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Had protected sex. Started burning throat and bumps on tongue. Got bacterial infection. Any advice?

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Practicing since : 1999
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Hello, my name is XXXXXXX I had protected sex In XXXXXXX with a womanthat immigrated from SouthmAfrica over 25 yrs ago. She is wealthy, white and seems healthy. A week later, I had some burning in my throat and some white bumps on my tounge. I then remember burning my throat on hot coffee at her home, I confronted her about stds and she denies any. A few weeks later I came down with a bacterial infection and after the second course of,antibiotics, it went away. Now I feel fine but have some sciatic pain in my right leg/ foot. I also take lisinopril for high bp and advair for asthma. I have had occassional skin outbreaks which my doc related to asthma. Rarely, I do get a pimple like bump on my butt or thigh. I also have a history of back problems. I am worried that I picked,up some nasty std and every ache / pain freaks me out. Advice?
Posted Mon, 8 Oct 2012 in Sexually Transmitted Diseases
Answered by Dr. Timothy Raichle 3 hours later
Hello, I would be happy to help you with your question. Here are the symptoms summarized:

1. New sexual contact
2. Onset of oral lesions / pharyngitis (sore throat)
3. Later onset of a "bacterial infection" - you do not specify where!
4. Later onset of right leg / foot pain

While I think that it is unlikely that you have an STD, just the fact that you are questioning this is an indication that there is some concern about this partner and her unknown STD status.

If I were to approach this from a strictly "what STD could this be" approach, two things come to mind:

1. Oral herpes - can be acquired through oral sex and you could have lesions within the throat. With a new exposure, there might also be a flu-like illness that would accompany the outbreak of ulcers in and around the mouth or on the genital area

2. Gonoccoal infection - also can be acquired through oral sex, and can cause a pharyngitis (sore throat) and disseminated disease (i.e. it spreads) can manifest as skin lesions like you describe. Disseminated disease can also cause an arthritis that can affect the foot and ankle commonly.

While I think that this is likely a common viral infection acquired through normal contact, with a host of other symptoms that are probably easier to explain as unconnected to sexual activity, I think that you need to do the following:

1. You need to go to your doctor
2. You need to ask for full STD screening (mention the concern about gonococcal pharyngitis)
3. Write down your symptoms as they occur over time in the simplest most succinct way possible.

I do not mean to alarm you with my answer. You asked me to suppose that this might be an STD and this is my answer. Go get checked out and I am sure that everything will turn out okay! Good luck. I hope this helped. - DR XXXXXXX
Above answer was peer-reviewed by
Follow-up: Had protected sex. Started burning throat and bumps on tongue. Got bacterial infection. Any advice? 1 hour later
Thanks for the reply and I find your answers comforting I.e. no HIV. My infection was upper respitory, nasal. I was treated with one course of drugs that did not work and was then prescribed a new antibiotic along with prednisone. This seemed to kick it. From your answer, however, this antibiotic would not have gotten rid of gonnoccol infection? Gonnocal or herpes, I can deal with, is there any chance it's HIV? I am also a persistent mouth breather, especially at night, would this change your answer in any way? Again, thanks for the info.
Answered by Dr. Timothy Raichle 16 minutes later
Well, first of all, the most common medication used for upper respiratory infections, azithromycin (Z-pack) would work against gonococcal infections. So my guess here is you were covered in terms of what they chose.

Herpes, while unlikely, would not be covered with antibiotics. It requires treatment with an antiviral medication, such as Valtrex. My guess is that the mouth sores would have been extremely painful.

In terms of HIV, the transmission rate with one sexual encounter is actually quite low. You also state that this was a rather healthy woman and "protection" was used. So I think that this is unlikely.

Being a mouth breather, and hot coffee burning your throat might explain the sores in your throat.

Overall, it sounds like this was a low-risk encounter. It is never wrong to go in for STD screening, though. While I take care of women almost exclusively, your story is really not gender-specific, and I would recommend the same to a female with the same questions.

I hope this helps and good luck! - DR XXXXXXX
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Follow-up: Had protected sex. Started burning throat and bumps on tongue. Got bacterial infection. Any advice? 21 minutes later
Not exactly sure what you mean when you say XXXXXXX one sexual encounter" ...are you saying that only having sex with this woman one time reduces the risk even if she is HIV positive? Also, not sure why herpes would be unlikely, the sores that concern me are on the back of the tounge only...not really painful, just a mild sore throat.

Thank you so much for answering these questions.
Answered by Dr. Timothy Raichle 1 hour later
You implied that you had sex with this one woman with protection. I was considering this a single encounter. You did not say "I had an ongoing relationship".

And yes, if she had HIV and you had sex once, your risk if HIV is less than if you had sex multiple times.

Finally, oral herpes would usually involve painful ulcerations in your mouth on the gums, not on the tongue. So I am saying that while this might be a concern, it seems unlikely as an explanation for you sore throat.
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