my scenario:

Day 0: performed cunnilingus on two strippers, had protected sex - condom on at all times.

Day 4/5: Sharp neck pain on right side only begins and is still present today, day 20.

Day 7: Urine test for chlamydia and gonnorhea was negative.

Day 18/19: very small white bumps appear on lips in near perfect symmetrical fashion, in middle of lip area.   clusters almost evenly distributed on each and in corners.  no pain, no itching, not really visible at all unless you stretch the skin.

day 20: today - white bumps remain.

I had been ready to turn the page on this event by testing for hiv and syphillis for reassurance.  the appearance of these very small white bumps on my lips have suddenly created high anxiety.

my questions:

1. should i be concerned about these bumps?

2. is the neck pain on one side from day one to today (20) a cause for concern?

3. i am going to get a full panel today with Early detection RNA and 4th gen HIV.

4. should i be concerned about oral gonnorrhea/chlamydia?

Outside of the symptoms I have listed, I have felt fine, slept well once I resolved initial anxiety, and had normal energy.  I have continued intercourse with my wife twice, avoiding kissing and oral sex.

Thank you so much for any guidance, doctors.

Also, before I go to your questions, I should point out as well that after an exposure which persons come to regret, it is quite common to become hypervigilant in looking for signs of infection, leading to noticing skin changes and sensations which would be overlooked at other times.  This may be contributing to the lesions you have described.  With this background, let's address your specific questions:

1.  The white bumps you describe are not suggestive of any STI but may be due to fungal colonization which can occur when persons frequently lick the corners of their mouths.  They are of no consequence.  This process is sometimes called angular cheilitis.  If the problem bothers you or persists, you may want to see your doctor.  It is easily treated with antifungal creams

2.  No.  The discomfort you describe is more likely to be due to tension and resulting muscle spasm than anything else.  It does not suggest any STI

3.  I am confident your tests will be negative.

4.  The risk is tiny but if you wish to be 100% (raher than 99%) sure you were not infected, a throat swab to test for these organisms would prove that you were not infected

I hope these comments are helpful.  EWH

Where I'm at now:

Fordyce.  I think my description was a bit off earlier.  I have what I think to be Fordyce and have never seen it before.  I noticed something happening in a corner of my mouth for the first time on day 7 and  all specs were visible day 17.  Looking at me, you would notice nothing. If you spread my upper lip, you will see groupings of several rice like, granular specs/dots.  In the corners of my mouth, there are a few more and they are little more pronounced.  There is no pain, no change in appearance, no itching, and they are minimally raised, if at all.  

Anxiety (or not?).  With the risk of losing family because of this mistake, what I perceive to be my anxiety is sky high. I have neck soreness that comes and goes in different spots.  Neck seems to swell and pulse, hot under the collar, hot ears, and now occassional random and short feelings of pain in areas that scare me after reading this forum (neck, groin, near armpits, above knee). shortness of breath, occasional sweating (sometimes light sweating at night - nothing new for me).

Questions:

1. Is this a bizarre coincidence that Fordyce would suddenly appear in my 40s after an exposure? 

2. The specs have been noticeable by me for 7/8 days with no blistering, changes, or irritation.  Do fordyce like spots and my timing align with any STD?

3. i don't know what ARS is, but people on the forum seem afraid of it when experiencing any aching or tension near areas with lymph nodes.  Is ARS something I should be thinking about?

4. Test now (day 24) or wait till 28 days?

Thank you doctor.  At this point, I fee like I have read this forum from beginning to end.  I am amazed at the patience, information, and assistance provided here.  I hope to never be back, but this is very impressive.

1.  Your description could be Fordyce spots or as I have already said, angular chelitis. Either way the lesions are virtually certainly not an STI of any sort. If you were concerned you can be seen by a clinician you can examine. We do not make diagnoses over the Internet.

2.  See my response above. Nothing you’ve described suggests an STI.

3.  No. Statistically, it is most unlikely that your partner had HIV. Even if she had untreated HIV, Cunnilingus is a virtually no risk exposure in terms of risk for HIV.

4.  If you test at day 28 with both an HIV PCR and, a fourth generation combination HIV antigen antibody test, the results will be conclusive.  I am confident that if you test, the results will show that you were not infected with HIV.

EWH 

I just tested on day 28 since exposure at Labcorp for:

Gonnorhea urine (again)

Chlymidia urine (again)

HIV 1 & 2 antibody 4th gen

HIV RNA

Syphillis

three additional symptoms to mention.  

First, my semen yesterday was very liquid like. 

 Second, I noticed a very small flesh/whitish bump up high (3/4" higher than the bottom of my lip) on the back side of my lip, in ither words, my gums.  It has been there since at least day 7 to 10 (guessing total of 20 days).  1-2 mm in size.

Third, saw 3 to 4 small bubble like lesions on bottom of my tongue.  All lesions 1-2 mm.

The final items I wanted to ask you about as I wait out test results:

1. With the onset of Fordyce and these additional lesions in my mouth, is Syphillis likely?

2. If I had an oral syphillis chancre - would it be fairly obvious, versus the constant scouring I am doing?

3. I have briefly closed mouth peck kissed my wife a few times.  Would she have any syphillis risk at all given the location of the lesions?

4. Is this (mouth spots described) indicative of NGU?

5. My plan - should I be fortunate enough to test negative for everything - is to move on and leave this behind.  I will see a doctor about the spots on my mouth after results, but would like test results first.  Am I putting my family at risk for syphillis or HIV, should i resume my normal life?  In other words, would my tests be conclusive?

Thank you for everything.

Again thanks for everything and best wishes.

Many of these follow-up questions are simply repeats of earlier questions ask in a slightly different way: straight to your replies:

1.  The chance that you have syphilis is extraordinarily low and should not be a concern in the least.