Possible herpes symptoms, please help.....

[ghghgh]

I had a questionable sexual encounter after having way too much to drink. I really don't remember if any protection was used at all. About 6 days afterwards, I started having a severe burning sensation when urinating. 11 days after the encounter, I was tested for HIV, chla, gonn, syph, and HSV I and II. All came back negative.

I had HSV I/II igG and HSV igM I/II combination done and it was all negative. That day I went to a minor emergency clinic and told the doctor what happened. He did a visual inspection and put me on metronidazole for 7 days. I'm on day 2 right now. He thought it was possibly trich, but didn't test for it. He took a urine sample and came right back and said it wasnt a urinary tract infection.  

I've been freaking out ever since. When I went to the doctor, I showed him what I thought was a red spot on the shaft of my penis, which he thought was just dry skin and has since gone away. Now I think I've found another red spot....it looks red and may have a tiny white pimple, but sometimes I look at it and just think I'm making the whole thing up and seeing things. I also am having a very mild case of chafing/jock itch on my left side where my thigh meets my crotch...it's more thigh than crotch, but there nontheless. Sometimes I can feel it, sometimes not. There is no rash in the area, it's not red at all.

The burning has pretty much subsided for the most part, although I do feel a little discomfort occasionally once a day, usually first thing in the morning. It's nothing like when it first started.

I cant think about anything other than this...Words cannot describe how stressed out I am. I've just been walking around in a daze for the last week.

How concerned should I be? It's now been 15 days since the encounter.  Can I take any comfort in the HSV testing?  Wouldn't a false postive for iGm be more likely than an false negative?

Please help me, I feel like I'm having a nervous breakdown.

[H. Hunter Handsfield, M.D.]

You were right to worry about STD when your symptoms begain.  However, most STDs that cause urethral pain with urinating also cause overt, visible discharge; or, in the case of herpes, blister-like sores that then turn into opens sores or scab-covered lesions.  However, the evidence of hte negative tests is more important and undoubtedly more accurate than your symptoms.  From your description, I gather that the painful urination is subsiding.

More to the point of your question, the red spots you describe clearly are not herpes; if you're not even sure it is abnormal (you can see it one time and not the next) almost surely it is in fact totally normal.  None of your other symptoms suggests STD, and as I have said innumerable times, when a person suspects his or her symptoms are due mostly to stress or other emotional factors, s/he probably is almost always right.  For more discussion about that, and about exactly the sort of symptoms you describe, see the following recent threads:  

http://www.medhelp.org/forums/STD/messages/4191.html
http://www.medhelp.org/forums/STD/messages/4153.html

The HSV IgG tests show you were not infected in the past, but it takes up to 3 months for HSV tests to become positive.  So conceivably you could have caught herpes that would only show up on a  later blood test.  Don't get me wrong:  I definitely do not think that explains your symptoms.  But if you remain nervous about herpes, you could be retested 3 months after the event.  If you do that, be sure your doctor does the right kind of test:  tell your doctor you refuse to allow the IgM test; and make sure the IgG test is a reliable one, such as HerpeSelect.  For more on this, search the threads of this forum for 'herpes diagnosis', 'HerpeSelect', and/or 'IgM'.

Bottom line:  Neither herpes nor any other STD explains your symptoms.  But follow up with your provider if they persist or you remain concerned.  

Good luck---  HHH, MD

[ghghgh]

Thanks for your answer.  One follow up question:

After masturbating, the area I thought might be red with a tiny pimple on the shaft of my penis now clearly looks the part.  It's just below the head.

It's a small red circle with two tiny red bumps in the middle.  What could this be?  Would an initial herpes outbreak become more visible immediately after masterbating (masturbating)?

Also regarding the igm test, I see how it's unreliable reporting a false positive since it could be many other things, but it seems like a negative test shortly after exposure (8-10 days) would indicate no herpes.  Am I wrong?

[H. Hunter Handsfield, M.D.]

No, herpes would not vary with stimulation from masturbating.  And if it were herpes, you wouldn't be rubbing it; too painful. Most likely some minor (normal) variation in the skin of your penis. Forget about it; or see a provider if you are still unsure.

Yes, you are wrong about IgM.  Not only does it give false positives; it also is often negative in early herpes.

Herpes is not the cause of any of your symptom, initially or now.  That's my last comment.

[sm007h]

Is the fact you wrote above, that herpes would be too painful to masterbate with, applicable to all ob's: primary and recurrent? Because I am still seeing various doctors until one can determine what I have, but in the meantime the bumps or blisters that I have only itched, and were never painful.

Even when I was just soaping up the worst I did was alleviate some of the itchiness, never caused myself pain. I could easily masturbate with this condition. There doesn't seem to be *any* consistent pattern of symptoms that any herpes information attributes to an outbreak--other than it can be one or many from a list and sometimes not even any of them?

[seanj]

A related discussion, Herpes Questions was started.