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Dermatology  (Expert Forum)
 | 
Bacterial, Fungal, Or Herpetic?
Answered by
Alan Rockoff, MD - dermatology, Child Skin Problems
The Rockoff Dermatology Center Brookline - MA
This forum is for questions regarding Dermatology issues, such as: skin rashes, acne, birthmarks, skin infections, rosacea, and general skin care.

Bacterial, Fungal, Or Herpetic?

by Dermostat, Oct 18, 2002 12:00AM
About two weeks ago, a female friend of mine and I got a little experimental (without getting a little educated) and had pretty fierce, unprotected anal sex. At the time, my penis was a little chaffed already, and therefore probably vulnerable to bacteria. Worst of all, we had an accidental moment of the highly dangerous "double dipping" when I slipped out and accidentally re-inserted into her vagina. Bad news. We did shower after this, but I am pretty sure she only cleaned her vagina with water.



After about a week or so, she performed some pretty extensive oral sex on me, and as it wore on, I began to notice increased sensitivity in my foreskin/glans area. Before she began, she noted that my foreskin looked dry. As is typical with people in the heat of passion, I shrugged this off as the pain got worse throughout the act. We then had vaginal sex again, possibly exposing my penis to a week old infection from the anal sex accident. We did not shower after this.



A few days later, my penis was a mess. The topside foreskin membrane area was very red, sore, raw, and gooey, smelly, and very burny right under the whole top half of the foreskin (the smell is kinda fishy, smells to me like bacteria.) In addition, I witnessed the rapid formation of large, pimple like bumps which then turned into ulcerative and slightly oozing sores (about 10) on only the entire shaft of the penis, but none of them appeared on the head, and no two sores were adjacent to

one another. None of them are blistery, and none are clustered together, but the skin between some of them has that sort of reddish pink "infection" tint to it. None of the peripheral symptoms associated with herpes (dysuria, fever, lymph node swelling, flulike symptoms, lower back pain) were present at all.

Most notably, the foreskin rashing/ulcering STINKS and I was under the impression that herpes doesn't smell like anything.

This smells to me like the stench under an extremely poorly maintained band-aid. I am, btw, circumsized.



My question is this: Could this infection be bacterial? I

tend to have skin that is very sensitive to staph and bacterial infections, I recently had terrible underarm rashes. I have also had molluscum before. If this IS bacterial, could this infection be getting *worse*? It sure seems like it, the pain is intense!

The NP at Planned parenthood just glanced at it and said "herpes" and handed me some Acyclovir, but I don't wanna end up with SEPSIS or something while I wait for their results to come back, if there is something else I could be doing. Plus I am worrying about herpes when I only have ONE of the symptoms.



What should I do? Are there any major differences between bacterial ulcers and herpetic ulcers, or their patterns? Can in infection of digestive bacteria (e-coli?) even CAUSE such oozing ulcers? I very well might have herpes and something else, but right now it's that something else that is killing me! Please point me in the right direction! Thanks



by Alan Rockoff, MD, Oct 18, 2002 12:00AM
Please see a doctor at once.  You very likely have a bacterial infection requiring antibiotics.  This does not sound like herpes.  Prompt treatment should result in complete healing.



If you don't have a regular physician, please look into a walk-in center or emergency room.  But a GP, dermatologist, or urologist would be fine.



Best.



Dr. Rockoff
Member Comments (6)

by Dermostat, Oct 18, 2002 12:00AM
Dr Rockoff,



Thanks! My circumstances are such that I can't really afford much more treatment (unemployed) unless it gets critical, and last night I decided to experiment and applied Neosporin to the sores. (Before I did this, I couldn't even sleep, the burning and throbbing were so severe.) Now, it is already feeling much better and it seems that a lot of the swelling has gone down. But if it worsens, again, I will definitely be hitting the ER, I live about 4 blocks from a hospital. Am I still rolling the dice here? I know bacterial infections can get real bad real fast...Thanks again, Doc!

by Alan Rockoff, MD, Oct 19, 2002 12:00AM
I'm glad things are improving.  But I still think you should see a doctor.



Dr. Rockoff

by Dermostat, Oct 19, 2002 12:00AM
Dr R:



Your advice is well taken, but it's a weekend and this just doesn't seem anymore like enough of an emergency at this point for me to get in the way of the people with the REAL problems at the ER.



If you have an email address I have taken pictures and I can send you a URL. Either Acyclovir or Neosporin or both seem to have caused some significant improvement.

by Dermostat, Oct 21, 2002 12:00AM
Also as a side note, and I find this kind of odd, I did some pretty extensive research and it appears I have a condition called chancroid?? At any rate, this is seriously improving.

by Alan Rockoff, MD, Oct 21, 2002 12:00AM
Chancroid is a bacterial infection that requires antibiotics.  If you think you have it, that's an even better reason to see a doctor.



Dr. Rockoff
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