Could it be Herpes or a yeast infection?

[Eric-S]

I had a sexual encounter with a prostitute a week and a half a go, and even though I took precautions, I think that I might have gotten an std.  A few days later, I had sex with my wife, and the following morning, I began to experience a tingling sensation on my penis, which also developed a sort of a rash. At the pharmacy (in Mexico) they gave me Ketoconazole cream and tablets, which I later learned that it was for yeast infections.  As soon as I got back to the US, I went to see a doctor, and she prescribed Levaquin 500mg and Doxycyl HYC 100mg oral tablets for a possible infection. She also ordered some blood and urine tests to test for possible stds, but I won't have the results until a couple more days.

The rash dimished in only a few days (not sure if it was due to the antibiotics or yeast medicine), but 7 days later, I still have a mild sensitive area on my penis right under the rim of the head (which had some purple spots)on the foreskin area, and I've had a mild burning sensation since the infection. Could this be Herpes, or are there other diseases out there that produce the same symptoms?

Acouple days after I noticed the rash and burning discomfort, my wife also began to experience a burning sensation on her vagina. She took 3-day over the counter yeast infection medicine, and she says that the buring sensation has almost completely gone away.  If it was Herpes that I transmitted to her, would the yeast infection medicine that she took aliviate the burning sensation?  Could it be that both me and my wife just have a plain yeast infection?

Please help!

[H. Hunter Handsfield, M.D.]

It's not possible to be certain from your description.  Your symptoms and your wife's, and your apparent response to ketoconazole, are more suggestive of yeast than herpes.  If it's yeast, it is more likely your wife had it first (it's not an STD, although males can get penile yeast from their partners) and that your extramarital contact has nothing to do with your symptoms or your wife's.  And if "took precautions" means you used a condom, it would be pretty unlikely for you to acquire either a yeast infection or herpes.  Having said all that, even expert examination doesn't always accurately distinguish yeast from herpes.  But I think yeast is more likely, and that you caught it from your wife, not vice versa--even though her symptoms started later.  

The treatment your doctor gave you clearly was intended to cover gonorrhea and chlamydial infection, but nothing you describe sounds like those.  The doc undoubtedly was just covering all bases.

For now, wait on the test results that are in the works, and speak with (or see) your doctor again about his/her opinion about the diagnosis.  But herpes blood tests might be required, depending on the results of the pending tests, how you and y our wife respond to treatment, and whether her or your symptoms recur.

Good luck--  HHH, MD

[steve123]

I  had a similiar problem with a girl I was with,  about 3 days after exposure we both started having an itchy rash.  Mine was all up one side of my penis from the head down to the scrotum in 2 main patches.   Her's was around the opening of the vagina. It looked like little purple/pink dots.  She applied a yeast medicine and me I applied tinactin and both of us cleared up completely in like 2-3 days.

[Eric-S]

Thank you for your comments. I'd be thrilled if it's not Herpes, and won't know for sure until I get the blood results (but I hear that they might not be reliable until at least 6 weeks after infection, so I might have to get retested.

I really would appreciate a docs opinion on whether he thinks it's Herpes, a yeast infection, or something else?

One thing that I would like to add to my case is that even though I used a condom (that might have slipped a bit since at times I did not have a full erecion) and did not allow oral sex, the prostitute did masturbate me violently using a lotion.  That's why I said that I might have had a sensitive area on my penis at that time of having sex with my wife.  I also masturbated the day before that, and could have worsened the situation, even though  I did not have symptoms of an irritation at that time.

A couple more questions for the doc: If she masturbated me violently, after touching herself, could I get Herpes that way?  She appeared to have no visible symptoms of an std. Also, in the last few weeks, my wife has had recurring cancer sores.  Could this be linked to the current situation (burning on the penis and vagina)?

Thank you in advance for your opinion.

[H. Hunter Handsfield, M.D.]

I would be very unlikely to get herpes by manual contact, even if your partner had first touched her own herpes lesions.

Your wife's canker sores probably also are irrelevant to the main issue--assuming they are indeed canker sores and not something else.

