STDs Expert Forum
Does this sound like herpes?
About This Forum:

The STD Forum is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

Font Size:
A
A
A
Background:
Blank
Blank
Blank
This expert forum is not accepting new questions. Please post your question in one of our medical support communities.
Blank Blank

Does this sound like herpes?

Jan 7th - protected sex with someone who said he did not have stds. We performed unprotected oral on one another.

2 days later I developed itching and redness in my genitals. Treated it as yeast infection. Symptoms only got worse including swelling. Made a doctors appointment and had a Pap smear. Came back positive for group A strep. Around this same time I developed an itchy, red anus. I was given penicillin for the group A strep vaginal infection and vaginal symptoms went away after several days (the whole thing lasted about 2 weeks) but my anus was still red and itchy for several weeks. I also had a sore throat and swollen neck glands. Had a herpes blood test done at 2 weeks after the encounter which was negative for both kinds.


Since then I have had an itchy red labia minora on and off (itches with discharge and is very red on the inside of my vaginal lips). Itching on my lower back, behind my knees, inner thighs, and scalp. I have also had a sore throat and swollen neck glands almost every other week. I have also had a sore lower back and aching in my right thigh (at one point it was painful to the touch). I have a pea sized swollen lymph node in my groin that my doctor said was just a "shoddy" lymph node. In the past couple days i found two tiny paper cut like sores in the crease between my labia minora and labia majora. And overall I always seem to have some genital itch going on.

Herpes blood test at 6 weeks negative for 1 and 2.

1. Do you think the original infection was due to a group a strep vaginal infection or due to herpes? I'm very skeptical because group a strep vaginal infections are very rare.

2. Do the symptoms I've described sound like herpes symptoms?

3. Do the two paper cut like sores sound like herpes sores or do you think I caused them from itching and "searching" in that area. (They bled and closed up in two days).

4. Finally, when should I be tested for herpes again so I can be certain I do or don't have it?
239123_tn?1267651214
Welcome to the forum.  Thanks for your question.  The bottom line is good news:  no herpes.

The main streptococcus found in the genital area is Group B, which causes few if any symptoms in women; it's primarily a problem if transmitted to a baby during delivery.  Group A strep is not common in the vagina; it is primarily a bacteria that causes throat infections ("strep throat") or skin infections (impetigo, cellulitis, folliculitis, and other forms of "pyoderma").  But when present in the vagina, it typicall causes the same symptoms as elsewhere on the skin -- i.e. exactly the sort of symptoms you had.  Initial herpes, on the other hand, usually causes blisters and open sores.  In addition, strep infections are often slow to heal; it is common for symptoms to take a few weeks to clear up entirely, even after effective antibiotic treatment, such as with penicillin.

Also, the large majority of people with new genital HSV infections would have positive blood test results by 6 weeks -- so your negative blood test result is additional evidence against herpes.  To your specific questions:

1) As noted above, I agree vaginal group A strep infections are rare. But rare things happen; and your positive strep culture is definitive proof you did indeed have that infection.

2,3) There certainly is overlap in the kinds of symptoms the two conditions can cause.  However, as discussed, your symptoms were more typical for a streptococcal skin infection than for herpes. Linear lesions (like paper cuts) certainly can occur with strep and this doesn't increase my suspicion of herpes.

4) If you remain concerned, have another HSV blood test at 16 weeks (4 months). I'm confident it will remain negative.

I hope this has helped.  Best wishes--  HHH, MD
6 Comments
Blank
Avatar_n_tn
Thank you for your quick reply. Just several follow up questions:

So even though it's been 2 months and I'm still having itching down there you don't think it's anything to do with herpes? Do you think my hormones might just be out of whack since having the Strep A infection causing the continual discomfort?

Also do you think the swollen neck glands are coincidental? It is winter and I suppose I could just be getting colds.

Also just for my piece of mind it would be pretty unlikely I would catch it from my sexual encounter anyway correct?

Your advice/responses are extremely appreciated.


Blank
239123_tn?1267651214
Herpes doesn't cause itching without visible sores, and herpes outbreaks never last 3 months; 3 weeks is about he maximum.  The most common cause of persistent genital itching in women is yeast infection.  I'm not a gynecologist, but I doubt it is anything like "hormones out of whack".  I would advise you to return to your doctor or clinic and get it checked out; or perhaps try one of the over-the-counter vaginal yeast treatments, then get professionally evaluated if that doesn't clear it up in a few days.

I can't link any of this with inflamed lymph nodes in the neck.  That's also something to be checked professionally if it persists.

It is conceivable that strep could be transmitted if your partner happened to be colonized with it in his genital area.  But most likely this is all just coincidental with that sexual exposure.
Blank
Avatar_n_tn
Thank you for your help.
Blank
Avatar_n_tn
Hi Doctor,

I have one follow up question if you would be willing to answer it.

All of my vaginal itching has subsided for the time being but for the past week I have had a burning/stinging/raw feeling in/around my anus and it is red at the opening. There have been no noticeable sores, bumps, or lesions and it does not hurt to go to the bathroom. I also have several swollen lymph nodes in my right groin.

I'm wondering (1) does this sound like a herpes outbreak? And (2) does a herpes outbreak ever cause a burning feeling in/around the anus without sores appearing and last for a week?

Thank you.
Blank
239123_tn?1267651214
Perianal itching is among the most common of all symptoms; it is experienced by all humans at one time or another.  The main cause is idiopathic (cause unknown) irritation, called pruritus ani (which doesn't really help much -- it's just Latin for itchy anus).  Yeast infections and any number of other minor superficial infections also can cause it.  Herpes is a rare cause, and would not happen without visible open sores.  Further, given all we have discussed about your situation, herpes is even less likely in you than in most people.

For garden variety pruritus any, treatment 3 times a day with a small dab of an over-the-counter steroid cream (e.g., 1% hydrocortisone) usually works wonders, so you might give it a try.  If this doesn't clear it up, you'll need to see your doctor for professional assessment and advice.  But you really needn't worry at all about herpes.

That should end this thread.  Take care.
Blank
Continue discussion Blank
This Forum's Experts
239123_tn?1267651214
H. Hunter Handsfield, M.D.Blank
University of Washington
Seattle, WA
300980_tn?1194933000
Edward W Hook, MDBlank
University of Alabama at Birmingham
,
MedHelp Health Answers
Blank
Weight Tracker
Weight Tracker
Start Tracking Now
RSS Expert Activity
242532_tn?1269553979
Blank
Emotional Eating Control: How to St...
Aug 28 by Roger Gould, M.D.Blank
233488_tn?1310696703
Blank
New Cannabis Article from NORTH Mag...
Jul 20 by John C Hagan III, MD, FACS, FAAOBlank
242532_tn?1269553979
Blank
3 Reasons Why You are Still Binge E...
Jul 14 by Roger Gould, M.D.Blank