[Question #9525] Unprotected Oral - symptoms & worried
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31 months ago
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Dear Doctor,
I am 51y straight male (Europe), married,father.
GP is family of my wife. 5 weeks ago, saw a sexworker on a whim. No high class,average girl.
Receive unprotect oral,gave oral + fingering. I touch my penis afterwrds. No other acts.
Started worrying, itchy penis, notice 2x white discharge in very small amount in the morning.
2 weeks after exposure drove 2 hrs abroad for anonym. test in STI clinic. At my place test go in system that your 'fixed' GP can see. They propose a rapid pcr test, result in 2 hrs, if pos.could be treated there, since I came from far. Tests neg.for Chlam & Gonor. Urine and throat swab.
After a few days, saw some "redness" and some tiny pencil tip yellow bumps just under corona of glans.
Worrying about syphilis went to a GP in town I work, explained all, he looked it and said that start of syph.sore could look like that.
To be sure, I insisted a bit, he prescribed Amoxicillin 3 x 1000mg/day for 5 days,box had 24 pills I took it 8 days. He said that normally it should be a shot, but this would do.
1 week after dose still enormous anxiety, often burning feeling after I urinate (can last 15 min. to an hour), "redness" and some tiny pencil tip yellow bumps still there.
Yesterday some white discharge 0,15 sq in
1)If Chlam & Gono test was false neg. would the dose Amox clear it?
2)If I got syph. would the dose eridate it, given treatment started 3 weeks after exposure?
3)Is test for syph. + rest 7 weeks after exposure, with the Amox treatment in mind useful?
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Edward W. Hook M.D.
31 months ago
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Welcome to our Forum. Thanks for your questions. I'll be glad to comment. The exposure you describe was low but not no risk for STIs. Both performing cunnilngus on an infected partner and receipt of oral sex from a partner with throat infection only occasionally lead to infection. The testing you received, at the time you had it, will have provided reliable results which should be believed. My sense is that your concerns over a possible STI are resulting in your looking more carefully for signs or symptoms of infection than you usually would and you may be noticing normal variations. This is not uncommon when persons become anxious following a concerning exposure. In reply to your specific questions:
1)If Chlam & Gono test was false neg. would the dose Amox clear it?
The likelihood of false negative tests for gonorrhea and chlamydial infection is low. If infection was present however, the amoxicillin you took would be expected to cure about half of gonorrhea infections and a somewhat larger proportion of chlamydial infections. FYI, Chlamydial infections resulting from either giving or receiving oral sex are very, very rare. If you had any infection at all, you may have acquired non-chlamydial NGU from the introduction of your causal partner's normal oral bacteria into your penis. Had this occurred, this is not a hazard to future partners and the amoxicillin would have been likely to cure it.
2)If I got syph. would the dose eridate it, given treatment started 3 weeks after exposure?
Yes. It is unlikely that you acquired syphilis from this exposure and the lesions you describe may well be normal cysts that are common on the penis rather than syphilis. If you had syphilis, the amoxicillin you took would have been curative. If you had acquired syphilis, the lesions you note on your penis would have progressed to form ulcers. I would suggest you have a dermatologist take a look- this really sounds nothing like syphilis.
3)Is test for syph. + rest 7 weeks after exposure, with the Amox treatment in mind useful?
If testing would be reassuring, then I would encourage you to get it. I am confident that this is not syphilis
I hope these comments are helpful. EWH
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31 months ago
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Dear Doctor Hook,
Thank you very much for your quick response. This relieves me already.
For the health of my wife, and my own piece of mind I will do a new test in two weeks, I'll keep you up to date.
I would also like to mention (initial question was limited to 1500 chars), that thanks to psychological therapy i took five years ago, I successfully refrained from seeing sexworker occasionally for more than 5 years. But this incident happend during a workrelated very high stress situation + school result issues with my son. These are no excuses, I know, but it happened. I also have an appointment with my psychologist this week.
Kind regards.
H.
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Edward W. Hook M.D.
31 months ago
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Thanks for the additional information. please don't punish yourself for your actions. I look forward to seeing your update with the results of testing which I anticipate will show that you were not infected. EWH---
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31 months ago
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Hello Doctor Hook,
As promised I would give you the results of the full panel test I took yesterday (7 weeks after exposure), just got back the results: and all are negative !
I took the full panel, including Chlamydia & Gono, Mycoplasma Gen, Trichomonas vaginalis, HIV (4th gen test), Hepatitis B and C and syphilis.
I feel really relieved now.
As you mentioned , anxiety (extra induced by guilt) did me think and feel al kind of things.
I also saw already my psychological therapist, and have soon another appointment.
Thank you so very much for your advice and also the great work you do here on the forum.
Kind regards.
H.
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Edward W. Hook M.D.
31 months ago
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Thank you for sharing your results. I know they are a relief to you and anticipate that the information you shared will be helpful to others to visit or forum.
This reply will complete this thread, which will be closed shortly. Take care. EWH
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