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Dr. Andrew Rynne

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Had protected sex. Have sore throat, itchy penis tip and painful urination. Am I at the risk for STD?

Answered by
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Dr. S. Murugan

HIV AIDS Specialist

Practicing since :1974

Answered : 2764 Questions

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Posted on Fri, 25 Jan 2013 in Sexually Transmitted Diseases
Question: hello Doctor, 2 months and and 10 days ago, i had protected genital sex and un protected oral sex with a girl who had an active cold sore that time i didn't know it well, 1 week and half later (on 3/11/2012) i developed painful urination, and tingling itchy pain at the tip of my penis. i ran to the doctor on the same day, he check on my penis, he said i can't see blisters around your penis so it's not herpes.

i also had a enlargement of lymphoid in my groin area. he sent me to do a blood test for syphilis, i did the blood test and it came out negative. he said that it might be either chalmydia or gonorrhea or maybe NGU, so he gave me antibiotics for 7-15 days on (6/11/2012) i started to have conjunctivitis and i ran to the ophthalmologist and she gave me some antibiotic eye drops.

on 9/11/2012 my painful urination improved and on (15/11/2012) that's almost after two weeks i got well with slight tingling pain and gone away after few days.

now it's been 2 months and 10 days, i'm doing well however i still feel some tingly pain on my penis specially when i'm tired or when i want to sleep at night, there is no pain during urination i developed some dry skin over my glans it went away after using olive oil on it.

i mostly feel tired nowadays, i see some canker sores on my throat that comes and goes, went to the doctor few days ago and he said it's pharyngitis and he gave me antibiotics i didn't buy them cause the pharmacy was closed few days later i got well, but now it came back again..

i tested for HAV, HBV , HCV , HEV, all came out negative at date 15/12/2012
i also had an hiv antibody test which also came out negative at date 26/12/2012.. i'm planning to do the test again at day 90..

my questions are as follows, what kind of STD do you think would that be , and why am i still having the tingly pain specially when i'm tired, and some times if i squeeze my penis tip i feel like there is an ulcerative pain? what could this be?

is the syphilis test (blood test) (after one week and half) that the doctor ask me to do enough or conclusive that i don't have syphilis????

is the HAV HBV HCV HEV tests conclusive for almost 1 month and half conclusive too? it was also blood test..
i forgot to mention that i didn't had back pain cold sore or penile discharge from the urethra during the infection time.

please help me

doctor
Answered by Dr. S. Murugan 1 hour later
Hi, Welcome to XXXXXXX
Thanks for posting your query.

Blood test for syphilis will become reactive only after 4-6 weeks after the contact.

As you had protective vaginal sex and unprotected oral sex. HIV is quite unlikely through oral sex. HAV,HBV,HCV. HEV need not to be repeated.
You mentioned as unprotected oral sex. Do you mean you had felatio ( introducing your penis into the mouth of partner)or cunnilingus ( licking the genitals of the woman).

If you did felatio with a woman, urethritis due to Gonorrhea and Chlamydia is unlikely whereas with cunnilingus pharyngitis can occur. Here also urethritis is not possible.
As she has cold sore during felatio then Herpes likely to occur. Sometimes, rarely without obvious manifestation one can have tingling sensation alone.

1. You have to undergo urine culture and sensitivity test for STD and non STD organisms to rule out urethritis..
2. you can also have Herpes antibody tests Both Ig G ,IgM antibody for both HSV type 1 & 2.
If both test are also negative then your symptom may be due your extreme fear for STD/HIV. Nothing else.
Your physician will direct you what to do.
Get well soon.
Dr S.Murugan


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. S. Murugan 13 hours later
thanks for the quick reply,

the oral was felatio, and i developed urethritis after 1 week and half to two weeks of the incident.

the doctor asked me to do the syphilis test when he saw the lymphoid enlargement on my groin area, and the test came out negative that was almost 2 weeks from the incidence, until now he insists that i don't have syphilis and that test is conclusive i don't know why?, is it possible that it was antigen test?! do syphilis have antigen test ? and should i do the test again if it's not conclusive in 2 weeks as you mentioned above.?

the first time i did urine analysis there was high WBC, with some blood in urine 3 days later with another urine analysis the WBC got back to normal and everything else was normal, the doctor said that my urine is normal and there is no sign of bacteria in urine. he also said i can do urethral swab if i want to make sure but then he said that it's so painful and i don't need to do it so he suggested me to just take the antibiotic course .

he also insists that it's not herpes since i didn't have clear blisters on penis and he said the fact that i'm circumcised makes the risk lesser

now after 2 months i'm normal just have some attacks when i'm tired or when going to sleep, while sitting down for long time, and some times when there is some friction with my trousers and feel pain if i press on the tip of the penis.

i will ask them if they have IgM IgG test for hsv-1 and hsv-2, should i do the syphilis test again, and does symptoms appear to be syphilis related?

doctor
Answered by Dr. S. Murugan 3 hours later
Hi,

Welcome back with follow up questions.

