Oral Symptoms After Unprotected Sex: What You Need to Know

Oral issues

Hello Doctor: I had unprotected sexual intercourse (two minutes of unprotected vaginal intercourse) on March 31.
About three weeks later, I experienced unexplained nasal discharge, and although my throat did not hurt, I felt a scratchy sensation.
When I moved my throat without swallowing, it produced a sound, and it felt like something was stuck in my throat, but there was no phlegm, and the nasal mucus was clear and white.
My first concern about HIV arose when I developed one or two painless, itchy red spots on my arm and chest, and two larger, firmer red spots on my heels.
These symptoms were new to me and appeared three weeks after the sexual encounter.
In the fourth week, I noticed my mouth was drier and stickier than before, and I had white patches resembling oral thrush on the back and left side of my tongue, with white stripes and circles on the sides and tip of my tongue.
When I touched the frenulum (the bottom of my mouth) with my tongue, it felt rough.
I am concerned that these symptoms might be due to a Candida infection caused by a weakened immune system, which has persisted into the fifth week and is a primary reason for my suspicion of having HIV.
In the fifth week, I noticed a small swelling under my jaw, just above the Adam's apple, and I wondered if it could be lymphadenopathy, but the symptoms only lasted for five days and then disappeared.
On the 35th day after the sexual encounter, I went to the hospital for an anonymous HIV test, and the result was negative.
However, I still have the aforementioned symptoms (though the nasal discharge and red spots have resolved), mainly the oral symptoms, which make me concerned about oral thrush.
The testing personnel told me that a negative result means I shouldn't worry too much, and that acute infection would not present with oral thrush symptoms.
I also did not have a fever, so there should be no concern about HIV infection.
If the possibility of HIV infection can be ruled out, I would like to ask the doctor why the above symptoms occurred and how the oral issues were caused.
Could there be other infectious routes leading to other bacterial or viral infections? I would appreciate your insights.
Thank you! If photos of my mouth are needed for diagnosis, I will attach them in my reply to your email!

andy, 20~29 year old female. Ask Date: 2023/05/06

Dr. Xu Wencang reply Urology

You can undergo some sexually transmitted infection screenings, and then consult an otolaryngologist for an examination.

Reply Date: 2023/05/06

More Info

After engaging in unprotected sexual activity, it is not uncommon to experience a range of symptoms that can lead to anxiety and concern about sexually transmitted infections (STIs) or other health issues. In your case, the timeline and symptoms you described warrant a thorough understanding of potential causes and implications.

Firstly, the symptoms you experienced three weeks post-exposure, including nasal congestion and a scratchy throat, could be indicative of a viral upper respiratory infection rather than an STI. These symptoms are often associated with common colds or allergies, especially if the nasal discharge is clear and not accompanied by fever or significant pain. The presence of red spots on your arms and chest, along with the hard bumps on your heels, could also be unrelated to STIs and may represent a benign skin condition or an allergic reaction.

The oral symptoms you mentioned, particularly the dry mouth and the white patches on your tongue, raise the possibility of oral thrush (candidiasis), especially if you have a history of immunocompromised states or if you have been under stress. Oral thrush is caused by an overgrowth of Candida, a type of yeast that can flourish when the immune system is weakened. This condition can occur due to various factors, including antibiotic use, diabetes, or other underlying health issues. The roughness you felt on the underside of your tongue could also be consistent with this condition.

Regarding your concerns about HIV, it is important to note that the negative test result you received after 35 days is a strong indicator that you did not contract the virus from the encounter, as most tests can reliably detect HIV infection within this timeframe. The assertion that acute HIV infection would not typically present with oral thrush symptoms is also valid; while some may experience flu-like symptoms, oral thrush is not a common early sign of HIV infection.

The swollen lymph node you noted in the fifth week could be a normal response to various infections, including viral infections, and its transient nature suggests that it may not be a cause for concern. Lymph nodes can swell in response to localized infections or systemic illnesses, and they often return to normal once the underlying issue resolves.

In summary, while your symptoms are understandably concerning, they do not necessarily indicate an STI or HIV infection, especially given your negative test result. It would be prudent to consult with a healthcare provider, preferably an ear, nose, and throat specialist or an infectious disease expert, to further evaluate your oral symptoms and any other lingering concerns. They may recommend additional tests or examinations to rule out other infections or conditions.

In the meantime, maintaining good oral hygiene, staying hydrated, and managing stress can help alleviate some of your symptoms. If you continue to experience discomfort or if new symptoms arise, seeking medical attention is advisable. Remember, open communication with your healthcare provider about your symptoms and concerns is key to addressing any health issues effectively.

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