Am I contagious?

I am a 36 year old, otherwise healthy, married Caucasian male looking for as much advice as possible.
4 weeks ago, I was the recipient of unprotected oral sex from a prostitute, followed by protected vaginal sex (condom). 5 days later I found a red, slightly itchy, patch on my testicles that looked like poison ivy. On day 7 following my exposure, my primary care Dr. said it wasn't herpes and prescribed antifungal ointment with a steroid. I got urine and blood tests done which came back negative for herpes.

A few days later, I noticed a ash on the top of my left foot and anus. My testicles had become red all over. On day 15, I went to Planned Parenthood. Dr there said it wasn't an std and added Desitin diaper rash cream to my treatment.

A few days later, my red testicles developed a few small pimply (white, not itchy) dots and the shaft of my penis got deep red. I focused on drying out my entire groin, used the Desitin and bought Lamasil Ultra since my prescription ran out. The pimply outbreaks on my scrotum scabbed and went away, except for one that is still there. I masturbated once and my red penis got worse, especially under the head. The anus and foot rash is gone.

It's been 28 days since my exposure. My testicles felling pretty normal except for one single small red patch, one eighth of an inch in diameter. Under the head of my penis is deep red and tingly, but this has decreased considerably from when I masturbated 4 days ago. I had two 24hour canker sores in my mouth around day 22 and day 24 of exposure. This morning I woke up with what I thought was another sore in my mouth but seems to be oral thrush. The white cheesy stuff brushed away easily, however my lip is feeling numb. I am gargling with salt water and eating yogurt.

I am worried about exposing my wife and 2 year old child even though 2 dr. said it was fungus.
I think my next step is a 4 month blood retest. Should I or could I do more? What does this sound like to you?

[H. Hunter Handsfield, M.D.]

Welcome to the forum.  Thanks for your question.

I reviewed your discussion on the herpes forum.  Terri seemed to doubt your symptoms are due to herpes, and I'm even more skeptical.  First, the location is wrong, based on the exposure you describe.  For an HSV infection to take, usually the virus has to be vigorously massaged into the tissues.  Therefore, initial herpes typically involves the sites of maximum friction during sex -- in this case your penis and probably not the skin of your scrotum.  Second, aside from the location, the description doesn't sound much like herpes. Third, herpes wouldn't cause a rash on your foot.  Fourth, the opinions of both your doctor and the PP clinician (who undoubtedly is very experienced in STDs) has to be respected, and both agreed this isn't herpes.  Further, everything you describe is much more typical for a fungal infection or other dermatitis, than it is for herpes.

I'm also very skeptical you have oral thrush, which isn't the same a a white coated tongue.  True thrush (yeast infection) of the mouth is uncommon.  Any number of minor illnesses, changes in nutrition, etc can cause coated tongue.  In any case, this certainly doesn't imply you have a new herpes infection.

So based on all this information, I see no need for your to be tested for HSV, and if I were in your situation I would continue unprotected sex with my wife with no worry about infecting her with herpes or anything else.  If you insist, you could still have a blood test for HSV, but if you do it, be prepared for the fact that the blood tests are not perfect.  Just scan this forum for many discussions about misleading HSV blood tests in people at low risk for infection.

If rash continues on your scrotum, feet, or anywhere else, continue to work with your doctor to figure out the cause and best treatment.  But I'm quite convinced these problems are not herpes and are not at all related to the oral sex event a few weeks ago.

I hope this has helped.  Best wishes--  HHH, MD

[ajchitown]

Which the chances of syphilis from receiving oral?

[jwhitman]

I appreciate your service. I'll try my best to relax over the next few days. Hopefully I'll get a break from this onslaught of symptoms (at least they aren't physically painful).

[H. Hunter Handsfield, M.D.]

There's virtually no chance of syphilis in this situation, especially if your partner isn't Latina from the US/Mex border area, or African American from an eastern or southern inner city.  Even in these circumstancs, the chance is exceedingly low.

Thanks for the thanks about the forum. Take care.

[jwhitman]

Any idea what would cause a puffy feeling inside my lower lip with occupational white coating that wipes away?

[H. Hunter Handsfield, M.D.]

"Occupational?"  Maybe "occasional"?

Maybe an oral hygiene issue?  In any case, no STD is a likely cause.  Beyond that, I can't venture a guess; we generally don't speculate about other causes of symptoms.

[jwhitman]

This morning I found a small scratch/sore on outside of nostril where it meets my face. If it's a cold sore, will it grow? Or how can I discern it from some random scratch or pimple. I am feeling so down that I can't go more than 24 hours without another symptom worry.

[H. Hunter Handsfield, M.D.]

4+ weeks is much too late; and herpes lesions don't simply appear as a "scatch".  If it looks like a scratch, that's probably what it is.

That will end this thread.  You may not keep returning with each additional anxiety driven thought that comes to mind.

[jwhitman]

Good. Bye. But most of all thanks.
PS - I think this service could charge more money, or you could charge for follow-ups. I certainly would have paid.

[H. Hunter Handsfield, M.D.]

Thanks for the thanks.  Take care.