General herpes inquiries...

[OnceTwice22]

I am a 23 year old male.  This past Saturday (4/22), I engaged in unprotected oral/vaginal sex with a 24 year old woman that I had met that evening.  3 days later, I noticed my lips beginning to feel kind of strange, like they were sensitive/swelling slightly.  However, my lips did not get sores on them.  This feeling has subsided as of yesterday. I had what I believe was a canker sore or two in my mouth, but they seem to have healed in about 2 days.  

Anyways, the alarming things about this encounter are as follows:
1.) As of 2 days after the encounter, my lymph nodes are very swollen in my left groin, and some on my right, as well.  Also, pain in my joints, back, and legs/thighs.  This has happened to me before after an unprotected encounter, but urethritis was deemed the culprit.  (Tested negative for all STD's (including HIV/HSV2) 3 months later.)
2.) I have a sore throat, headache in my forehead and pain around my eyes, general feeling of fatigue, cough/phlegm.  My lymph nodes are also sore/swollen in the left side of my neck, as well....but not the right side.
3.) Itching in the same areas (left groin area, base of penis, right testicle) since the encounter...no blisters or lesions (believe me, I've been looking), just itching.

I am just curious...I know the information I have here is vague, and it's obviously tough to give any kind of definitive advice via the Net, but any idea of what this could be?  

My health care provider prescribed me Cipro in case of possible UTI/gonorrhea, & Minocycline, presumably to cover any bases with chlamydia bacteria.  I have two days left on my Cipro prescription, and I feel no better.

I guess I am in fear that I contracted HSV-2 orally and genitally, and that the strange feeling on my lips and "canker sores" (if that's indeed what they were) that healed within a day or two are just the beginning.
My mouth hasn't felt intensely sore where eating/drinking was interfered with, nothing like that.  

How long do oral herpes sores take to heal, usually?  Just wondering if what I had was herpes, would the symptoms have subsided in 2-3 days like they did...  

Could this be HSV2's attempt at oral infection, but doing a poor job of it due to it's inclination to the genital area?  

Do you think there is any correlation to the sore throat/fatigue/lymph nodes swelling to a case of genital herpes that has yet to show itself, or the burning/swelling feeling I had on my lips?

On heterosexual males, are herpes outbreaks usually on the penis, or in the pubic area?  Not sure.

Is HSV1 usually a milder gential outbreak than HSV2, assuming it shows symptoms?

Also, do you feel an HSV HerpesSelect test at 3 weeks after this encounter would yield a relatively reliable result?  I know 'longer is better', but just wondering......?

I know that is a lot of questions...but, I know you are a definitive source; a lot of info on the 'Net is contradictory.  Thanks in advance.

[H. Hunter Handsfield, M.D.]

Your doc probably gave the antibiotic a try on the chance your problem was bacterial, but I never thought it was.  Your symptoms did not suggest a bacterial infection, and only bacterial infections can respond to antibiotics; and the lack of response tends to support my conclusion.  My guess is that your symptoms have nothing to do with the sexual encounter you describe, perhaps just coincidence.  Or perhaps you caught some sort of virus from her.  For example, adenovirus (a respiratory tract virus) could cause all the symptoms you describe.  Anybody close enough to have sex with someone is plenty close to catch a garden-variety respiratory virus.  But whatever is going on, almost certainly it is not an STD.

HHH, MD

[ChicShane]

abcd123 you will need to post that as a new topic for the Doctor if you would like to have it addressed.

[OnceTwice22]

Thanks, Doc.  Just wanted to clarify a few things...I think I was given Bactrim last time I had this back pain, leg pain, swollen lymph nodes in groin....it alleviated the issue in a little more than a week.  

Is Cipro a comparable alternative to Bactrim?  It hasn't done much for me, in all honesty.  

Also, in regards to oral herpes...if I was having a 'primary' outbreak, would I know it?  From my research, it looks like it wouldn't be something I was guessing about, due to a lack of clarifying symptoms.

My doctor confirmed my swollen lymph nodes in my groin, and suggested it was a response to some kind of bacteria or infection...but like you, could not make any definitive diagnosis due to no outward symptoms of STD's.

It has been about 7 days since this encounter...do you think symptoms like this would occur, and then herpes lesions would follow?  I am beginning to agree with you in regards to herpes being a stretch, due to the fact this began 2 days after the encounter, and hasn't shown any outward symptoms as of yet....besides my mouth feeling 'weird'.  

Have you ever heard of anything like this following an unprotected encounter?  I know urethritis and prostatis can cause these symptoms, but they surfaced so quickly after the encounter (along with fatigue/headache, sore throat, swollen lymph nodes in my neck), so it kind of scared me.  My doctor doesn't have much to offer in terms of advice, besides visiting a urologist.

Thanks again...I don't mean to bombard you with questions, but since this is your specialty, I figured, 'why the heck not?'  I do appreciate your assistannce.

[H. Hunter Handsfield, M.D.]

Herpes doesn't seem likely as an explanation of any of your symptoms, with the possible exception of the apparent canker sore.  Lip sensitivty and swelling, and perhas headache and phlegm, could be an allergic reaction, (lubricant, a genital hygiene product, lipstick, etc) except that a 2-3 day delay would be unlikely, so maybe allergy to something else in your environment unrelated to sex.  Genital area itching also could be allergy or some other nonspecific irritation, but not suggestive of herpes.  Self-assessment of lymph node enlargement is notoriously unreliable; I wouldn't assume your groin nodes actually are enlarged until/unless confirmed by a health professional.

There is no significant difference in severity of symptoms for genital infection cause by HSV-1 vs HSV-2.  Most outbreaks by far are on the penis; public area much less common.

You could have HSV antibody testing if you wish, but if positive for either HSV-1 or HSV-2, it would not necessarily mean herpes explains your symptoms.  The way to nail down a new infection would be to get tested ASAP, find a negative result to either virus, then get tested after 3 months and document becoming positive to one type or the other.  But herpes seems such a stretch in your case, it makes more sense to have a single test after 3 months (if you get tested at all).  In any case, a 3 week test won't be definitive either way.

You should discuss all this with your own health care provider; or if uncertain about his/her expertise, visit your local health department STD clinic or other specialist, e.g. a dermatologist.

Good luck--  HHH, MD