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Could this be Herpes 1 or a fugal infection?
Back in April I had unprotected oral sex and unprotected sex, only for a second, before putting on a condom. After that I only had sex with my girlfriend who I began dating after the previously mentioned sexual encounter. She claims to be clean as of January when she says she was tested.
On June 22nd, a rash began on my scrotum. It started as a burning sensation that grew over a few days. Over those days, I was outdoors in the heat, participating in a sporting event. After about 3 days, the rash had grown into what appeared to look like herpes. It was red with puss being excreted from the rash. I did have one pimple-like sore show up on the shaft of my penis. I never experienced flu symptoms that I've learned are associated with Herpes. I also have never had anything related to Herpes show up previously. During the time of my rash, my girlfriend experienced some pain around the opening of her vagina during sex and said that two red areas appeared around the opening of her vagina.
One week since the rash began, I saw a doctor and he said it was a fungal infection and prescribed Nystatin cream and did a blood test for Herpes. After one week I returned and the cream had almost made the rash disappear. My blood test was negative for Herpes.
One week later, the rash returned, although not as severe. I saw another doctor at the same practice. He prescribed a slightly different cream—Nystatin Triamcinolone—and since I was concerned that it might be Herpes he prescribed a version of Valtrex to take three times a day. I used the cream and took the medicine. It cleared up in roughly five days and hasn't returned since.
Since I was concerned that it could be Herpes, I am returning for a second blood test in a week and a half from now.
1) If it is Herpes, would Nystatin cream have made it clear up like it did?
2) If it is Herpes 1, would I have experienced flu-like symptoms?
3) Since I didn't get an initial culture during my first visit, are the blood tests conclusive?
On June 22nd, a rash began on my scrotum. It started as a burning sensation that grew over a few days. Over those days, I was outdoors in the heat, participating in a sporting event. After about 3 days, the rash had grown into what appeared to look like herpes. It was red with puss being excreted from the rash. I did have one pimple-like sore show up on the shaft of my penis. I never experienced flu symptoms that I've learned are associated with Herpes. I also have never had anything related to Herpes show up previously. During the time of my rash, my girlfriend experienced some pain around the opening of her vagina during sex and said that two red areas appeared around the opening of her vagina.
One week since the rash began, I saw a doctor and he said it was a fungal infection and prescribed Nystatin cream and did a blood test for Herpes. After one week I returned and the cream had almost made the rash disappear. My blood test was negative for Herpes.
One week later, the rash returned, although not as severe. I saw another doctor at the same practice. He prescribed a slightly different cream—Nystatin Triamcinolone—and since I was concerned that it might be Herpes he prescribed a version of Valtrex to take three times a day. I used the cream and took the medicine. It cleared up in roughly five days and hasn't returned since.
Since I was concerned that it could be Herpes, I am returning for a second blood test in a week and a half from now.
1) If it is Herpes, would Nystatin cream have made it clear up like it did?
2) If it is Herpes 1, would I have experienced flu-like symptoms?
3) Since I didn't get an initial culture during my first visit, are the blood tests conclusive?
MEDICAL PROFESSIONAL
Welcome to the STD forum.
Based on your description, your scrotum rash doesn't sound at all like herpes, and obviously your doctor agrees. Herpes and fungal infections look quite different from one another, and aren't usually confused by trained health care providers. Second, the first genital herpes outbreak rarely occurs on the scrotum. For an HSV infection to take, the virus has to be massaged into the tissues -- therefore the intitial outbreak is generally on the body parts that receive the most friction during sex (usually the penis in men, vaginal opening and labia minor in women). For the same reason, the brief exposure you describe (before putting on a condom) was very unlikely to risk an HSV infection. Most likely the second physician prescribed Valtrex to humor you, not because he really believed you have herpes. To your specific questions:
1) No. Herpes does not respond to nystatin cream. This is additional evidence against herpes.
2) Not necessarily. Not all initial HSV infections are accompanied by flu-like symptoms. But this is pretty much irrelevant, for the reasons stated above.
3) It can take 3 months for HSV antibodies to show positive on a blood test. The negative blood test argues against herpes, but it isn't definitive. However, the chance you had herpes was too low to be tested anyway.
This problem isn't herpes. Just forget that idea and move on. You don't need any more testing.
Regards-- HHH, MD
Based on your description, your scrotum rash doesn't sound at all like herpes, and obviously your doctor agrees. Herpes and fungal infections look quite different from one another, and aren't usually confused by trained health care providers. Second, the first genital herpes outbreak rarely occurs on the scrotum. For an HSV infection to take, the virus has to be massaged into the tissues -- therefore the intitial outbreak is generally on the body parts that receive the most friction during sex (usually the penis in men, vaginal opening and labia minor in women). For the same reason, the brief exposure you describe (before putting on a condom) was very unlikely to risk an HSV infection. Most likely the second physician prescribed Valtrex to humor you, not because he really believed you have herpes. To your specific questions:
1) No. Herpes does not respond to nystatin cream. This is additional evidence against herpes.
2) Not necessarily. Not all initial HSV infections are accompanied by flu-like symptoms. But this is pretty much irrelevant, for the reasons stated above.
3) It can take 3 months for HSV antibodies to show positive on a blood test. The negative blood test argues against herpes, but it isn't definitive. However, the chance you had herpes was too low to be tested anyway.
This problem isn't herpes. Just forget that idea and move on. You don't need any more testing.
Regards-- HHH, MD
MEDICAL PROFESSIONAL
Genital yeast (fungal) infections are sometimes shared by sex partners, and are the most common cause of genital itching or burning in women, including pain during sex.
Based on all the available information, I'm quite certain you don't have herpes. But if you want even more certainty, an HSV blood test at 3+ months would provide it. Up to you. If you do it, don't lose sleep in the meantime. You can expect it to remain negative.
Based on all the available information, I'm quite certain you don't have herpes. But if you want even more certainty, an HSV blood test at 3+ months would provide it. Up to you. If you do it, don't lose sleep in the meantime. You can expect it to remain negative.
Thank you very much for your quick answer to my question. I have two small questions, though, and based on your initial response, these questions could be redundant, so I apologize.
Does my condition have anything to do with the pain that she experienced during sex? This all occurred around the same time as my rash.
If it does take three months for antibodies to show up—and I know you said no more testing is needed—would it be smart to get tested one last time since it will have been well over three months since possible exposure, making it a good chance that if antibodies are present they would show up?
Thank you again for the help,
Anxious177
Does my condition have anything to do with the pain that she experienced during sex? This all occurred around the same time as my rash.
If it does take three months for antibodies to show up—and I know you said no more testing is needed—would it be smart to get tested one last time since it will have been well over three months since possible exposure, making it a good chance that if antibodies are present they would show up?
Thank you again for the help,
Anxious177
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
