Could this be herpes, folliculitus(folliculitis), or other STD?

[newly celibate]

Exactly (11) days ago I had unprotected sex, which was extremely rough in nature. During the act, the woman ejacualated on top of my pubic region, similar in nature to that of a male ejaculation (ie-a lot of visable fluid, in a stream). We continued to have sex, at times it becoming very dry and causing a lot of friction. I did not wash gential area after the incident...I went to sleep at 12 noon and awoke approx. 6hrs later.  In the 6hr to 12hr time frame after the incident, I noticed red bumps in the pubic region.  Some were on both sides at the base of the penis and some were in the general pubic region above the penis.  There was no particular pattern to the red bumps, which eventually (1-1.5 days later) became to look like pimples...(2) more severe than the rest (approx 2mm). All seemed to have a hair follicle at the center. Over the course of a few days the red bumps around the base of penis disappeared, while the (2) main bumps remained and are just clearing up. Over the course of the (11) days there has been a slight/moderate burning/itching sensation in the pubic region. To me this is not a 'classic' description of genital herpes.  The woman maintains she had been tested approx. 5-6 weeks ago, by her gynocologist for all STD's, and had a pap smear.  All turned up negative, however there is no way to determine whether or not she is being truthful. In addition, I am under the impression that a Herpes test is not part of the general tests a gynocologist would perform.  

I have since seen (2) doctors:



The 1st (a fill-in, not my regular doctor) dismissed my visable symptoms as anything of concern, prescribed my a 10 day supply of Levaquin, and told me to give blood in order to find out if I have an STD.  I find this to be an extremely unethical approach to a diagnosis.



The 2nd doctor (my PCP) gave me a thorough examination.  He said he was on the fence as to whether or not my symptoms were gential herpes. He did not agree that due to the friction, and amount of female fluid involved, that this could have caused the red bumps and said it is not Folliculitus (folliculitis). He did agree I am not showing the 'classic' blister/lesion symptoms of genital herpes.



I have taken full blood work, through Quest Diaganostics...tested negative for syphilus, and am awaiting the results of the HerpeSelect test (according to the Quest website this is the test they perform). These are the only (2) STD's I am being tested for.



Questions:

What is your opinion based on my description?

If not Herpes or Folliculitus (folliculitis), what else could this be?

Could there be visable symptoms of genital Herpes so quickly after the incident?



I just wanted to say THANK YOU!! for creating this website and using your precious time to help others.  It's truely an admirable and amazing thing you and your coleauge's are doing here.

[H. Hunter Handsfield, M.D.]

No STD, including herpes, starts causing symptoms only a few hours after exposure; it always takes at least 36 hr to 2 days, usually longer.  Your herpes vs folliculitis do not sound like syphilis at all.



So the timing is against herpes, which by default makes folliculitis, or perhaps physical irritation that in turn made you susceptibel to folliculites, more likely.  Beyond that, I cannot speculate; an online forum doc simply cannot provide more accurate information than a provider who has actually examined someone, so you need to rely on your own docs.



Thanks for the thanks.  We try to help!  Best wishes--  HHH, MD

[bluebird05]

I think the Doc. will tell you Herpes or any STD does not show up 6 to 12 hours later.

[newly celibate]

Thank you Doctor, for your time and consideration...much appreciated.

bluebird05, thanks to you too...for taking your time to address my concerns as well.

[newly celibate]

Hi Doctor,



This will be my last post...



As you mention the timing of my symptoms would not point to Herpes...BUT...



My visual symptoms are pretty much all gone, but I am experiencing an itchy/burning sensation, not only in the groin area, but on areas of my inner thighs and inner portion of the knee.  

Obviously, my concern is that these symptoms could be similar to muscle aches associated with a 1st herpes outbreak.  



Questions:

Is it possible or probable that my visual symptoms that I mentioned in my post above is an infection as you mention, and that herpes is following close behind?(prodronal symptoms?)



In relation to Dermatology, what else could be causing the symptoms I have been describing?

[H. Hunter Handsfield, M.D.]

Herpes doesn't cause itchy/burning sensations in the absence of either 1) an overt herpes outbreak or 2) as prodrome before an outbreak--and prodrome only lasts 1-2 days.  From your description, herpes does not sound likely to me.  I am not a dermatologist and will not speculate about possible non-STD causes of your symtpoms.



Good luck--  HHH, MD