There is no Antigen test for syphilis.
Your symptoms are not related to Syphilis. But as a completion and rule out the latency of both in Syphilis and HSV, It is wiser to repeat Serology test for syphilis once again and to go with HSV IgG, IgM for both type 1&2.
As your urethritis at present is o.k., not to bother about the same.

You can ignore the symptoms over penis during sleep and with the friction of your trousers.

Get well soon.
Dr S.Murugan
Above answer was peer-reviewed by : Dr. Mohammed Kappan
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Follow up: Dr. S. Murugan 2 days later
thanks i will do the tests that you suggested to make sure,
i have questions

1-is there possibility of getting cold sore from kissing and does it cause pharyngitis?

2-is there possibility of getting chlamydia,gonorrhea,syphilis,hpv and others through kissing and does that cause pharyngitis and dry lips.

my issue is that since the last months my lips are always dry and when i put lip gloss or etc i see some cracks in white color, and if i rub my hand on my lips the white wet cracks falls down , if i don't put lip gloss for a week or 4 days my lips gets so dry and cracks up and if i touch it with my tongue i can test blood...
i also got pharyngitis and had lymphoid enlargement on my throat, and got well by it self can that be due to STD that is contracted through kissing??? if the answer is yes how can i get treated from it and would i transmit this to my family if i drink from the same cup,plate, or spoon etc....


doctor
Answered by Dr. S. Murugan 14 hours later
Hi,

Pleased to answer your follow up questions.

1. Of course Cold sore can be transmitted through kissing. But pharyngitis is rare.

2. If the partner had obvious lesions of Syphilis (sore mouth) or HPV (warty growth) there are possibilities of getting these disease through kissing.
If the partner had pharyngitis due to Gonorrhea or chlamydia and with XXXXXXX and prolonged kiss, we cannot rule out the possibility of Pharyngitis due to STD. Without XXXXXXX kiss, it is unlikely to get pharyngitis due to STD.

Dry lips is not due to any STD. It may be due to winter climate. You can consult your dermatologist, he/she will help you for the dry lip. As your pharyngitis subsided spontaneously without any treatment, it is unlikely due to STD and there is no chance for the same to be transmitted to your family members.

Don't imagine remote possibilities. You will be alright soon and not much chances for STD.

Hope I have answered your questions. If you are satisfied, please close the discussion.
Dr S.Murugan
Above answer was peer-reviewed by : Dr. Mohammed Kappan
doctor
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Follow up: Dr. S. Murugan 38 hours later
thanks Dr.

1- i read some websites suggesting hepatitis test should be done after 3 months,i think the test i did contained some antigen or DNA testing not sure, but they took three blood tests at one time, i'm not sure if it was antibody test or dna etc?

2- i'm quite worried about hiv too as i have said, some forums suggested that 9 week is almost conclusive because many researches have shown that the the antibodies start to form as early as 6 weeks and 9 weeks is almost enough... do you agree with them? i'm doing the test anyways, but is 9 weeks -ve result at least encouraging?

3-i thought to my self maybe because my case is considered low risk , that means less virus could be transmitted and this might make antibodies to be produced later because of less virus that could have been transmitted,.... that's my own theory, is there any thing like that to be considered in medicine??

THANKS

doctor
Answered by Dr. S. Murugan 1 hour later
Hi,

Every human body has individual variations. It is not constant and conclusive with any reaction and its end result. Because of that, ranges are usually mentioned. Within these ranges, the majority will take place. So we can say possibly or usually and never able to say exactly. The HIV antibody test will become usually reactive between 8-12 weeks.

All the viruses that enter into the body cannot make disease. Especially HIV virus is highly fragile and cannot withstand to normal temperature and atmosphere. Our body also will try to eliminate any foreign body that enters into the body as far as possible. Only when adequate concentration of infectious material is there in adequate virus concentration, virus can establish an infection. Otherwise if the virus are in sub-optimal dose they will be destroyed and antibodies will not be formed. Late formation of virus with lower dose is not correct.

So nothing to worry.

Dr S. Murugan
Above answer was peer-reviewed by : Dr. Shanthi.E
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