Dr. thanks for your response. There are a few things that I left out unintentionally. I was tested at day 3 for Chlamydia and Gonorrhea, still waiting on those test results. Planned Parenthood said with any abnormalities that I would be called in less than a week and it has been 9 days.
I did want to clarify that my incident was only oral sex (I received and did not perform on her) so should I be concerned about HSV-2? I thought HSV-2 was only passed through intercourse and not oral sex from reading your past threads? Did I misunderstand something?
Also, if my tests all come back negative for chlamydia and gonorrhea, should I suspect being positive for genital herpes? Lastly, if I do have genital herpes, would the sores be any deeper than just inside my urethra?
Thanks for your help, it's been most appreciated!
Your sore throat probably is just a cold. I can't really say anything about the penile lesion. Herpes can cause single lesions as well as clusters, so it may be a possibility. What did the doctor who examined you say about it? His or her opinion is more valid than mine can be with just a verbal description.
HHH, MD
Doctor HHH or anyone else,
Thanks for all your Advice and this is my last posting. So far my tests have come back negative for gonorrhea, chlamydia, hep, HIV, and syphillis.
Here is the update to my initial situation:
1. On Day 13, I woke up with a single red spot with a tiny gray head on the underside midline of my penis. The doctor cultured it, and all that remains today, day 16, is a small scab from the surgical blade. I have also had a herpeselect test ordered.
2. Day 14, the pain while urinating has gone away
3. On 14, I got a sore throat and it has persisted through Day 16. It hurts to swallow and seems to be only on the left side.
All of this being said, do you suspect that it was genital herpes causing the burning based on the fact that all other STD's have been ruled out. I know that typcially herpes comes in clusters, could a single bump be an exception to the rule and does that make you believe I have HSV-1 Genitally? Are there any other possibilities besides STD's causing these symptoms?
Thanks for all of your help,
CBoarder
Sorry, I missed the fact that your exposure was oral. Chlamydia is zero risk (no case ever shown transmitted to the urethra by oral sex), gonorrhea and herpes very low risk. You're right, HSV-2 is not an issue, and HSV-1 probably not either. As I said above, "Given the absense of herpes lesions, on balance it is unlikely you have herpes; urethritis alone is an unusual presentation." Also, internal herpes lesions typically are excrutiating--some men describe it as the worst pain they have ever experienced. And more diffuse discomfort ("muscle aching" etc) is not a symptom of herpes or any other STD.
HHH, MD
Almost certainly you did not have a garden-variety UTI, which would be rare in a generally healthy younger man without a preexisting urinary tract abnormality. Clearly you had sexually acquired urethritis, i.e. gonorrhea, chlamydia, nonchlamydia nongonococcal urethritis (NGU), or perhaps herpes. Since you don't mention it, I gather your doc didn't test you for STDs. S/He should have done that. But if not, you'll probably never know for sure. If you know how to contact your partner that night, you should tell her about your problem and encourage her to get examined and treated.
The relative severity of the pain you describe is more suggestive of gonorrhea or herpes than NGU or chlamydia. Tequin and the other antibiotics would take care of all these except herpes, so the improvement makes herpes less likely. But these are only probabilities, not proof one way or the other. So to answer your specific questions:
1) Yes, your symptoms could be due to herpes (not necessarily HSV-1, could be HSV-2). But no way to be sure, at least not yet; see above.
2) See above; if you had NGU, chlamydia, or gonorrhea, they're gone now given the treatments you had. But symptoms can take a while to clear up completely.
3) Your doc is right about HerpeSelect not being "accurate" only if s/he says so because 12 days indeed is too soon. But even that can be useful; if negative now and becoming positive in a few weeks, that would confirm a diagnosis of HSV-1 or HSV-2. In other words, you could be tested now with a repeat in 12 weeks; that would be the best way to nail down a new HSV diagnosis for certain. If you are tested only at 12 weeks and positive for either virus, you won't know for sure when you were infected.
4) Given the absense of herpes lesions, on balance it is unlikely you have herpes; urethritis alone is an unusual presentation. Most likely, therefore, it is safe now to have unprotected sex with your new partner. But for more certain protection, wait until your herpes test after 12 weeks.
Good luck-- HHH, MD