I had unprotected sex with my ex-girlfriend one time. Next day she complained of pain when urinating and a rash. Her doctor diagnosed yeast infection and UTI. Two weeks later I had a painless black dry ulcer on the bottom of my penis shaft where it touches the testis. I went to a urologist. he said he couldn't do anything as it was healing (although 1st day I noticed) and ordered Elisa IGG test (neg for HSV1&2). Next day I had red painless bumps next to the ulcer. Went to a derm who diagnosed yeast infection and intertrigo. He gave diflucan which caused my testis/penis to become red and inflamed with shooting pains down my thighs and sensitivity. Week later redness and pain in the groin went away but the bumps lasted 3 months. The derm biopsied a bump and came back as psoriaform dermatitis. He ordered a Herpesselect IGG test at my urging at 11.5 weeks from exposure. Neg (.5) HSV1 and Neg (<.2) HSV2. He said its definitive and to stop obsessing. I went to my PCP who said that two IGG blood tests in 3 months, plus the biopsy was enough and definitive and I'm "losing it". I was ready to put this all behind me until I woke up to lower back pain (never had before) and pins and needles from buttocks to feet especially in the thighs and calves. Next day I felt exhausted and had a slight burning on my penis. A few hours later, the burning spot turned bright red. I went to different derm and when i got there two hours later the red was gone. He looked at my penis under a microscope and saw nothing. He looked at my 11 week test and complete chart and said, you are losing your mind and dont' have herpes. I then called my PCP and he told me I am being irrational. I saw the red burning spots even though they were gone two hours later. Felt 100% next day. I know 11 weeks is long enough for seroconvert but not 100%. I know the odds of 1 encounter is very low. I have never had a classical presentation. I don't know what to do.
Either your PCP is quite undiplomatic in his terminology, or you are interpreting his comments with your own spin. However, in essence I agree with him. While I wouldn't use the terms "losing it" or "irrational", I believe you are overreacting and can pretty much discount any chance you have genital herpes. The scientific evidence against it is quite conclusive.
First, your partner's symptoms are irrelevant. Her symptoms are typical for a UTI and/or yeast infection, and started too soon to be due to any STD from a sexual exposure less than 24 hr earlier.
Second, in regard to your "genital ulcer": your description is not typical for herpes, and your blood test results show you don't have HSV. You may be overly focused on the true fact that herpes is a common cause of genital ulcer. But it isn't the only cause, and the evidence is strong that it isn't herpes in you.
Third, your later symptoms are not compatible with herpes, which is not a cause of back pain or the "pins and needles" sensation you describe. (You may have read about herpes causing neuropathy with such symptoms. But that is only with recurrent herpes, not the initial infection.) And herpes does not cause a "red spot" or other skin irritation that clears up in a matter of hours. Once herpes starts to cause a skin lesion, the skin will not appear normal for at least a week, often 2 weeks or longer. And the other symptoms clearing up a day later also is incompatible with herpes as the cause.
As for your closing comment, "I don't know what to do": This is pretty easy. What you should do is suck it up, forget herpes, and move on with your life. Whatever the cause of your various symptoms, it wasn't herpes. No further testing is necessary.
Dr Handsfield. Thank you so much for your response. I have great respect for you and your work. My PCP was a little blunt but what I left out is how frantic I've been over this. I went to a urologist, 4 different dermatologists, my pcp and a neurologist with over 15 apps in the last few months. They are all "top docs" in NYC. I wanted to believe them but my body is just telling me otherwise. Those red bumps that came after the ulcer lasted months and months. I thought the red bumps were the first OB and the back pain and pins and needles was a recurrent. The first doctor i saw who i didnt know (but was able to see me immediately) injected my penis with kenalog without telling me what he was doing and have atrophy and neuropathy from this. My pcp and neurologist believe this may have even caused the bumps and flare ups. So for 5 months now ive had continuous skin and nerve damge that has put me over the edge. This situation ruined my relationship with my ex as I constantly accused her of giving me herpes. I have spent days and days on the Internet researching my symptoms and I always see herpes as a cause, never an injection. I have driven my drs insane with my insanity. I have never been like this in my life but my docs have only been able to speculate. The injection seems like an easy cause but I felt it was also an easy scapegoat. 5 months of constant burning coupled with the initial ulcer, the red bumps for months, the unprotected sexual encounter, and everything else and I'm completely gone. My docs have been dismissive at this point. I just want to move on with my life but every night I go to sleep and expect to wake up with a true outbreak. I'm so sorry for laying all this out but I've felt very much alone through this. I was premed and after all my research a dr friend accused me of having "medical student syndrome". Thank you for your time. It is much appreciated and I will certainly respect your advice. JJ
Having seen all those highly qualified physicians, I don't know what additional expectations you had from a forum like this. In any case, the additional information doesn't change my opinion or advice. You describe a rather intense psychological problem -- which is not anything I can help with. I suggest professional counseling -- and to stay off the internet. Like most anxious people, it is clear you are being drawn to information that inflames your fears and are missing the reassuring parts.
That will end this thread. Good luck with it, and best wishes for success in your medical training and career.
Thank you Dr. Handsfield. I came on this forum simply because I am well aware of yours and Dr. Hook's expertise on the subject matter and I trust your assessment implicitly. I felt that the other doctors were dismissive of my situation and symptoms. I now realize that this was not the case. Thank you very much for your time and advice. It is greatly appreciated and respected.
Dr. Handsfield, I'm sorry for posting again but I realized that when I posted to you initially, I was in a frantic and irrational state. I apologize for that. I will not post again. I just want to bring closure to this experience and if you choose to respond it would be appreciated.
It's been 5 months from exposure. My PCP and Derm won't even give me another blood test. The skin pain that has been continuous has subsided and i have not had any type of dermatologic lesion since the initial issue which was diagnosed as yeast and a kenalog reaction.
Based on my 11 week blood test results and lack of true OB, I do not believe I contracted HSV2. My fear has always been HSV1 with the "high negative" which is constantly referenced by Terri Warren. Being that my ex-gf had a genital infection for which she was treated, that would lead me to believe that whatever i got was genital to genital. I also believe that I have had cold sores in my life so another test may come up positive for HSV1 regardless further complicating the issues, but that would also mean that my odds of GHSV1 infection are further reduced. Here are the pertinent facts:
1. HSV1 from genital to genital (low risk).
2. Possible existing HSV1 oral (low risk).
3. One encounter (low risk).
4. Low risk population
5. No classical representation of herpes
6. Negative blood test at 3 weeks and 11.5 weeks.
7. Negative skin biopsy
8. Numerous qualified doctors dismissed possibility of herpes based on clinical observation.
I feel like I am now thinking clearly and believe I can put this behind me without another blood test. Would you agree? Thank you.
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