2 months of uncertainty

[helpmepleasedoc]

I am a 34 y.o. uncircumsized male. Since June 05 have had red/white/flesh colored pin sized small bumps on the head of my penis, concentrated on the tip and inside the urethra. Initially, the tip of my penis was very sensitive to touch (sharp sting when touched), as well as pain in the left glan. Bumps are not painful nor blistering. More visible during erection. No pain urinating, but stings after urinating as urine dribbles out after I think I'm done. Other symptoms: stomach pain (both sides, more recently lower abdomen), loss of appetite, nausea, sore throat with swollen red dots, aching joints, head aches, pain in armpit/groin (lymph nodes?), night sweats, fatigue, eye pain, chapped/dotted lips (small white/yellowish dots), first cold sore ever was at the beginning of this.

I saw a general practitioner: gonorreah, chlamydia tests (swab from urethra and urine sample) were negative. Blood tests (1.5 months after initial symptoms, after taking Cipro) were neg for gon, chlamyd, syphillis, HIV, but were POSITIVE for Ebstein Barr and HSV1 and equivocal for HSV2 (IGM tests). He thinks it's fungal. Used two antifungal creams (ineffective) and two antifungal oral meds (Keto... and Sporanox) which were somewhat effective, but bumps still at the tip & inside urethra. Also took Doxycycline for any residual bacterial infection.

Recently met with infectious disease specialist. He said I have no STD. To ease my mind, he is testing now for HSV2 with HerpesSelect - expecting results shortly. Checking my blood sugar as I am "pre-diabetes" (overweight). He suggested that I pull back my foreskin often to "dry out" and "toughen the skin" on my penis. This seems to be helping a bit after a couple of days.

STD concerns because:
- About 8 yrs ago before I got married, I got a massage from a woman that touched her tongue on my scrotum and I had a single large pimple-like bump on my scrotum shortly after that. Was painful and popped although it was more like a hard pimple. These painful bumps reappear occasionally and more recently they had been moving closer to the base of my penis (still technically the scrotum) 2-3 at a time now, not 1, but they have not popped recently.
- Other symptoms listed above
- Itchy rash around breast bone periodically
- Weakened immune system in recent yrs - got shingles, EB, tongue fungus
- Have had dizzy/near fainting spells in stressful situations or while driving in heavy traffic or long trips
- My wife has similar dizzy/near fainting spells and has heavy menstruation and recently found fibroids & a polyp in her uteris (to be surgically removed).

Could this be syphillis? Recent test for syph was negative but after taking Cipro. Could I have had syph for years and not known it? Could the syph be at a stage that it is very difficult to detect?

Explored unprotected anal sex with wife in past 6 months - baterial infection? Also, I never have had vaginal nor anal sex with anyone other than my wife.

Your thoughts?

[H. Hunter Handsfield, M.D.]

I really can't help.  It is clear you don't have any STD.  Your symptoms don't suggest STD, the sexual event you describe 8 years ago was very low risk, you have had negative tests for all conceivable STDs, and two physicians--including an infectious diseases expert--have found no STD and reassured you accordingly.

To answer some of your specific questions, both the overt and implied ones:

Most of symptoms you list (urine dribbling, stomach pain, appetite, body aches, headache, fatigue, chapped lips, itchiness, dizzy spells, etc) are not those of any STD.  The rash/bumps you describe on your penis do not sound like herpes.  Syphilis blood tests are highly reliable, and cipro makes no difference (it is entirely inactive against syphilis).

The lesions you had of the scrotum 8 years ago and now near the base of the penis since sound like pimples or folliculitis, which are especially common in overweight persons and perhaps in pre-diabetics.  In advance form, this could be a condition called hidradenitis suppurativa.  Problems of this sort are related to moisture and warmth in skin folds where there is little air circulation, hence the association with obesity.  Not sexually transmitted; and the very first lesion probably was coincidental with the oral exposure you describe, not caused by it.

