[Question #8569] Syphilis risk with cunnilingus
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42 months ago
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This incident took place around 1st of December - had oral with a lady - she also performed oral on my penis - I did not notice any open sores on her vagina - (but lighting was not the best) well about 1st week of January - I had what looked like a cold sore on my lip - and inside my mouth in my upper pallet on the roof of my mouth I had what looked like 3 cold sores - I also had a pretty good headache - so just thought this time of year with the change in weather that is more than likely some sort of cold sore - fever blister. They were sore and had some pain. So I did I salt water gargle. They were not open sores - not really puss like - but looked like blisters. They are still present today - not as blisters and when I slide my tounge over them they feel bumpy. One is a red dot one is faded red like purple other looks like a horseshoe shape or indentation in my pallett. How likely is it that is could be a std - such as syphilis. Do you see a need to test?
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H. Hunter Handsfield, MD
42 months ago
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Welcome back, but sorry you found it necessary yet again. Once again you are concerned about syphilis despite a low risk exposure and symptoms that are not particularly suggestive of syphilis.
You say nothing about your partner and whether there are particular reasons to think she might be likely to have syphilis. (Sex worker? Drug user? Bar pickup?) In the US, the large majority of syphilis occurs in men having sex with men, not in females, including sex workers. But even if she was at high risk, I doubt you have syphilis. Syphilitic chancres generally do not mimic oral herpes outbreaks (cold sore, fever blister) or cause sores in the mouth. That said, occasionally syphilis could show up with such symptoms, and you should be examined and tested for it. A blood test at this time would be completely reliable. It sounds like the abnormalities in your mouth have healed, but if anything visible still is present, you could be examined by an experienced clinician, such as your local health department STD clinic. But at a minimum, have a blood test. (The specific test doesn't matter, either an RPR or EIA test would be OK. A negative result with either would rule out syphilis.)
Do you have a history of oral herpes, i.e. past oral outbreaks? A cold sore on the lip would be typical, but sores inside the mouth are different and are not called cold sores or fever blisters. These more likely were aphthous stomatitis (canker sores) and are not caused by herpes. In any case, if you have not previously been diagnosed with oral herpes, you might consider doing so the next time you have an apparent outbreak. Or you could have a herpes blood test, i.e. antibody to HSV1 (and HSV2, although that's unlikely as a cuase of oral herpes). If you test for herpes, DO NOT have an IgM test -- only the IgG tests are valid and helpful.
I hope these comments are helpful. I'll be happy to comment further after you have had the syphilis blood test and would like to let me know the result. Before then, however, I won't have any additional advice.
Best regards-- HHH, MD
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42 months ago
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I do have a blood test scheduled and as always, I am appreciative of your advice - I am not sure what you mean when you say that canker sores are not caused by herpes- I have a history of getting cold sores or blisters on my lip - especially with the changes in weather - (is this the same thing as oral herpres) - I met her through and on- line dating app. and could be high risk because she is looking for a financial arrangement - we discussed our std testing prior and she said she did not have any stds - I am married and I have not had any sex with my wife - and no deep kissing - as I said i will test - if its positive is there a possibility that I could passed it on to her through a kiss?
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H. Hunter Handsfield, MD
42 months ago
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Yes, cold sores are oral herpes. The sores inside your mouth probably are different -- cold sores (fever blisters) are on the lips or around the mouth. Although if you usually get sores in the mouth at the same time as an outbreak of your lips, it might be part of the same outbreak. But sores inside the mouth aren't typical with oral herpes.
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If the oral sores were due to syphilis then yes, there is a chance of transmission to your wife. But probably only with open mouth (sexual) kissing; the typical superficial (social) kiss is unlikely to transmit syphilis.
You have just one follow-up comment coming; let's save that until you have your syphilis test result.
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