[Question #866] fingering and rimming with serosanguinous sore on cuticle

51 months ago
I saw a female CSW, in mid-March.  I fingered her but I had a serosanguinous leaky sore on cuticle but the skin was not open, just a layer peeled back.  she also rimmed me and gave me a condom BJ.  I never saw a chancre on my anus or my finger.  a month ago, I got a big red 1cm volcano on my arm, squeezed it, it still hasn't healed.  since last friday (now about 90 days post exposure) I have sore swollen lymph node left neck and sore throat with red tonsils.  my tongue has red and white in the back near tonsils.  no fever.  looks like 2ndary syphilis, but no primary chancre on finger or anus.  only small lesion on arm, sore throat & nodes.  huge painful cystic zit on R neck.  I am freaking the hell out. i tried to get tested today but too late will return tomorrow.  can I have secondary syphilis with no apparent primary chancre?  I know you will say no chance of HIV, but I'm married and scared, have had numerous intercourse with wife. high hiv and syphilis area of u.s.
Edward W. Hook M.D.
Edward W. Hook M.D.
51 months ago

Welcome to the Forum.  I'll try to help.  I suspect that you are assuming that two unrelated occurrences are related.  The exposure you describe was quite low risk, even in a region where syphilis or HIV may be common.  If you had acquired syphilis from your masturbation of your partner, you would have almost certainly developed a chancre on your finger- that did not happen.  Similarly, while persons may have rectal chancres (lesions) without being aware of them (they tend to be painless) transmission of syphilis through oral sex is so rare as to be reportable and the absence of a sore or lesion on your partner's mouth makes it unlikely that this could have happened.  On the other hand, it is quite common for skin lesions that have been squeezed or otherwise manipulated to become chronically infected and inflamed which sounds like what is happening in this instance. While secondary syphilis can occur without a primary lesion, in the situation you describe this is most unlikely.  What you have and the time course of exposure and events sounds nothing like syphilis.  Getting a syphilis blood test will COMPLETELY rule out this possibility (same for HIV- at this time following exposure your HIV test will be completely reliable).  If your lesion is secondary syphilis your blood test will certainly be positive.  I am confident that it will be.  After you have ruled out syphilis, I recommend that you have your doctor take a look at the lesion on your arm that concerns you so that it can be taken care of,

Living in a part of the US where HIV and syphilis are relatively common still does not make the sorts of exposures you describe likely to lead to syphilis or HIV.  Nothing about the exposures you describe suggests any risk for HIV.

Please feel free to post the results of your syphilis and HIV test results.  In the interim, please try not to worry.  EWH

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51 months ago
I hope you are correct doctor. One clarification please- you said you "are confident it will be".... did You mean confident it will be a negative test, or confident it will be positive if it's 2ndary syphilis? I will share my test results to help you and others. The HIV test as you know is an instant result, the syphilis takes a few days. I haven't been picking my lesion, just visually assessing it, so I'm worried. I have sworn off seeing escorts because it's not worth this anxiety! Thanks again Dr, I should know better than to do this but I'm only human.
Edward W. Hook M.D.
Edward W. Hook M.D.
51 months ago
I am confident that your tests will be negative and that what you describe is NOT secondary syphilis. 

Please don't beat yourself up over this.   EWH
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51 months ago
My HIV test is negative. My syphilis test won't result for a few days but the tester said my lesion on my arm and my tongue/throat do not look like syphilis. He also advised that hsv2 is very easy to catch even from rimming. I'll share my other test results when I receive them. Thanks again Dr hook you are doing very important work.
Edward W. Hook M.D.
Edward W. Hook M.D.
51 months ago
Glad we could help.  I remain confident that your syphilis test will be negative.  Likewise I am skeptical that this is herpes.  I remain confident that your current problems are unrelated to the sexual encounter you described.  EWH---
51 months ago
called to get my results today.  All STD batteries were negative.  I guess you were right.  It's amazing how I thought I saw a rash developing on the palms of my hands consistent with syphilis, and have been in a complete panic.  I guess I was just reading tea leaves that weren't even there.  I should have listened to you Dr. Hook!  thanks for your advice!  
Edward W. Hook M.D.
Edward W. Hook M.D.
51 months ago

Thank you for the follow up.  Hopefully with these negative results you can move on with peace of mind.  Take care.

This thread will be closed in a few hours.  EWH

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