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Swollen Lymph Node
Hi Doctor. I am a 26 year old male. About 10 days after receiving unprotected oral sex, I started having a burning sensation while urinating. About 4 days after that started, one lymph node on my groing became swollen and was tender for a few days. There was also a very small amount of very clear discharge. I saw a urologist and he diagnosed it as mild urethritis. He said the discharge was a result of me constantly milking the urethra. He did not give me any medication and said the symptoms would clear up on there own. The syptoms did clear up. The burning stopped very quickly. The lymph node was still swollen for a few weeks, but was only tender for a few days. I was still concerned however so I had a urine test for Ghon/Chlym which came back negative. The lymph node scared me however and I had a non specific IgM test for Herpes that came back at 110. I then had a HerpeSelect type II test which was negative. My questions are..
1) How likely is is i contacted HSV1 on my penis? The girl said she does not get cold sores, but i am not sure i trust her.
2) If I did contract it, could the lymph node and burning be the only symptom and how long would it take to have an outbreak?
Any advice? I am seeing a dermatologist tomorrow. Thanks.
1) How likely is is i contacted HSV1 on my penis? The girl said she does not get cold sores, but i am not sure i trust her.
2) If I did contract it, could the lymph node and burning be the only symptom and how long would it take to have an outbreak?
Any advice? I am seeing a dermatologist tomorrow. Thanks.
A related discussion, i'm confused was started.
Thanks for the info. First, the urolgist did check my urine and said there were no signs of infection. I do not know if that is adequate or not. Second, you wrote "It is possible you acquired genital HSV-1, but not impossible". Was that supposed to say something else? And what did you mean by the timing is OK for a herpes outbreak? I really appreciate your advice. Thank you for your help.
MEDICAL PROFESSIONAL
Yeah, I caught that typo after I posted it; sorry. I meant "It is unlikely but not impossible."
Good luck-- HHH, MD
Good luck-- HHH, MD
MEDICAL PROFESSIONAL
Several comments:
"Constantly milking the urethra" will not cause discharge. We docs typically don't like to criticize other health professionals, but here goes: most urologists are embarrassingly naive about STDs and it sounds like you found one.
You almost certainly acquired nongonococcal urethritis (NGU) from the sexual exposure you describe. The symptoms and timing are like out of a textbook.
NGU can be caused by herpes, but usually is extremely painful, not subtle. I'm glad you got the HerpeSelect blood test, but you probably need the type 1 test as well as type 2. So if your symptoms persist or recur, even though mild, have a type 1 HerpeSelect test. (As you apparently know, the IgM blood test you had for herpes is worthless, regardless of the result.)
Oral sex can lead to NGU, usually not due to chlamydia. In many (most?) such cases, it is likely that bacteria that are normal in the mouth can cause inflammation in the urethra. So you could have caught it from the episode you describe from an entirely healthy partner. As you suggest, her lack of a history of cold sores doesn't prove she doesn't have oral herpes.
The negative tests for chlamydia and gonorrhea and the fact that your discharge went away are reassuring, but not entirely so. You need another exam to check for urethral inflammation, e.g. a microscopic exam for white blood cells; or you can pee into a cup (only the first half ounce or so) and a dipstick test for leukocyte esterase can be done. Your dermatologist probably can do one test or the other. If white cells are present, and especially if the herpes work-up remains negative, you should be treated with azithromycin or doxycycline.
Now on to your specific questions:
1) It is possible you acquired genital HSV-1, but not impossible; your urethral symptoms were milder than expected but the swollen lymph note fits with that diagnosis. You should have a HerpeSelect type 1 blood test; if negative, repeat in a month.
2) As implied above, the answer to both questions is yes. The timing is OK for a herpes outbreak. If it does turn out to be herpes due to HSV-1, don't worry too much. Genital infection with HSV-1 usually doesn't recur and is not commonly transmitted by vaginal intercourse, because asymptomatic shedding is rare with genital HSV-1.
Please post a follow-up once things become clear. Feel free to print out this response and bring it along to your dermatologist. Good luck--
HHH, MD
"Constantly milking the urethra" will not cause discharge. We docs typically don't like to criticize other health professionals, but here goes: most urologists are embarrassingly naive about STDs and it sounds like you found one.
You almost certainly acquired nongonococcal urethritis (NGU) from the sexual exposure you describe. The symptoms and timing are like out of a textbook.
NGU can be caused by herpes, but usually is extremely painful, not subtle. I'm glad you got the HerpeSelect blood test, but you probably need the type 1 test as well as type 2. So if your symptoms persist or recur, even though mild, have a type 1 HerpeSelect test. (As you apparently know, the IgM blood test you had for herpes is worthless, regardless of the result.)
Oral sex can lead to NGU, usually not due to chlamydia. In many (most?) such cases, it is likely that bacteria that are normal in the mouth can cause inflammation in the urethra. So you could have caught it from the episode you describe from an entirely healthy partner. As you suggest, her lack of a history of cold sores doesn't prove she doesn't have oral herpes.
The negative tests for chlamydia and gonorrhea and the fact that your discharge went away are reassuring, but not entirely so. You need another exam to check for urethral inflammation, e.g. a microscopic exam for white blood cells; or you can pee into a cup (only the first half ounce or so) and a dipstick test for leukocyte esterase can be done. Your dermatologist probably can do one test or the other. If white cells are present, and especially if the herpes work-up remains negative, you should be treated with azithromycin or doxycycline.
Now on to your specific questions:
1) It is possible you acquired genital HSV-1, but not impossible; your urethral symptoms were milder than expected but the swollen lymph note fits with that diagnosis. You should have a HerpeSelect type 1 blood test; if negative, repeat in a month.
2) As implied above, the answer to both questions is yes. The timing is OK for a herpes outbreak. If it does turn out to be herpes due to HSV-1, don't worry too much. Genital infection with HSV-1 usually doesn't recur and is not commonly transmitted by vaginal intercourse, because asymptomatic shedding is rare with genital HSV-1.
Please post a follow-up once things become clear. Feel free to print out this response and bring it along to your dermatologist. Good luck--
HHH, MD
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
