Acute symptoms?

Dr. -

I am a bisexual male. Over the last several months I have had several homosexual encounters that consisted of giving/recieving oral sex w/o a condom and once oral/anal. NO unprotected anal sex.

Recently I experienced a sudden (over 2-3 hrs) inflamation (inflammation) of inguinal lymph nodes that were verey painful and inflamed bilaterrally and lasted 2-3 days and then resolved - no noticable lymph node reaction elsewhere. That same night I had chills/fever that lasted one night. The next day I had no signs of fever.  I have since developed a itch in the groin area and buttox but no rash and a lump on the anterior surface of my penis near the head that feels like a 'nudule' just below the surface of the skin but no eruption of the skin.  The lump is tender, but not necessarily painful to touch unless pressure is applied (then only mild pain). The is no penile discharge.

Benadryl alleviates the itch.

Over the last week , the lump essentailly comes/goes. The itch persists but no rash or any other sx.

I had an ELISA which was neg.

Q's:

Any ideas? Sorry this seems vauge, just worrisome to me due to possible sexual behavioral risks. Any other testing needed?

Thank you.

[H. Hunter Handsfield, M.D.]

It sounds like you had a transient infection, probably bacterial (staph, strep, and the like); nothing else is likely to cause lymphadenopathy that flares up and resolves so quickly.  Most likely nothing sexually acquired.  It might or might not be related to the penile nodule, which could be an infected/inflamed cyst--but doesn't sound like an STD.  However, I can't say much about the itching.

At this point, I suggest leaving the penile bump alone; avoid the temptation to repeatedly feel for its size etc, and definitely no squeezing etc.  If it just goes away, don't worry further.  If it persists a week or two, or if it any time it obviously enlarges or gets inflamed, see a health care provider.  But if in doubt, of course see a provider anyway; my advice is not a substitute for personal health care.

Good luck-- HHH, MD

[mpo131]

If HIV is your concern, based on the experiences you have had, contracting HIV is along the same line as winning the Powerball, especially if your test was after 4 weeks.