I don't know why one of your doctors did a test for EBV, but depending on the type of test done, the large majority of the population is positive; and in any case, EBV is not normally sexually transmitted (saliva exposure/kissing is the norm).  The IgM test for HSV probably mean nothing, but HerpeSelect will sort it out for sure.  The odds are good you indeed carry HSV-1, as most people do; and it is probable the result will be negative for HSV-2.

You should contintue to follow up with your primary care doctor and/or the ID specialist; sounds to me like they are on top of things and you can rely on their advice.  You also should ask them whether your symptoms reflect anxiety or depression, which strikes me as a real possibility.  I suggest it out of compassion, not criticism.  Whatever else is going on, it isn't any STD.

Good luck--  HHH, MD

[BenG]

Hi there, do you live in England? If so, which doctor are you seeing? I am trying to get the HerpesSelect test done but can't find anyone who does it.
Your help would be appreciated. Thanks
Ben

[download2005]

Hi Ben. a GUM clinic should do a herpes select test. I had one done at the GUM clinic in nuneaton warickshire about a month ago and there was no problem, i asked specifically for it and they did it. It showed pos HSV1 and Neg HSV2 so they do it if you ask. Cheers - Download2005

[download2005]

You can forget syphillis,you dont have it and never have. even if you previously had it and had been treated it would show up on a syphillis blood test that you had previously been infected. Whatever the problem is it's not syphillis and probably isn't std related but the doc will tell you more.

[BenG]

Thanks - I asked the GUM clinic in London but they wouldn't do it. They said the use the NHS laboratory that uses their own, in-house version of the test. Very fustrating.
Guess I will have to look for a private one.
Thanks anyway,
ben

[JohnnyV]

Ben,

Hi, I saw your post from Aug. 1 about the herpes risk, and something just crossed my mind that might help.

I'm not a doc obviously, but I've had a lot of experience with fellatio and went through several STD scares that always turned out to be false alarms. A couple things that might shed light on the things that were worrying you:

*Depending on the kind of soap a guy uses on his penis, you can have an allergic reaction in your mouth, especially if you were performing fellatio on him for a long time. This happened to me once; I don't know if that might be part of your swollen gums. I know that I've had an irritated throat and mouth from allergies and thought I had something but it wasn't an STD.

*Maybe you got a really bad sore throat? Sometimes that causes white spots that look like sores. If you were deep-throating someone, the trauma to your throat can make it easier to get sore throats and then when the spots form they are worse than usual. One PCP also told me that the pre-*** that some men might ooze might have a particularly strong pH, which can burn your throat tissue but not give you an STD.

*Also, a few times when I got head from men I didn't know very well, I freaked out and tried to clean my penis with too much soap. It caused a horrible reaction in my urethra and urinating was murder for two weeks. I went to doctors and got negative STD results on everything, until my PCP finally told me it was probably from washing too harshly with too much soap, and from ejaculating too many times in rapid succession. In my case, I hadn't gotten head in a long time and I was overly excited about it and came several times in a period of a few hours.

Hope this might help.

J

[helpmepleasedoc]

Thank you, doctor HHH, for your reassuring comments.

I forgot to tell you that my initial symptoms in June began a few days after spending a long weekend in a very warm pool (where the climate is usually 90-115 degrees F).  Could I have contracted any bacteria from the pool water?  My family was in the same water and they are ok.  Also had very high stress regarding finances 3-4 weeks leading up to my recent symptoms.

Also, I have similar white/flesh colored very small bumps on my fingers and hands. Sometimes there is pain. This occurred about 2 weeks into all of my other symptoms. They got a bit better with the antifungal cream but did not go away, just less white. My fear is they have spread from my penis to my hands, and I am afraid of touching anything and infecting my family. My ID specialist says it's no STD, but what are these?

