Herpes?

[tmac1421]

Situation,

Unprotected vaginal for approx 2 mins with girl from Holland while on vacation.

Symptoms
-Discomfort in groin a few days later. Yeast/candida perhaps?
-Red bump/blister high on pubic area, disappeared after 1 day.
-Large white bump grew on side of penis after shaving, as well as many fordyce spots.  White bump confirmed as wart and frozen.
-2 months later, tingling sensation in pubic area (prodome?), so shaved the area.  Broke out into many sores in pubic area that sent me to doctor very worried over herpes and over the next 2 weeks had alot of tingling in the groin area, but not pain as I would expect in primary herpes outbreak.  Doc said sores looked like folliculitus (folliculitis), but I had never seen them before.
Also in 2 week period, single red blister grew on base, which was cultured, along with a dry sore in the pubic area.  Came back negative.  The blister was gone in 2 days with no scabbing, but did hurt slightly.
4 months later, large sore on right butt cheek, could not get cultured.  3 weeks since there is still a sign of it.  Showed to my doctor who said it did not look bad but if it happens again, get it cultured.  Had pimples on other butt cheek as well.

So, I am not 100% convinced I don't have herpes, and being in Canada, I don't think Herpeselect tests are available.  Any insight as to what it might be?

[H. Hunter Handsfield, M.D.]

Sounds more like folliculitis than herpes.  My understanding is that the HerpeSelect test is available in Canada.  Not recommended by most public health authorities there (don't get me started), and because they have influenced overall perceptions, many providers probably wrongly believe the test isn't clinically useful, so there may not be much demand.  As a result, probably not all labs offer it.  But at least some commercial labs probably do so and I'm pretty sure HerpeSelect can be ordered by private providers.

So there are 3 options.

First, simple clinical observation:  if you continue to get recurrences, and if each of those is a) in more or less the same area (within an inch or so) and b) the outbreaks are always limited to one side of the body, i.e. not lesions on both sides of the body midline:  then herpes is likely.  Any other pattern of recurrence is unlikely to be herpes.

Second, if/when you get recurrence of pubic area lesion(s), see a health care provider immediately, within 1-2 days, and ask for a culture for HSV.  If positive, the diagnosis of herpes will be nailed.

Third, have a blood test, as discussed above.  If you can't find a provider to order the test, and if you live fairly near the US border (as do 80-90% of all your fellow citizens), come on down!  But from your description, my bet is that you don't have genital herpes, which typically causes typical lesions on the penis; outbreaks of herpes in the pubic area are uncommon.

Best wishes--  HHH, MD

[tmac1421]

tested negative for clam, gon 1 week post exposure.  HIV and Syp 16 weeks post exposure.

[H. Hunter Handsfield, M.D.]

I missed the comment about the buttock lesion.  Having recurrences in 2 different areas (pubic, buttock) is strong evidence that not both of them are herpes.  Presumably one could be herpes and the other not.  But it sounds more likely that you are a skin carrier of staph or strep that is periodically causing folliculitis or other superficial infections. This scenario is supported by the possiblity that superficial trauma (shaving) might have triggered the problem at least one of the times.

[tmac1421]

One question regarding a culture.  My doc used the same swab to touch the fresh blister and 1 week old pubic lesion, would this effect the validity of the test?

Thank you.

[tmac1421]

This has crossed my mind too, both times I broke out (penis, pubic area) was directly after shaving.  But I have shaven my pubic area for years now and have never seen anything like this.  Does the sexual encounter have anything to do with it?

[H. Hunter Handsfield, M.D.]

Testing 2 or more lesions with the same swab is OK; neither will affect the result of the other.

I think your sexual encounter is entirely unrelated to any of this, assuming you don't have herpes.

[tmac1421]

What would your advice be regarding staph or strep?  Should I try to get a blood test first and rule out herpes and then explore the possiblity of staph/strep?

[H. Hunter Handsfield, M.D.]

There's probably nothing ti di about it.  We all carry staph or strep from time to time.  If that's the problem, most likely you'll just stop having localized infections over time.  If it happens more than 1-2 more times, ask your provider about whether you need to be tested for staph/strep carriage and perhaps treated for it.

Herpes testing is up to you.

[tmac1421]

Thanks for the advice, I think i'll wait it out and see if I get another sore in the next month or so, it's been a tough 5 months not knowing what if anything is wrong.

I said earlier I was tested for HIV at the 16 week mark.  I'm going to test again at 24 weeks just to be safe, but should this be a worry with modern testing that I was a negative at 16 weeks?  I'm hoping my Province has up to date HIV tests.

[H. Hunter Handsfield, M.D.]

Six weeks is long enough with modern HIV tests.  Even 16 weeks is overkill.  There is no point in testing again at 24 weeks.  Proper, modern HIV tests are used nationwide in Canada.  Anyway, even with the tests in use 10 years ago, there was no need to test later than 12 weeks.

[tmac1421]

I appreciate all your advice, excellent service this site provides.

[tmac1421]

Sorry Doctor, one more question.  What other than herpes could cause the single blister on the penis?  I was examining it an obsessive number of times due to stress, but could that be the reason?

[H. Hunter Handsfield, M.D.]

A pimple, folliculits, whatever. Not stress.

This thread is closed.