Bacterial Infection vs. STD (Herpes or HIV)

[mjpe]

I am a faithful, late 20s, heterosexual male.  

In early April, much to our surprise, my fiancé tested positively for Chlamydia.  As far as I know, we are both faithful and only engage in unprotected vaginal sex.  We do not engage in anal sex and usually I only do oral on her.  

We both took antibiotics (I did this for precautionary reasons), but later I received a negative Chlamydia test result.  Up until that point, I never dreamed of having an STD.

In late April 2007, I developed a rash on the cheeks of my face that seemed to start from a pimple near my mouth.  I used over-the-counter hydrocortisone cream and the rash seemed to go away.  Then, a dog licked me during our house search and I broke out in a violent allergic reaction (I have a history of bad allergies to dogs, dander, cats, some foods, dust, etc.).  I had blotches all over my neck and face.  

That night, however, my rash and allergic reaction seemed to go away so I shaved.  The next day, the rash broke out all over my face including my neck.  It looked like a densely packed patch of acne with whiteheads.

I went to the Emergency Room on May 1st and the nurse who first saw me thought it was Herpes, which absolutely freaked me out.  

However, the first doctor who saw me thought it was only a bacterial infection.  

Because I had received two very different assessments, I asked that the head-doctor-on-call look at me who also said it was a bacterial infection and nothing worse than that (i.e. neither HIV nor Herpes).

To calm me down, the head-doctor-on-call performed a Herpes culture exam, which two days later returned negative results.  

The doctor prescribed Bactroban ointment and Cephalexin 250 mg tablets.  Using both of these antibiotics, my rash cleared up in two days and was completely unnoticeable in 3 days.  I continued taking the medication until completion to ensure the infection does not return.

The doctor said the reason the infection spread so badly is I shaved before I had completely healed and this spread the infection across my face.  She also said I had a vitamin deficiency and needed to improve my diet and worry less about work.

After my night at the Emergency Room, I took a Rapid Test HIV exam at a local center, which came back negative.

Can I safely assume this is over?  I am confident that my fiancé is faithful but the positive Chlamydia test was a surprise.  

The only other “symptom” that I have is a scratchy throat right now, but I think this is largely derivative of my allergies and the fact that this is the spring.  I have had a couple of nights of "sweats" but I was using a heavy blanket at the time and that seemed to be the reason why this happened.  After using a lighter blanket, my "sweats" went away.  

I do NOT have any of the following symptoms rapid weight loss, diarrhea, hair loss, thrush, loss of appetite, etc.  

Please let me know what you think.  I am hoping to hear a positive 3rd opinion that reaffirms the assessments of the two doctors.  Thank you for your time.

[H. Hunter Handsfield, M.D.]

The description of your facial rash doesn't sound like herpes; both the location and the nature of the outbreak are much more consistent with bacterial folliculitis or something similar, probably due to staph or strep.  Spread of such infections by shaving is typical.  The individual skin lesions can appear similar to herpes, which probably influenced the first doc's knee-jerk reaction.  Most likely the second doc was more experienced (maybe they were intern and resident, respectively?).

There is no obvious reason to suspect any connection whatever with the chlamydia.  Your respiratory and sweathing symptoms are not at all suggestive of HIV, and clearly there is nothing here to suggest high risk for HIV, despite your partner's chlamydial infection.

You can judge the truthfulness of your partner's assertion of no other recent sex partners, and your own truthfulness in that; I cannot.  But if chlamydia can be carried for months, rarely up to a few years, especially in women, and if you are confident in your fidelity and hers, the infection undoubtedly dates back to some past partnership.  Chlamydia always clears up on its own, eventually--so despite your negative test, you could have been the source of your partner's infection, even though your test was negative.  Or vice versa.  You will never know which was which, and it doesn't matter.

Bottom line (no pun intended):  All is well and likely no harm has been done.  Best wishes--

HHH, MD

[H. Hunter Handsfield, M.D.]

Sorry, that's nurse followed by doctor, not 2 docs.  Even better evidence the rash wasn't herpes.

HHH, MD

[mjpe]

Thanks for your response.  It is a source of comfort.  May I please ask you a couple of follow up questions?

What is the likely cause of bacterial folliculitis?  Is it contagious?  

My fiance and I did not kiss for a while after the break-out and are only now returning to "business as usual".  So I think she would be low-risk for it anyway but just curious.  

The doctors said stress and a poor diet could have caused this in conjunction with the dog that licked me possibly having some bacterial infection.  Does that sound correct to you?

If some of these medical conclusions do not make sense, I apologize - they were explained to me at 3AM on a weeknight after a several-hour wait.

The doctors were very confident, though, that this was nothing more than a bacterial infection.  It was the nurse who originally said Herpes.

Given the doctors' opinions and my negative test results as well as your opinion, I guess I should feel pretty good about all of this.  

Thanks again for your time.    

[H. Hunter Handsfield, M.D.]

"What is the likely cause of bacterial folliculitis? Is it contagious? "  As I said above, mostly staph or strep. We all carry such bacteria on our skin, with infection triggered by minor trauma, like shaving.

"The doctors were very confident, though, that this was nothing more than a bacterial infection. It was the nurse who originally said Herpes.  Given the doctors' opinions and my negative test results as well as your opinion, I guess I should feel pretty good about all of this."

Yup, exactly.  Complete the antibiotic therapy then forget the whole thing. This sort of infection happens to everybody from time to time.  It's nothing.

[mjpe]

Thanks, Man, I appreciate it.  Good luck.  You do a great service on this site.

[mjpe]

Dr. HHH,

Sorry, a few more follow-on questions.  I had a candid discussion with my fiance after receiving your replies.  

Here are more details.  

She did have sex with another man but it ocurred 4.5 months ago and was supposedly isolated to a one-night stand (or at most a weekend).  

Protection was not used; it was an old boyfriend.  I largely believe her about the length of time; she was in tears.  But, I guess there could be a fudge factor here.  

Her ex claims that he tested negatively for all STDs a couple of months ago, which I guess jives to some extent with the fact the Chlamydia seems to come and go on its own.  

My only point is does my situation sound anymore at-risk than before based on this information?  

I had a negative Rapid HIV Test and negative Herpes culture results in early May.  I had a negative Chlyamydia and negative Gonorhea test results in mid-to-late April.  

Since then, the only health issues I had were the bacterial rash and a scratchy throat this weekend with the occasional sweats at night.  I honestly think I'm starting to get overly paranoid about this situation and am probably doing more damge worrying about this than anything else.  

But to reiterate, I have bad allergies (which could have affected my throat) and the sweats seemed to stop when I discontinued using a heavy blanket for a lighter one.  

Otherwise, I have no other symptoms (diarhea (diarrhea), flu-like symptoms, weight loss, hair loss, swollen glands throughout the body, inability to eat, fatigue, etc.).

Thank you.  

[H. Hunter Handsfield, M.D.]

Well, that explains the chlamydial infection. But the additional information does not otherwise alter my risk assessment or my advice.

[mjpe]

Dr. HHH, sorry...this is my last question (for sure).

Considering the Bactroban and Cephalexin was so effective in treating my rash, is this another positive indicator that I am in good shape?

Thanks for the patience.  That's my last quesiton.  

[brayden11]

Hi I was just wondering if it is possible to transmit herpes via sharing razors for pubic hair.

and ....   can herpes spread to other parts or you body ex. chest face arms..

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