Acute recurrent localized Lymphadenopathy

[mikeshams]

Hello Doc,

Here's my history: for the past 2 years, only 1 of my inguinal lymph node gets swollen (LEFT side). Its tender and pain when i push on it. usually 1cm. this is probably the 3rd or 4th time.. It gets hard, bumpy in couple of days (right now); goes away usually in a week or 2. Its only one and always the same one i think (even when its not swollen, I still can find it sometimes around 1-2mm) I kept thinking its an insect bite. No history of trauma to leg
The reason I am posting my concern here is that I am a hetrosexual, but I have this fetish with cute shemales. I had "Only" oral sex (using condom) both ways and some *** play (only touching the anus, but no fingering)...ALWAY Condom first before starting anything; with couple of shemales that I didn't know for the past 2 years. so I am thinking maybe its an STD.
ALSO I have, or maybe still have hematuria. I had some 3/10 LEFT flank pains and I thought it was a kidney stone!? But I think I got ride of it because i don't really have the pain anymore
My questions:
1- I have NEVER had itching, ulcers, vesicles, pain in urination or any other signs or symptoms for any types of STDs, can I still have a STD and just keep getting this acute single localized lymph swolling
2- How are the lymphadenopathy signs for HIV is different than my case? chronic means non-tender; straight for couple of months?
3- with these sexual activities that I mentioned, do you think I can get HIV or any of the STDs? Or I shoud stop doing and having this fetish of mine.
4- could it be just recurrent kidney infections and I get this one single lymph node getting swollen everytime?
5- OR maybe just psycological and feeling guilty for being with a shemale and keep thinking I have got a STD?.
6- what do you think could be? because what you say would really means to me; since you are an infectious specialist...
Thank You so much
P.S. that was a loong history; I hope it was useful to you :)

[Edward W Hook, MD]

Petechiae are not a manifestation of recurrent herpes.  As I said before, rather than trying to work this out over the net, you should be examined by a health care provider.  EWH

[mikeshams]

Thanks Dr. hook,
Actually I wasn't really thinking about it since this last episode where I start to have all these flying thoughts...
right now after a closer look, I see a petechia on my scrotum (2mm). I remember I have had this before, 2-3 of them but smaller than this one (0.5mm) which were gone in couple of weeks..I thought that was just because of the hair follicles.
do u think it can be herpes; thats keep coming back after being stressed alot; but on my scrutom!!?? since I use the condom but the scrutom is not covered by it and can be passed by touch?...or is it sign of something else?
I have to say this is a great site; team of doctors in different specialties who are ready to give answer and their thoughts to very anxious people...or in my case no quick access to a good doctor as well...

[Edward W Hook, MD]

There are many, many causes of inguinal lymph node swelling, ranging from athlete's foot to bacterial skin infections to STDs.  The finding is non-specific and if it is worrying you, you should see a health care provider for evaluation when it is present.  If all of the exposures are, as you describe, condom protected, the chance that you have an STD is quite small.    

I will answer each of your specific questions momentarily but, before i do, I have to ask. If these problems have been present and on your mind for two years, why have you not been tested?  that would seem to do a good job of answering many of your questions.  Now, on to your questions:

1,  STDs can casue a variety of symptoms and present in a variety of way HOWEVER, I have never heard of an STD which presents solely as recurrent swelling of a single lymph node without other accompanying findings.
2.  Persons with HIV have persistent lymphadenopathy, not swelling that comes and goes.  Once again, if you are worried about HIV, why have you not been tested?
3.  No.  the fetish will however get you into trouble if you allow it to go forward beyond the current status of protected exposures..
4.  Unlikely
5.  This is a possibility.
6.  Again, my advice is that the next time the swelling is present, see a health care provider for evaluation. This should help you to sort things out.  EWH