Hope you can help

[Andeee]

Hi Doc, thank you for taking my question.

I'll give you a brief rundown of my situation. Around 12 weeks ago i was out one night, had a little to much to drink and got a little to carried away with a girl i met at a bar. We had unprotected sex (vaginal) for 20 -25 minutes. I had no reason to believe she was an IDU or of any other 'high risk groups'. Anyway about 3-4 days later i came down with a very unsettled stomach which persisted for 3 weeks. This was accompanied by occasional sore head, loss of appetite, slight weight loss, a day or two of fatigue and slight joint/muscle pains. No rash/fever although i do remember a very brief stage of chills.

From day 1 i had a rather annoying thrush on my penis, not painful, but i did notice a clear discharge. This persisted and at around week 2 i noticed two red, blister looking sores, one under my foreskin and one at the tip of my penis. Again not particularly painful.

My first thought was herpes, but because of the other symptoms, Hiv also worried me. I have been tested 3 times for hiv at 4,6 and just under 10 weeks with hiv duo.

I have also been tested for all other std's Chlamidia/Gonorea which all came back negative. My GUM clinic also took a swab test of the sores, however this was when they were beggining to dissapear.

My questions to you are:

1. Given that the sores were beggining to dissapear, is there a chance that if it was herpes, a standard swab test would not pick it up?

2. If not, what else could it be?

3. Does HIV cause blisters/sores during primary infection? or would you have to have been co-infected with something else to casue that?

4. Have i been tested enough to completely rule out hiv?

Thank you for your patience and for all your support.

[Andeee]

Thank you once again Dr. Your support and guidence is very much appreciated.

Thank you

[Edward W Hook, MD]

I answerd the question before- HIV does not cause ulcerative skin lesions.  If you acquired infctious blisters/sores they would have to be due to something else.  EWH

[Andeee]

Thanks doc, i appreciate your response. Just as a follow up, yes i was tested for herpes with a standard 'swab' test they called it, but not a blood test. I may follow this up.

I know that hiv is all but ruled out but would you be kind enough to answer question 3 above? regarding co-infection.

Thank you again for your continued support.

[Edward W Hook, MD]

The penile fungal infection (thrush) could cause erosion and discharge because of their location.  Sometimes the infectious process of thrush make the involved and surrounding skin swell a bit and thus be more vulnerable to erosion.  This would be my leading guess as to what is going on.  The fact that your other STD tests are negative is reassuring.

Were you tested for herpes?  Is this what was meant by the swab test?  If so, as you point out, if the lesions were healing, there is a chance this could be a false negative test for herpes.  A serological (blood) test using a type specific assay such as the HerpeSelect may help to sort this out although, to be honest, if it is positive it does not necessarily mean that the lesions you have are due to your herpes infections, nor can the blood test tell you when you got your infection.

This is not HIV and you have been tested enough to be comfortable that this is not the case.  HIV is ruled out.

Hope this helps.  EWH

[Andeee]

Just to add to this, my swab test came back negative also.