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'boil' on scrotum, testicular pain, etc. = Herpes?
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'boil' on scrotum, testicular pain, etc. = Herpes?

Dear Dr. Rockoff,

I have had some unusual symptoms in the last two months and I'm curious if they may possibly be due to a "mild" genital herpes infection.  I have a long-distance relationship with my girlfriend, and we were last together for the New Year's holidays. We had unprotected sex at that time.  On Jan. 28, I woke up in the middle of the night and found I had a large boil (about the size of a whole cashew) under the skin of my scrotum, about 1 - 2 cm below the base of my penis, above my right testicle.  This seemed to appear overnight, but I was working alot at that time and had noticed some unusually sharp pain in that area when I would scratch down there, so it's possible it had been there a few days without me noticing it.  As soon as I touched it, it burst, oozing alot of blood and pus.  I cleaned it thoroughly and in the morning it had scabbed over and had completely drained.  It seemed to me to be like a typical boil or large pimple.  It healed and was gone in 4 or 5 days, just as I would expect any large boil to heal, with no wet ulceration period.  The scrotal skin in that area was red at first, but that too quickly disappeared.  However, at the same time and after the boil had healed I was having considerable pain in my testicles, especially the right one.  I was fatigued and I also felt like I had a swollen lymph node, at the top of my right leg, to the right of my pubic area.  Also I had some pain after urinating in about the last 1 cm of my penis, not usually during urination but afterwards, even up to 1 or 2 hours later.  I went to see my doctor, who did give me a testicular exam and found nothing.  He said the only thing he couldn't rule out was an STD.  He swabbed the end of my urethra to test for chlamydia or gonorrhea, but those were negative.  To be complete, I should mention I had an infection in my mouth about the same time (periodontal absess (abscess)), but both the dentist and my doctor felt that my genital symptoms were unrelated to that.  The testicular pain has resolved since then.  I also have recently had some anal itching, which had me concerned that if the first problem had been herpes, I may have spread it there by scratching first the boil area then my anus before realizing what was going on.  However, some internet research has me thinking this may be just from me washing the area more than usual while I was worried I had gotten herpes.  To summarize, I'm a little concerned I may have a mild HSV-2 infection that was a small lesion I didn't really notice, and became infected to become a boil.  If it hadn't been for the testicular pain and my doctor's comments, I probably wouldn't be so concerned about it.  Also, I keep reading that most people's HSV-2 symptoms are so mild they don't notice, so I'm wondering if I'm in that category.  Could this have been a small herpes lesion that became infected? Do you think I should get a blood test to see if I have HSV-2 antibodies?  I'd appreciate your comments.  Thanks!
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I just think you had a boil.  Nothong in your description makes me think of herpes.  Herpes doesn't turn into boils, by the way.

Blood tests for herpes aren't very helpful.  I'd advise you to forget about the episode.  If you get another rash down below, by all means bring it to medical attention, but I don't think this episode will have any long-term implications at all.

Best.

Dr. Rockoff
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