[Question #9407] Oral,syphillis,gonorrhea

33 months ago

Hi hope you can help I had an encounter with a transgender escort 11 days ago. It consisted of protected oral both ways and her rimming me. After this encounter I’ve become extremely anxious. Two days after the encounter I started on a course of doxycycline 200mg twice daily. I’m on day 9 today my fear was syphillis. 2days later I took 2 g azithromycin and 400mg Cefixme. Out of fear of gonorrhea in my anus as she rimmed me.

My questions are

1. Is this a likely exposure to syphillis and gonorrhea?

2. When I took the azithromycin and Cefixme I had a 1 bad Diarrhea episode at 1 hour 50 minutes after taking them. If I had gonorrhea would this be a treatment failure due to Diarrhea?

3. My anus seems to be sweating a lot this last week, and Also been a bit sore, possible gonorrhea symptoms?

4. Day 9 after the event I have found a single red blemish, mark,spot (not sure how to describe it)on my penis shaft close to my scrotum, this bit would of been uncovered during the oral so I’m concerned possible syphillis? Or huge coincidence?

5. I have suffered with herpes in the past, so I’m wondering if this spot is that, I’ve been extremely stressed and worried this last week could this be the case?

6. Are there treatment failures for syphillis with doxycycline?

Thank you in advance

Edward W. Hook M.D.

33 months ago

Welcome to the Forum. Thanks for your questions. The encounter you describe was virtually no risk for acquisition of STIs, including HIV. Even most transgender commercial sex workers do not have HIV or STIs, and when they do, most exposures do not result in infection. In your case, condoms are highly effective for STI/HIV prevention and rimming is a virtually no risk exposure. In response to your specific questions:

1. Is this a likely exposure to syphillis and gonorrhea?

No, see my comments above.

2. When I took the azithromycin and Cefixme I had a 1 bad Diarrhea episode at 1 hour 50 minutes after taking them. If I had gonorrhea would this be a treatment failure due to Diarrhea?

If your medications were down for an hour or more, they would have been effective. The diarrhea was most likely due to the antibiotics.

3. My anus seems to be sweating a lot this last week, and Also been a bit sore, possible gonorrhea symptoms?

Your anal exposure was no risk. Further, these are not symptoms of rectal gonorrhea,

Coincidence and possibly the fact that you are probably looking more closely for symptoms than you would otherwise.

5. I have suffered with herpes in the past, so I’m wondering if this spot is that, I’ve been extremely stressed and worried this last week could this be the case?

I cannot assess whether this is a recurrence of your HSV or not.

6. Are there treatment failures for syphillis with doxycycline?

The are no drugs that yield 100% cure rates but failures are very, very rare. Further, please remember that the activities you describe carry virtually no risk for infection.

Hope these answers are helpful. Please don't worry. EWH

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33 months ago

I wrote this quite quickly and left 1 or two things out. So the rimming also involved fingers however they didn’t go inside me. Looking to day the spot in my prime shaft looks like a tiny ulcer would this be suspicious of syphillis? I also had a rapid syphillis test done at 9 days, they state that it’s accurate would this be the case?

Also say I had contracted gonorrhea and syphillis would the doxy and azithromycin and Cefixme clear it? I’ve realised I’ve been taking doxy 15 mins after drinking coffee would this affect its effectiveness?

I’m super concerned about syphillis and anal gonorrhea it’s really driving me mad

Thank you dr hook

Edward W. Hook M.D.

33 months ago

Given the antibiotics you took. Syphilis is NOT a concern!

As I already informed you, in the extraordinarily unlikely circumstance that you were exposed or had gonorrhea or syphilis, the antibiotics you took would have cured it.

Coffee in no way affects the effectiveness of doxycycline.

EWH

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32 months ago

Thank you Dr hook,

Last question in the Uk Azithromycin and Cefixime are alternate therapy’s for gonorrhea, and doxycycline is the same for syphillis. Does that mean that these don’t work aswell as other therapy’s? Sorry for asking just need to confirm in my mind they were ok to use, say for example I was exposed to either infection.

Thank you

Edward W. Hook M.D.

32 months ago

It’s not simple. Some but not all syphilis is resistant to azithromycin and a single dose of cefixime would not cure syphilis. Some Gonorrhea infections fail doxycycline therapy.

As you know we provide up to three responses to each clients question. Thus this is my final response. Please do not return with additional repetitive, anxiety driven questions related to you are virtually no risk exposure. Take care. Please don’t worry. EWH

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