Yeast Infection and Possible Herpes

[fred21701]

About 2 months ago I (31-male)had an unprotected sexually encounter with a co-worker(24-female) vaginal and oral(me receiving).  About 4 days later I began to have an intense burning sensation on my scrotum accompanied by a very bright redness.  This got me all worked up so I went to see my PCP to get it looked at and to get a full STD panel.  He stated that it was Jock Itch and then prescribed me clotrimazole.  I used this for a little over two week with no results.  STD panel excluding herpes at about 4 weeks everything neg.  Now 4 weeks of non-stop burning and redness it began to spread to the shaft of my penis. I went to the local walk-in clinic, Dr. looked at it very carefully and stated that it was a yeast infection.  Prescribed Difucan and Nystatin w/triamcinolone and said to keep it dry w/ baby powder cornstarch.  After 3 days the redness and burning on my scrotum was gone and the rash that had spread to my shaft had started to fade.  After 10 days the scrotum is fine, but the rash that was on my shaft is now peeling as if the yeast has dead(die-off?) and now my body is trying to shed it.  At 2 months I asked my PCP for another HIV test and a HerpesSelect IGG to be on the safe side and for peace of mind.  What I received on my lab slip was a test for a Herpes Simplex II titer.  I have never had a cold sore or any genital blisters.  I have had some pressure in my groin, headaches, muscles aches, and I had 2 canker sores in my mouth (not at same time), but read that they are not herpes and I have had them in the past.  

My questions are

1. Could I have gotten the yeast infection from her or could it have just come from me?

2. Is the peeling on the shaft normal after a yeast infection, is this a good thing?

3. What are my chances of having HSV2?  Will the titer correctly test for it?

4. Will the 2 month mark be long enough for HSV2 to show up or should I wait a little longer?

[Edward W Hook, MD]

First a word of caution.  Testing for HSV by lower risk persons (I would consider you in this group) can open a "can of worms" by turning up long present infections.  As you consider what you will do with the information you get from being tested.

As for the peeling skin, this is part of the healing process and further treatment for the infection is really probably not needed.  On the other hand, the cream does moisturize the skin somewhat and that is probably good for the healing process.

Take care.  EWH

[fred21701]

Thanks again for your response.  I did not have enough room to explain why I would like to have the herpes test in the first post.  The reason why is that I have been in committed relationship for 6 years except for the week where I had this encounter.  I have been riddled with guilt and stress and  just wanted to be on the safe side before resuming sexual relations with my girlfriend again.  I do not believe this girl to have anything she said that she is clean, but just wanted to cover all bases.  I have not had any symptoms, but know that they can take a while to present, that being the reason for the blood test.  Final question, should I continue the topical treatment for the yeast infection until cream is gone in about a couple of days or is the peeling a result that everything is dead?  Thanks again for all your help and this post will be my last.

[Edward W Hook, MD]

From your post it was not clear as to why you wanted a herpes blood test.  There was nothing in your post to suggest herpes.

Canker sores are not herpes.

Please do not ask for an IgM test.  They do not provide useful information and are frequently misleading.  Just get the IgG for HSV-1 and HSV-1 using a reliable, type specific test such as the HerpeSelect.  EWH

[fred21701]

First let me say thanks so much for your response.  Just to clarify I have not yet had the Herpes II titer yet.  I was asking what exactly it is and if it would test for IGG or IGM.  I have not had any gential uclers or have I ever had a cold sore, but actually a canker sore between my gums and cheek.  I will be testing next week at the 2 month period.  Are you saying that this is the lesion that could present as a positive test for HSV2? I thought that canker sores in the mouth were not a result of herpes.  Thanks again for your response.

[Edward W Hook, MD]

Sounds like you were seen by a good thoughtful doctor.   Sometimes they can be a bit tough to find.  Straight to your questions:

1.  We all normally have yeast present on our skin.  Sometimes there are reasons why we get yeast (fungal infections) and sometimes they just appear for no good reasons.  Most of he reasons for getting yeast have to do with having moist areas where the fungus can grow.  Sometimes antibiotics make the appearance of a yeast infection more likely as well.  The infections (as opposed to the yeast) are more common in women than men, probably because of the moisture associated with the inside of the vagina.  Your fungal infection is not an STD and could have come from your own body or from her.  There is no way to tell.  I should add however that if you were to have sex with her again, there is no reason to think that you might get another yeast infection even if it did come from her.
2.  Yes, for the skin to peel after such an infection is not uncommon, particularly if your were irritated as sounds to be the case for you.  It is nothing to worry about and is part of the healing process.
3.  Nothing you've told me suggests HSV.  It is not clear to me that your test was a HerpeSelect however- was it?  If so, you will get a reliable answer at this time.  If it was not, the results will be less reliable.
4.  Two months should be fine in your case.  I say this because you had symptoms and irritation.  As soon as two to three weeks after lesions appeared you would expect the antibody test to be positive.

Hope these comments help.  Take care.  EWH