I didn't know from your initial post whether a herpes blood test was done; sounds like it was.  But you're right, it's too soon to be reliable, and you might need retesting in a few weeks.  Make sure your doctor ordered the right kind of herpes test (HerpeSelect); see many other threads on this forum for more information.

HHH, MD

[Eric-S]

Thank you for your response, Doctor.  A few more questions, if you don't mind? If it's unlikely to be Herpes, then what else could it be based on my symptoms?- initial small rash with very tiny red dots on the head of the penis that went away very quickly (the dots, still have a small senstitive, slightly red and slightly swollen area on one side of the soft area of the penis), but most of all, the frequent burning sensation? Could it be a yeast infection? But why did my wife also experience burning symptoms that appeard to have gone away with yeast medicine?

Thank you so much for your advice.

[Eric-S]

Please disregard my previous posting.  I jumped ahead of my self and didn't realize that the yeast question had already been answered.  Thank you for your response.

[Delilah]

A condom doesn't protect you against herpes....no matter what any doctor says.  It just doesnt.  I know of several people that contracted hsv even when a condom was used.  There is not such thing as safe sex....unless its with your partner that also..keeps it in his/her pants, which you have decided you didnt want to do.  Now you have possibly infected yourself and your wife.  CONGRATS!

[H. Hunter Handsfield, M.D.]

That's just not true, Delilah.  The research studies are quite definitive:  Condoms aren't perfect (for any STD) but they substantially reduce the risk of genital HSV transmission.

HHH, MD

[ry2fly]

Hey thanks Deliah. The man is trying to get help on this board and you go making a moral opinion about him. Mind your own business and dont judge others. This is a medical forum not a regilious/morality forum. Its about helping people not judging them.

[Eric-S]

Hello Dr.

I would like to give you an update on my situation and would really appreciate your advice.  It turns out that my rash dissapeared within a couple days, but I don't know if it was from the antibiotics, or the ketoconazole. Hower, 10 days later, the burning sensation is still there.  

I did see the Dr. yesterday to review the blood and urine results.  To my dissapointment, she tested for other stds, but not Herpes (she didn't think it could be Herpes since I did not have any sores).  Everything on the blood and urine results turned out negative.  If it were a yeast infection, would the urine results catch it? She prescribed a pill of fluconazole, in case it's a lingering yest infection, and even though I feel a little better, I still have that mild burning sensation and frequent need to urinate. Is this normal for a yeast infection after 10 days of taking ketoconazole and 1 day of fluconazole?

I took the spit test, and it showed that I have a high level of yeast in my body.  The test consists of spitting in a clear glass of water first thing in the morning.  I it turns white and murky, and begins to dissolve towards the bottom of the glass in web-like fashion, then that indicates a probable yeast infection. I tried it and got that exact reaction.  Could this test really indicate a yeast infection?  Information about this test could be found here, but it's all over the web: http://www.yeastinfectionadvisor.com/maleyeastinfection.html

The worst thing is that my wifes symptoms are flaring up again. After taking over the counter yest infection medication for 3 days, her symptoms (mainly burning) seemed to be goin away, but I she just told me yesterday that she's still getting sharp burning pains, and she's discharging some yellow fluid. She says that one side of her vagina actuall feels or appears to be swollen.  I took a brief peak and only noticed red irritation. Could this actually be a stubborn yeast infection or something else, like Herpes, for example?  I'm trying to convince her to see the Dr., and I will have to tell her that I've exposed her to a potential std.

I'm still concerned about Herpes and will be taking the HerpesSelect test.  However, given that I was exposed to the potential std less that 2 weeks a go, does it still make sense to take it even though it might not be accurate and re-take it a few weeks later. Or shoud I just wait until I know that the test results will be accurate? I do have a history of cold sores, so I wouldn't be surprised if I was positive for hsv1, but I'm fearing hsv2.

[H. Hunter Handsfield, M.D.]

That yeast website is crackers.  There is no such thing as systemic yeast infections of the type it emphasizes, causing fatigue, bloating, depression, and all the other symptoms cited.  The spit test is meaningless.  Yeasts and other fungi are part of the normal microscopic organisms that inhabit the bodies of almost every large animal, including humans; their presence does not in itself indicate disease.  Period.

