Concerned

[bob17]

I am a 21 year old male. approximately 5 weeks ago i recieved unprotected oral sex from a female for about 30-45 seconds probably and then stopped, i did not notice any types of sores on her lips or anything, but i also did not do a thorough inspection as i was intoxicated at the time. about one week later while urinating i noticed my foresking to be a bit red when i pulled it back. no pain, but later in the afternoon felt a slight burning at the tip of my penis, not on the foreskin, more around the urethra opening. when i returned home later on in the day i immediatly started searching the internet, and worried my self to the point of nauseation, i do not believe i had a fever or anything, just believe i worried myself sick. i did not sleep well at all that night and for the next 3 or so days, could not eat either due to the worrying myself sick. nothing changed in the next few days, went to see a doctor about 5 days after the first symptom, i also noticed white bumps sort of on the bottom side of my foreskin which i thought were there before but due to overinsepctcing and worrying i was not sure, he said that they were just glands in the skin and nothing to worry about(they have not changed appearance at all so i do believe now that they were there before). he said he believed i developed urethritis, i was tested for evertyhing, gonoreaha ,chlamydia, bloodtest for hiv and herpes, all came back negative. in the meantime he put me on doxycycline for 10 days. the burning seemed to go away some days and then come back on others, never painful, but just sort of was there. it seemed to go away at night when i slept and slowly built back up during the day. on the 9th day of doxycycline i seen the doctor again because i was still expierencing slight burning at the tip of the urethra. he then told me that if it was still there in a few days to call him and he would phone in a prescription of zmax. i did get him to call it in and took the 2gr of zmax oral suspension. i am now at the 4 week point of my first noticable symptoms, and 5 weeks since exposure, i believe most of the burning has gone away but i still am experiencing some slight burning. the doctor reassured me both times he seen me that he did not think it was herpes but that however herpes can be assymptomatic. the burning was somewhat constant, but seemed to vary, sometimes worse, sometimes woudln't notice it, but it was never worsened during urination, i never had anything that resemble a blister or open sore or anything of the type, and never noticed any discharge of any kind. I don't think i will stop worrying about this until i can get an anitbody test done again. I am wondering if you think this could possibly be herpes, and how long it takes for most people to test positive in an antibody test. i have heard that 90% will show up within six weeks, but to be abosltuy sure is 12 weeks. if i was to be tested between 6-8 weeks could i be fairly sure that i do not have it

[bob17]

I already had the blooyesy for herpes and they did come back negative. i aam not sure exactly what test was done, i will confirm with my doctor before i do the next testing, if they were both negative thoough, and on my next test was positive for hsv 1, we would assume i had it on my genitals? and if i were to get tested at the 6-8 week mark could i be fairly sure i did not have it?

[H. Hunter Handsfield, M.D.]

Oral sex can result in nongonococcal, nonchlamydial urethritis (NGU), probably due in most cases to normal oral bacteria that cause inflammation when they get in the urethra, and NGU certainly can cause the burning sensation you describe.  However, NGU usually causes abnormal urethral discharge as well; and almost all cases respond completely (and rapidly) to doxycycline or azithromycin.  So the fact that your symptoms are persisting despite both those drugs argues against that diagnosis.

Herpes does not cause the burning sensation you describe, and if your doc has reassured you about that possibility, it makes that infection even less likely.  Go ahead with the HSV blood test at 12 weeks to be sure, but I don't expect the result to be helpful.  Half the population has HSV-1 antibody, so there is a good bet that test will be positive anyway; and people don't get HSV-2 from oral sex.  So regardless of the HSV test results, it isn't going to help determine the cause of your symptoms.

Bottom line:  I'm sure your symptoms are unrelated to herpes or any STD.  Most likely they will fade with time, without any long term consequences--and without you ever having a firm answer about the cause.  In the meantime, you can be certain no harm will come any time in the future, either to yourself or a future sex partner.

Good luck--  HHH, MD