Have I got syphilis?

Looks like canker sores as well. Did you show your doctor these symptoms as well?

Yes i have two, one blue and white called 'canesten' that i have been using for a few days and one red and white called 'canesten antifungal' which i am yet to use.

Ok - keep at those and complete the treatment.

I have just re-read your initial post. Did you not get a full STI check - including chlamydia and gonorrhea?!

Yes i had the full blood test for Syphilis and HIV and swabs (ass and throat) for gonorrhoea and I think it was a urine sample for chlamydia - all were negative, a month ago

I'm confused by the original post. You said you had unprotected oral sex (you giving or receiving or both?) and when did symptoms first appear?

There is obviously a noticeable issue in your mouth. What is your oral hygiene like - brushing/flossing and scraping the tongue with a tongue scraper? I am trying to work out whether the canker sores are unrelated and circumstantial to an otherwise obvious infection and/or relatable to the inflammation to the penis head.

I had casual unprotected oral (giving and receiving) on 25th Feb. Penis symptoms appeared 7-10 days ago. Mouth symptoms have been on and off for the past 9-12 months.

Could be entirely unrelated of course but googling symptoms of syphilis has got me a little worried, though if my blood test was negative on 20th Feb then surely the mouth symptoms must be unrelated (or could blood test results be wrong?).

My oral hygiene is very good.

Ok - Well I am not convinced by Syphilis, but is still worth another test for that now.

The penis doesn't look too bad. Has there been a sore there previously that healed?

I can't see the cheeks or back of throat in pictures either.

Go back to the clinic and repeat the same test. You should visit usual Dr for Blood tests though. You will need CBC and suggest HbA1c for blood sugar history.

Let us know how you get on with that and the Canesten, too! Try not to worry. Even if Syphilis that is entirely treatable. I suspect something less severe.

No, no previous sore there that heeled. It feels raised; see the almost white swelling line there too?

Cheeks and back of throat are fine.

Bloods generally for the mouth condition are all normal.

I'll send off for another blood syphilis test. There is no way the blood test would come back negative by mistake, would there? As in, if you have syphilis it WILL show in your blood at all times, even if primary stage?

No, if the test was conducted correctly it should be conclusive. My issue is with the timings so worth getting checked again anyway - if only for your peace of mind.

Are you able to scrape the side of the tongue and does the leukoplakia come off with it?

I would request the doctor also conduct a EBV test.

Thanks for all your advice @RyanG85

Have been applying Canesten for a few days now and looks no different. Just had a shower and taken some more pics; still looks like a red spot that is not particularly sore but it is a little raised. I have also got the blood results; hopefully you can make sense of them. I was told they are normal with the iron / b12 one being 'borderline' but not significantly bad.

Hi JTA

Well, there are a number of things going on here - possibly linked, but requires further investigation.

Firstly - Bloods. All look fine. Elevated Folate which, on its own, you'd suspect is fine (ish) particularly if the B12 is good. I wonder if they conducted Active or Total B12. Active B12 is the one to look for. That said, elevated Folate doesn't necessarily mean any less chance of anaemia any more than low - although your RBC is perfectly normal, so no concern there.

I do, however, suggest a THYROID check on receipt of the updated detail. I can also see your thumb nail in one picture - and the lack of lunula coupled with leukonychia may be a hint towards a thyroid issue - which may also explain the tongue (or at least hint again).

You penis is red raw, however! Some severe reddening that needs a urologist to look at this. It may be a multi approach to it as there is likely (in my opinion) an underlying autoimmune cause for this (which would explain all other symptoms - 'possibly linked' as I said at the start). But this does need treatment. Possibly with a potent corticosteroid. Possibly plasma cell balanitis looking at it closely...

Out of interest, have you noticed any patches of hair loss? Or pins/needles anywhere? Any tinnitus in ears? Toenail changes?

It is a pity there was no HbA1c test conducted for 3 month avg sugar levels , nor U&E or LFT - in addition to the thyroid. I'd be interested to see the TSH/T4 free thyroxine levels in particular. In the UK these can be by finger-prick test at home ('Thriva'). Have you had a urine test (normal one - not for STI)?

I do think further tests need to be conducted as your FBCs are fine - but the high folate and other curious findings point me to be suspicious of your thyroid and immune issues.

Whatever you decide to do, please let us know back here! This is an interesting one (with no offence intended!)

Thanks @RyanG85 for the comprehensive response.

I have never noticed my nails before; just taken some photos of them for you if you think they indicate something is amiss?

I have not noticed any patches of hair loss. I do get pins and needles if I sit in one position too long (for example if on the toilet), think I always have done.

With tinnitus I sometimes hear ringing in my ears but nothing frequently nor ringing that lasts longer than 20/30 seconds and certainly not something which disrupts my life in any sort of way.

Toe nails I have also taken a photo for you. my big toe on my left foot is a bit off down the right hand side, has been for a year. I used to run a bit and thought it was down to that or suspected fungal nail - was applying ointment for 6 or so months but never managed to clear it up.

I will try and push my Doc for thyroid test. At the minute they are only offering phone appointments (Corona); no availability today so will try again tomorrow.

Ok -

Pins & needles: fine. Normal.

Tinnitus: Nothing significant and could be wax build up, but could be indication.

Nails - some signs here of an issue, but again could be normal.

The reason I asked is to do with immune issues - and I do suspect this. The thyroid is sometimes the cause of an issue here, but not always. It's a frustration but sometimes have to rule things out before looking at other options.

Given the high folate and NRBC, it's worth getting the thyroid done. ESR/GFR would be a good one to look at, too. Dr may then want to look at Immunoglobulin and antibody tests.

It's clear that you have recurrent infections and that needs addressing. There is nothing alarming in the FBC/CBC so far, however. So try not to worry - but explore other options. Immune issues are always frustrating as it's a combination of things rather than a single and simple 'Yes' and 'No'.

Thanks @RyanG85.

So the red mark on my penis could be related to the ulcers in my mouth and it could not be an STI, which is a relief.

I read somewhere in my research something called Bechets Disease?

I have also recently seen a maxillofacial specialist privately re: mouth ulcers; originally they were suspecting herpetiform ulceration, but I had a viral swab taken and was prescribed anti-virals (Aciclovir), but I am still getting ulcers. Another thing the specialist suggested was oral lichen planus, but isn't convinced by it.

They want to do it a biopsy where they cut away an ulcer and send it for analysis - not keen on the idea, imagine it will just come back saying 'ulcerated tissue'!

I have woke up today and I have a load more mouth ulcers coming (see photos), especially down the right hand side underside of my tongue. Give it a day or two and I won't be able to talk or eat, it is that debilitating.

Hi JTA

It's possible, yes. Given the tests you've had already and negative, I'd suggest unlikely STI related.

Bechets is also possible - the reason a ESR/GFR blood test would be good. That and CRP. Bachets is one of many autoimmune issues and complicated.

Yes, lichen planus - I'm not convinced, although one picture you shared (upper hard palate) had some sign - but looked insignificant.

Yes - people shouldn't underestimate a Dentist's knowledge either. They spend a significant number of years specialising in oral health. It's not a bad idea to have a biopsy done at this stage. They can test extensively under a microscope and the pathophysiology.

Use a hydrogen peroxide mouthwash in the meantime (if it doesn't cause pain) for a week or so and see how you get on. There will be an underlying cause and needs time to work it out. Bloods being normal is encouraging so far.