Although your symptoms don't sound much like herpes, your wife's sound pretty good for that disease.  She should be examined.  But I'm not sure it's necessary for you to tell her (yet) about your outside exposure.  If she has yeast, your other contact is irrelevant; and if she has herpes, it wouldn't necessarily imply other partners.  But this is a tough decision, and if the information is bound to come out, sooner may be wiser than later.  I can't give you specific guidance.  As you suggest, you could go ahead and have the HerpeSelect HSV-2 test now; a negative result will not rule out infection this soon, but a positive result would increase the likelihood that your wife's problem indeed is herpes.  

Sorry I can't be more helpful.  Good luck--

HHH, MD

[Eric-S]

Thank you very much for your response. Could you please cofirm if my lingering tingling/burning and frequent need to urinate symptoms could still be caused by a yeast infection even though I have taken yeast medication for 10 days?

[H. Hunter Handsfield, M.D.]

Yeast infection rarely if ever gets inside the urethra and probably does not have anything to do with any discomfort with urination.  I doubt you have any continuing infection at all in your urethra.

HHH, MD

[Eric-S]

Hi Doctor,

I'm almost convinced that I contracted HSV2.  My symptoms have entirely gone away, but my wife's are getting worse.  She went to the Dr. but she was told that it was most likely it was no an std and did not get tested for it.  They just prescribed more medicine that I believe it's to treat yeast infections- metronidazole.

I understand that Herpes can trigger yeast infections, and I believe that's her case. It looks like she did have traces of yeast, but now she's having flue-like symptoms (body pains, fever/chills, etc., and she still has what I thought were canker sores in her mouth. Could these be caused by Herpes? But she actually began having these sores in the mouth weeks before the genital infection and flue symptoms. Could a culture test on them confirm at this stage if it's Herpes or not? She doesn't appear to have sores downstairs, other than irritation, but I'm not sure if she was thoroughly inpected for that.

From what I've read, it seems that she has the symptoms of a "primary" HSV2 outbreak. Would you agree?  I'm pretty sure that I've had HSV1 for years (just didn't know it was Herpes), so I have the antibodies that kept my "non primary or initial" HSV2 (I'm pretty sure that's what we both contracted) infection under control. I'm concluding that's why my symptoms were not as severe as hers.  Does it make sense?

She went to the Dr. again today and the sent her home saying that it was probably just stress, tiredness, or lack of sleep. Of course she is. I told her that I have exposed her to an std, and the poor thing is a mess. Would stress and lack of sleep trigger flue-like symptoms?

I feel so terrible for having put my loved one throuogh this. She's going to have an extremely hard time recovering from this (infedility + Herpes?).

[mickey05]

people like you make me sick to my stomach!! I really hate to form an opinion about someone but THE TRUTH MUST BE TOLD>>my friend is going through exactly what "your wife" is going through,but thank GOD it's not herpes.. Whats the point of being married if you're going to cheat and how coulld you LOVE someone if you put their LIFE in jeopardy?? It's obvious that you are aware of your actions but not aware of the consequences of your actions. You definately need further evaluation. sorry that your wife has to go through that.                  

-angry housewife-

[monkeyflower]

Well, first of all, people do all kinds of things for all kinds of reasons. Nothing happens in a vacuum; there are always precipitating factors and extenuating circumstances. In fact, you might even find yourself in the same position someday. We all make mistakes. We all do things we wish we hadn't. But you know, they happened for a reason and they're all opportunities for growth :-)

My opinion is, a single episode with a sex worker is hardly something to destroy a person or a marriage over. It's a pretty harmless event if you ask me. But I also understand that many people don't feel that way, and that's fine. Eric, I hope things work out for you and your wife. I'd encourage you to seek counseling, preferably from a sex therapist, since they're more likely to approach this from a sex-positive viewpoint. You may even find your relationship is even stronger as a result.

[looner_]

A related discussion, if my vagina opening is slightly sore   was started.