Do i have gental herpes?

In Oct 2008 i had unprotected oral and vaginal sex with a girl i just met while on vacation after drinking to much. Two weeks later when i got home i got a pink spot on my penis about the size of a quarter which burned and was painful for a day along with genital tingling for three days and felt very tired for four days, I also got sores in my mouth on my cheeks and tongue.In Jan 2009 i got headaches, ear aches, mild fever, very bad cold, cough, muscle aches and sore throat. All these symptoms have been coming on and off for the last year. I also got really bad neck pain in Jan 2009 for about two months.In March 2009 i got a lump in groin on right inner thigh the size of a golf ball saw doctor and he said it was a swollen lymph node. He also looked at my throat and told me i had thrush and prescribed me antibiotics and it went away in a couple of days.I had swollen lymph node in groin again April 2009 May 2009 and June 2009 which stays swollen for about a week to ten days. I got ultrasound done and doctor said it was full of fluid. Lymph node is still firm to this day but not swollen.In July i now have another smaller pink spot on my penis that looks like a layer of skin is missing that has come back three times in the exact spot. Went to doctor and showed him and said if it were herpes it would usually blister and ordered me herpes type specific blood test which cost me $140 and came back negative for both (Oct 2009) I have also been tested for hiv three times out to seven months after encounter with girl so i know i don't have hiv. I still get tingling in groin usually in the upper inner thigh almost always to this day. Is the herpes test they use in Toronto Canada accurate?  What could be causing these pink spots on my penis that come and go in the exact same spot along with my other symptoms besides genital herpes? Do my symptoms sound like genital herpes?

[H. Hunter Handsfield, M.D.]

Welcome to the STD forum.

My initial reaction was to the wording of your question, before reading anything else.  It is commonly believed that herpes frequently causes "atypical" symptoms.  Actually, it rarely does so.  When herpes causes symptoms at all, mostly they are quite typical, just mild.  Therefore, when someone asks whether their as yet undiagnosed symptoms are due to herpes, usually the answer is no.

In reading the body of your question, my initial reaction holds up well.  The answer to the closing question is no:  your symptoms do not sound like genital herpes.  An initial "pink spot" on the penis doesn't suggest herpes, especially starting 2 weeks after exposure (3-5 days is usual). Your doctor is correct that herpes lesions usually are blister-like.  Herpes certainly does not cause "tingling in groin usually in the upper inner thigh".  Also, your "almost always" comment is strong evidence against it; herpes outbreaks never last more than 10-14 days, never recur more often than every 4-6 weeks, and between outbreaks there are no symptoms at all.  There are few or no exceptions to this pattern.

Finally, the blood tests are highly accurate -- regardless of country.  There are only a couple of test methods that exist, and they are the same everywhere.

As to " What could be causing...[these] symptoms besides genital herpes?", I really cannot help.  On this forum we generally try to avoid speculating about non STD explanations, and clearly it is no STD -- or anything else that comes from the sexual encounter last year.  If your primary care physician can't give a clear answer, you should consider seeing a dermatologist.  But you can put all concerns about herpes or STDs aside.  

Best wishes--  HHH, MD

[jimmyserver]

Thank you for your response, i have made an appointment with a dermatologist for this coming Monday. Also the blood test i took was immunoblot from LifeLabs, i was wondering how accurate do you think this test is?(90%,95%,100%?) I am hoping the dermatologist will be able to tell me what is wrong with me and that 100% i do not have genital herpes.

[H. Hunter Handsfield, M.D.]

The immunoblot tests generally are very reliable; the main one on the market is the HerpeSelect brand, produced by Focus Technologies -- but you'll have to ask LifeLabs whether that is the one they use.  No test is perfect, and all the HSV-2 antibody tests fail to become positive in 5-10% of infected people.  But you still can be 100% certain you didnt' catch herpes, based on the combination of all the available data:  unlikely chance your partner had HSV-2, low risk of transmission even if she did have it (probably 1 in 1,000 transmission risk), symptoms that don't suggest herpes, plus the negative blood test.

A dermatologist should be able to tell you what it is -- but even if not, please let the herpes idea go.

[jimmyserver]

Thank you for helping me!