I was in vacations so I was having drinks almost every day. Would this relevantly impact for the antibiotic do not make effect?

Even thought the antibiotics didn’t work, new lesion would reappear if it was syphilis?

If not syphilis any other STD that it could be? Herpes would give an outbreak just few days after other? I’m very intrigued what it could be taking into account I’m sure these lesions are not common because I never had it before and would be a huge coincidence I hurt my penis without noticing close to this event.

I’ll wait 2 weeks to make the blood tests, but until there I’m just very anxious and would kindly be very happy with your thoughts on that.

Many thanks.

Edward W. Hook M.D.

43 months ago

Welcome back to the forum. On this occasion I will be answering your questions. To prepare to answer your questions I read your earlier interactions with Dr. Handsfield and agree with all that he said. If the lesions you described were syphilis the several of the antibiotics you took including ceftriaxone, doxycycline, and often azithromycin are highly active against syphilis and would have cured your infection. The fact that you were drinking alcoholic beverages at about the time you were taking the medication would not keep the medication’s from working. Of course, whether or not the lesion was syphilis will not be known because of your self medication. If it works for us however, the Syphilis would be cured and would not be transmittable to sex partners.

Just as was the case with Dr. Handsfield, I cannot tell you what the lesions that appeared after you had taken antibiotics might’ve been. They could’ve been herpes, a medication reaction, or or the other dermatologic process. The best way to determine what they might’ve been would be to have an experienced clinician look at them and evaluate them. With herpes recurrent lesions can occur following healing of an initial outbreak. As I understood your original post however, the lesions that you had healed over the course of just a few days would be would be a typical for an initial episode of genital herpes. If the lesions were due to herpes hey PCR swab test would be the best method of diagnosing the lesions when they are present. Interpretation of blood tests for herpes can be quite difficult and not always reliable.

I hope these comments are helpful. EWH

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43 months ago

Hello Dr Hook. Many thanks for the fast reply.

So if I understood right these 2 lesions after only one week of the end of antibiotics are virtually zero chance of being from syphilis? Just one theoretical question (and I promised I won’t start going further on the what ifs) that is bothering me is Im thinking on the possibility those antibiotics suppressed syphilis but didn’t kill it all, and one week later it increased and appear a new lesion (same

way as being a new infection). Would that be possible or in that scenario the symptoms would only appear as secondary stage, meaning that new lesions (chancres) would not appear? Sorry if seems I’m having a hard time to believe when you said these antibiotics are highly effective against syphilis and it would have cured. The Doctor told me to repeat test in 2 weeks to confirm and this hypothesis is killing me in this meantime.

Please one confirmation for avoidance of doubt you typed “…however the lesions that you had healed over the course of just a few days would be would be a typical for an initial episode of genital herpes…”

Did you really mean would be or you meant would NOT be? I’m just asking because reading the construction of the phrase might suggest you meant to say “would not be” and made a typo.

Many thanks again.

Edward W. Hook M.D.

43 months ago

The antibiotics that you had taken are powerful and highly active against Syphilis. How do you acquired the infection these antibiotics would have certainly cured it, not just suppressed the infection. I suspect that your doctors recommendation was being conservative admit to provide you with reassurance, not the fuel further concerns on your part.

I apologize for my typographical error. You are correct, for lesions due to an initial herpes infection to resolve so quickly (over just a few days) would be most atypical. I left out the word NOT.

Please don’t worry. EWH

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