Herpes concern

About 4 days ago, I had sex with a CSW.  We used a condom for intercourse, but oral sex was given and received unprotected.  When I woke up the next day, I noticed that the tip of my penis felt sensitive.  When I looked at it, I noticed a slightly raised red spot - kind of like a pimple.  About a day later, I checked the under side of my penis and there are two clumps of reddish-brown spots (not raised) near the base.  I really never look there so I have no idea when that might have happened.  Also, I have felt a constant need to urinate since I woke up that day after sex. Yesterday I noticed two small red dots on the tip of my penis.  

There is no pain associated with any of this.  The "pimple" is not as pronounced now, though you can still see it.  It is not sensitive like it was a few days ago.  The spots on the base of the penis do not hurt or itch, and don't seem to have changed since I noticed them three days ago.  There is no burning feeling when urinating - just a constant feeling like I have to go (though this seems to be getting a bit better today).

I am generally very careful about this stuff, and actually hadn't had sex for several months prior to this (alcohol was a big contributor to this incident).  I'm now very paranoid about herpes (and hope that my paranoia might be contributing to my symptoms).  I saw a doctor today - he said the darker spots at the base of my penis don't seem like herpes, but it's hard to say.  He said the "pimple" looked more suspect.  It's strange though because I thought std symptoms wouldn't appear for at least two days, but I can't imagine what other explanation there would be.  He suggested that I get tested for herpes and chlamydia, which I'm going to do, but since I know herpes might not show up in a blood test for several months, I thought I'd ask here to see what you think.  Any thoughts would be appreciated.  Thanks.

[H. Hunter Handsfield, M.D.]

No STD, including herpes, can show up in less than 24 hours.  Two to 3 days is the minimum period before symptoms can begin.  (This applies to just about all infections, not just herpes or other STDs.)  You have done the right thing by seeing a health care provider.  From both your description and his opinion, it is very unlikely you have genital herpes; and if you do, you caught it sometime before the sexual encounter you describe.  

If the doc thinks herpes really is suspect, you don't need to wait for a blood test; the "lesion" itself (if that's what it is) can be tested.  That he didn't suggest that implies that the "lesion" in fact isn't suspicious.  If in doubt, you could get a second opinion, such as from a dermatologist or your local STD clinic.

As far as chlamydia is concerned, it's not a bad idea for all sexually active persons to be tested from time to time. But people don't catch chlamydia from oral sex (even though some outdated health education sources talk about oral sex as a risk), so if that turns up positive, it also will be from an exposure other than the CSW encounter.

Bottom line:  I see no serious concerns here about herpes or any other STD, based on the very low risk from the encounter you describe, the too-rapid onset of symptoms, and symptoms that don't sound like STD anyway.

I hope this helps.  Best wishes--  HHH, MD