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STDs (Expert Forum)
STD??? I am officially scared!
Answered by
University of Washington
Seattle - WA
Welcome to the STD Forum, which is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.
STD??? I am officially scared!
by nervousstomach, Jun 16, 2007 12:00AM
9/06, I receive unprotected oral sex and condom vaginal sex from escort 3 occasions. I get a tingle when I pee. Zovirax 10 days. Pain terrible but no sores on penis-Penis hole red - no lesions. Also, no discharge from penis. 3 dys later pink eye. Worrying = terrible ulcer. 4 wks later blood work(to check for Hep A&B, liver probs)and H-pylori test. H-pylori positive- 12/06-I develop a circular red spot on chest that looks like hickey no raising to it. Red spot will fade but then it will be bright red again. 6/07-I get the red spot after shaving near it. I go see doc to have her look at it.Diagnoses it as a fungus. Get 2nd opinion and says eczema. Still flat and red looks like bruise. This week - tingle down on penis. Red ulcer sore under head of my penis. Hurts little bit not like cold sore on lip. I take meds to control HSV-1 for sores on lip. I go see doc nxt day. She says: 1)Herpes 2)Syphilis 3)Staph infection- She cultures it and blood work for HIV which freaks me out! She said HIV could cause sore on penis. This morn eye was crusted up again. Blood taken 3 times last 18 months= 11/05 fine. Physical 3/06-Normal. 10/06- Hepatitis, H-pylori, etc. Normal. Wife has no symptoms of anything. I am so freaked out that I got HIV w/escorts. Is that possible from oral sex? Syphilis? Possible that I didn't get a sore until 9 months later. Possibly sore was in my penis which caused urinating pain. HSV-2 from oral sex? Red spot?Conjunctivitis?
Doctor's Answer
by H. Hunter Handsfield, M.D., Jun 16, 2007 12:00AM
, Jun 16, 2007 12:00AM
You clearly have more that one problem going on; no single diagnosis is likely to explain everything. Probably you have no traditional STD.
The first problem likely started as nongonococcal urethritis (NGU) due to adenovirus. Adenovirus causes a few percent of NGU cases. It is primarily a respiratory virus and therefore genital infection is acquired primarily by oral sex. In addition to NGU if it gets in the penis, adenovirus commonly causes various combinations of sore throat, other cold symptoms, and--ta daa!--conunctivitis. There is no treatment for adenovirus infections, but they clear up completely on their own.
But that might not have been the only problem. Certainly the occurrence of a genital ulcer is consistent with herpes, but that's not likely given the Zovirax treatment, which would have cleared things up right away. I cannot comment on your doc's thoughts about eczema, but any dermatologic problem can sometimes involve the penis: lichen planus, psoriasis, allergic reactions, eczema, etc. The circular-pattern skin rash on your chest lesions suggests the possibility of erythema multiforme, which can be associated with genital ulceration--which together is called Stevens Johnson syndrome. EM and SJS are immunologic reactions, not an infection. They can be triggered by HSV infections (oral or genital, either HSV-1 or HSV-2), but also by any number of other viral infections (and maybe adenovirus--I'm not sure). Or some other, similar condition.
I cannot completely rule out syphilis, because it can mimic so many other medical conditions. The odds are nearly zero based on your exposure history and the timing of symptoms, but it's easy to do a blood test if not yet done. There is absolutely nothing in your symptoms that suggests HIV, and your risk for that was truly zero or close to it; although controversial, there are no clearly proved cases of catching HIV by receiving oral sex, and HIV is rare in escorts (as opposed to street hookers).
The bottom line is that almost certainly you do not have an STD, and likely you no longer have anything else that can be transmitted to anyone, sexually or otherwise--which is consistent with your wife's continuing health. Your story suggests your doctor is pretty good, testing for all the right things, etc. If she hasn't raised the issue of EM, SJC, adenovirus etc, you might ask her about it. If in doubt, a consultation by a dermatologist might be in order.
Good luck-- HHH, MD
The first problem likely started as nongonococcal urethritis (NGU) due to adenovirus. Adenovirus causes a few percent of NGU cases. It is primarily a respiratory virus and therefore genital infection is acquired primarily by oral sex. In addition to NGU if it gets in the penis, adenovirus commonly causes various combinations of sore throat, other cold symptoms, and--ta daa!--conunctivitis. There is no treatment for adenovirus infections, but they clear up completely on their own.
But that might not have been the only problem. Certainly the occurrence of a genital ulcer is consistent with herpes, but that's not likely given the Zovirax treatment, which would have cleared things up right away. I cannot comment on your doc's thoughts about eczema, but any dermatologic problem can sometimes involve the penis: lichen planus, psoriasis, allergic reactions, eczema, etc. The circular-pattern skin rash on your chest lesions suggests the possibility of erythema multiforme, which can be associated with genital ulceration--which together is called Stevens Johnson syndrome. EM and SJS are immunologic reactions, not an infection. They can be triggered by HSV infections (oral or genital, either HSV-1 or HSV-2), but also by any number of other viral infections (and maybe adenovirus--I'm not sure). Or some other, similar condition.
I cannot completely rule out syphilis, because it can mimic so many other medical conditions. The odds are nearly zero based on your exposure history and the timing of symptoms, but it's easy to do a blood test if not yet done. There is absolutely nothing in your symptoms that suggests HIV, and your risk for that was truly zero or close to it; although controversial, there are no clearly proved cases of catching HIV by receiving oral sex, and HIV is rare in escorts (as opposed to street hookers).
The bottom line is that almost certainly you do not have an STD, and likely you no longer have anything else that can be transmitted to anyone, sexually or otherwise--which is consistent with your wife's continuing health. Your story suggests your doctor is pretty good, testing for all the right things, etc. If she hasn't raised the issue of EM, SJC, adenovirus etc, you might ask her about it. If in doubt, a consultation by a dermatologist might be in order.
Good luck-- HHH, MD
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09/06 - buring sensation in urethra. Feels like needles. As bad as anything I have EVER felt.
09/06 - comjunctivitis in both eyes
10/06 - 25 to 30 days after escort experiences. Have blood work done. Turns up nothing. Get H-pylori test and H-pylori positive. Take all meds and feel much better.
12/06 - get 1 red circular spot (size of a quarter - looks like a hickey) on upper chest after trimming chest hair back and shaving at the top of clavicle area. Redness appears to fade over a week. But gets very red when irritated like re-shaving area.
06/07 - red spot on CHEST still there in same spot. First doctor says fungus. Next doctor, a dermotologist, says eczema.
06/07 - Taking acyclovir on a fairly regular basis. However, over past 3 weeks or so I try not to take it just to clean system out.
06/07 - Feel tingle in groin area. Pull underwear back to see 1 red lesion on underside of penis head. Take an 800 mg. tablet of Acyclovir. Sore has some pus to it but I have been taking 800 mg of Acyclovir for sore for about 4 days now. Sore is not as red and irritated but has not formed a scab yet.
06/07 - Conjunctivitis in eye again.
Hopefully...this gives you timelines better and helps you follow better than my run-on sentence last posting. Thanks in advance.
I got all my tests back and EVERYTHING was negative - herpes 1/2,syphillis, HIV, etc. The only thing that came back positive was a Enterococcus bacterial infection which is what the doctor said caused the ulcer. He put me on 10 days - 2 x a day of amoxicillin,
Thanks for everything.
The internet is a wonderful place but boy did all of the surfing around on the net about this give me an ulcer. ughhh. Glad everything turned out the way it did.