[Question #9654] Quick Follow Up - Syphilis
 |
30 months ago
|
Good Morning Doctors.
I hate to follow up so soon, but due to something that has arisen, I need some clarification please.
Day 0 - Protected Oral (received) from DR female csw (I'm a male)
Day 28 - had unprotected sex with wife.
Day 43 - Negative 10 panel STD test. I had asked if a 43 day RPR syphilis test was conclusive. I think Dr Hansdfield said that negative test and no symptoms should be conclusive.
Dilemma:
1. I had a whiskey drink or two, roughly 12-14 hours before blood was drawn. I keep seeing alcahol within 24 hours of RPR test can cause false negative.
2. Day 45, thought the nightmare was behind me. shaved my public area, and found two lumps close to eachother (1 bigger, 1 smaller) bigger one being BB size maybe, under skin on right side / base of penis. Lumps are attached to skin under and resemble an ingrown hair with no head. Shaved roughly 7 weeks ago. Could this be a healing Chancre? Start of a Chancre? Did I put my wife at risk at day 28? Hasn't changed in 3 days. Tried to pop it. Also started expired doxy 100mg, twice daily. But it's 3 years expired.
Note. I do carry a gun (I'm law enforcement) in the appendix area, and had been in the seated position for multiple hours, 1 day before shaving. The barrel and holster would push on this exact spots the lumps are.
Am I overthinking again?
|
30 months ago
|
Also to add. While receiving the protected blowjob, I'm 99% sure her lips / mouth never touched my bare skin below condom, but her saliva did I'm sure. Not sure if bacteria containing saliva can transmit syphilis.
 |
Edward W. Hook M.D.
30 months ago
|
Welcome back to the Forum. thanks for your questions. Dr. Handsfield and I share the Forum and on this occasion I happened to pick up your questions. In preparing to answer these new questions and agree with all that he said- the exposure you describe was virtually no risk and your day 43 tests prove that there was no STI present. That said, I know that following an exposure that one regrets, it is not unusual for persons to worry and to examine themselves more closely that they might otherwise. I suspect that is what is happening here. With this background, let's address your specific questions:
1. I had a whiskey drink or two, roughly 12-14 hours before blood was drawn. I keep seeing alcohol within 24 hours of RPR test can cause false negative.
This statement is incorrect. Alcohol has little or no effect on the reliability of RPR tests. You can have confidence in your RPR- you did not get syphilis from the exposure you described.
2. Day 45, thought the nightmare was behind me. shaved my public area, and found two lumps close to each other (1 bigger, 1 smaller) bigger one being BB size maybe, under skin on right side / base of penis. Lumps are attached to skin under and resemble an ingrown hair with no head. Shaved roughly 7 weeks ago. Could this be a healing Chancre? Start of a Chancre? Did I put my wife at risk at day 28? Hasn't changed in 3 days. Tried to pop it. Also started expired doxy 100mg, twice daily. But it's 3 years expired.
These lesions do not sound at al like syphilis or any other STI. The DO sound like inflammation of the hair follicles which can occur, particularly in areas where shaving has occurred. Alternatively, they could be related to the positioning of the gun but what I can tell you is that they are not due to syphilis. I see no need for the doxycycline.
I hope these assurances are helpful. EWH
--- |
30 months ago
|
Thank You Doctor Hook for the quick reply. It is Much appreciated. I was not sure what a healing Chancre would present as. That being said, if it had been a chancre, I assume my RFR would have been positive. Does saliva that touched a chancre (let's say in the mouth) usually transmit? Or is direct contact usually needed? So in your opinion, should I put this all behind me?
|
Edward W. Hook M.D.
30 months ago
|
If you were goiing to develop a chancre, it would have developed long before now (most typically 2-3 weeks after an exposure). Further, as you note, your RPR would have been positive.
Direct contact is needed for syphilis transmission.
I think you are overthinking this. I urge you to put your concerns behind you. EWH
---