I appreciate your comments about anxiety/depression. I know I have anxiety because I have been hospitalized with rapid palpitations on more than one occasion, and I don't handle stress well.  I don't know what to do about it though as I am the sole provider for my family and I can't just take a "time out".  I am concerned that I'm slowly killing myself with this anxiety/stress which seems to also be turning into depression. How do I begin to treat this?

Thank you.

[helpmepleasedoc]

Also, could the lesions on my scrotum have been due to razor burn or the like?  I shave down there to keep it neat, but perhaps I'll discontinue that.

[helpmepleasedoc]

ben_uk, I am unfortunately not in England so will not be of much help to you.

[H. Hunter Handsfield, M.D.]

Thanks for thanks; nice to know it helps.

There are indeed a few infections that can be acquired from contaminated warm water, especially hot tubs; but they are rare, and the risk is even lower from a warm swimming pool.  In any case, your symptoms don't suggest any of those infections, which would cause a rash all over your body.  The flesh-colored bumps on your fingers aren't an STD, but I can't guess at an explanation.

Yes, indeed, razor burn can lead to infections on the scrotum; that may be a good possibility, depending on timing of lesions with shaving.  My advice (to everyone) is that shaving around the genitals isn't a good idea.  I understand many women need to do so in order to wear fashionable swimwear and other clothing, and maybe sometimes men as well--but not on the scrotum.

You start to treat depression or disabling anxiety by recognizing it (a very important first step) and discussing it with your health care provider.  If s/he isn't comfortable with this area, s/he may refer you to a mental health professional.  There is no other realistic option; nobody should ever assume they can just "snap out of it."

Good luck--  HHH, MD

[H. Hunter Handsfield, M.D.]

Thanks for thanks; nice to know it helps.

There are indeed a few infections that can be acquired from contaminated warm water, especially hot tubs; but they are rare, and the risk is even lower from a warm swimming pool.  In any case, your symptoms don't suggest any of those infections, which would cause a rash all over your body.  The flesh-colored bumps on your fingers aren't an STD, but I can't guess at an explanation.

Yes, indeed, razor burn can lead to infections on the scrotum; that may be a good possibility, depending on timing of lesions with shaving.  My advice (to everyone) is that shaving around the genitals isn't a good idea.  I understand many women need to do so in order to wear fashionable swimwear and other clothing, and maybe sometimes men as well--but not on the scrotum.

You start to treat depression or disabling anxiety by recognizing it (a very important first step) and discussing it with your health care provider.  If s/he isn't comfortable with this area, s/he may refer you to a mental health professional.  There is no other realistic option; nobody should ever assume they can just "snap out of it."

Good luck--  HHH, MD

[BenG]

Thanks for your suggestions - they were helpful.
ben

[JohnnyV]

You're welcome. It sounds like you've been through a lot of stress and anxiety. I hope everything turns out well. For some added comfort, there are a few threads in which the doc basically stated that oral sex is low risk for HIV and almost all STDs. Check them out (some of them have my tag name by them.)

J

[HKSH25m]

About 2 months ago I had unprotected sex with a girl twice.  She gave me no reason to think that there might be anything amiss yet a few days following that episode, I developed soft, red fleshy bumps on the rim of the head of my penis leading to the urethra in conjunction with a sort of shedding of the top layer of skin from the shaft leaving the skin pretty dry.

As a reaction I put some antibiotic ointment on the bumps and shaft and within a few days everything was pretty much back to normal.

After that time, though, I've had spot episodes of an itchy feeling in the urethra and pains in my lower abdomen which often come and go and are less frequent than originally, and for some time I had flulike aches and pains throughout my body.

After explaining this to my doctor, he said it was most likely just some sort of bacterial infection.

But ever since, I've continued to have those spot symptoms of itchyness in the urethra and have since developed bumpy rashes behind my knee and have been extremely itchy all over my body, more than usual.  On top of that, I seem to always have a new body pimple.  Never more than one in a spot, but a new one constantly coming out of nowhere.

Is it possible that I have an STD?

[jeat1812]

A related discussion, Rash was started.