Urthral Herpes Help!

[lost344]

I am a 26 year old male who had a drunken somewhat protected encounter with a 21 year old black woman everything else un known. The reason I say somewhat protected is because we took a breather and i desided to re-use a condom and may have possibly put it on inside out. A few days later I started to notice a very noticable but not EXTREMELY painful "as seems to be the norm with urethral herpes"-constant pain/burning in my penus and the head was sensitave to the touch of clothing if i applied preasure to the metus I would get a slight paining feeling that I can not re create now, a week later it had not gone away and I wouldnt say it was more painful when urinating but noticable with increased sensitivity at the opening slightly red, I went to the doc they did a urine test and said that I had WBC and was spilling protein in my urine and he gave me amoxicillin for a uti, took that for one week 850mg 2 times for 12 days, no change. I went back the following week and got a std test done clap, gon, "swab" hiv and herp type specific "Blood". All negative, to early for HSV i know, they gave me Zpak and a single pill for gon not sure what it was, still no change. Went back the following week and they gave me doxy for one week, same results none, some days it was better than others. The next week I went to the urologist he said my prostate was inflamed which I think is BS gave me cipro this was about 4 or 5 weeks into it, went back at week 6 and did an additional test for HSV-Negative I forgot to say type 2 neg type 1 pos on both prob a cold sore in my childhood is what my doc said. At this point the pain has subsided but I have kinda of a dull pain in my pubic area right beside my shaft not sure if it's my Lymph Node or not but from what I can tell on line Lymphs are more in the groin area not the pubic area, never the less no swelling bumps or knots that i can find and this is happening weeks after the fact.

[Edward W Hook, MD]

Sorry, this is not a debate.  You asked my opinion and I outlined my opinion and the reasons for my reasoning.  the absence of lesions and the duration of symptoms being among them, all of which are supported by your negative test at a time when the majority of persons with recently acquired tests would be positive.  

My answers do not change.  I do not think you got HSV from the encounter you describe.  I would suggest you let this go (again)  EWH

[lost344]

Doc I just made contact with the girl that I had the encounter with. She is telling me that a week or so before we met that she was diagnosed with Bacterial Vaginosis and has had yeast infections in the past... She is telling me that she had vaginal itching and discharge! Now I am really freeked out that she had herpes and was miss diagnosed... Im not second guessing you here but could you please tell me why you think my penile pain, loss of appitite, fatigue, pain with urination that started days after my encounter and that did not respond to meds or show up in any test is not consistant with herpes despite not having any overt external lesions? From what I have read the onset of the symptoms is about right and the duration of the symptoms is close 4 to 5 weeks. O yeah and the lymph node pain that started at about week 4 and is still kinda bothersom now.

Please dont think that I am second guessing you here Im not sure what I would do without you and this forum... As for a 3 month test would you recomend not having sex with my wife until I get those results or would you say that I should go with my 6 week test and let it go.  

[Edward W Hook, MD]

Welcome to the Forum.  Your post is a bit hard to follow but it sounds as though you had severe urethritis (pain in the urethra) following the sexual encounter you describe over 6 weeks ago and that your discomfort, while improved (not clear  how much) has been there since that time.  Urethritis can cause the pain and discomfort on urination you describe.  In contrast, as You know to have HSV without lesions would be most unusual.

There is little in the description you provide to suggest that your problem is HSV.  You did not have lesions (the inflammation at the tip could well be urethritis I mentioned) and your test is negative at 6 weeks.  

If the discomfort persists and has been there throughout, this too is not at all suggestive of HSV or, for that matter, other STDs. EWH

[Edward W Hook, MD]

Last answer to this thread.  Believe your tests.  There is no evidence that you have genital HSV.  You really should look for another cause of your discomfort.  

This thread is now over.  EWH

[lost344]

Dr. Hook,

I just wanted to follow up with some symptoms that have returned. At my 3 month mark I took an additional blood test and the results were the same HSV Type II Negative. The problem that I am dealing with now is about two weeks after that test my symptoms returned, very mild urethral pain and raw irritated feeling and faint redness at urethral opening this lasted less than two weeks, still never any lesions or anything like that. My question is: how much should I rely on my 3 month test? I read that Igg type specific blood work at 3 months should be around 97% accurate, anything to add to that? I was completely past all of this until this last little bout; I would really appreciate your opinion on this again
Thanks again,

[Edward W Hook, MD]

Really stuck on this, aren't you. M. genitalium and/or ureaplama MAY be a cause of urethritis.  When present (testing cannot be done with reliablity at the present time except in research labs) it is treated using the same medications as used to treat NGU which you have received.

Since you are having trouble letting this go, I must help.  Please, no further "what if...." or "could this be..." questions.  If posted they will deleted without comment.  EWH

[lost344]

Dr.Edward,
What are your thoughts/experiences with mycoplasma genitalium or ureaplasma?  Would this fit the picture with the symptoms that I have presented more so than HSV?

Thanks again,

[Edward W Hook, MD]

Thanks for summarizing your earlier post. this confirms my impression.  The symptoms you describe are not consistent with herpes or any other STD.   Not sure what might be causing them but it is not an STD.  Prostatitis might.  EWH

[lost344]

Sorry I tent to ramble on
Here we go...

Week 1- Noticable pain inside tip of penus approx where the metus joins the shaft.
Week 2- WBC and Protein in urine treated for UTU with Amox- No help...
Week 3- Pain inside of Urethra and Tip, pain elevated slightly with urination. Went to the    Doc and was tested and treated for STD's.
Week 4- Pain still the same, Test results Negative Re-Treated with Doxy.
Week 5- Urologist told me I had enflamed prostate and gave me cipro that I didnt take. Pain was decreasing
Week 6- Pain subsided and re-took IGG- Results still negative...

The pain started a few days after sexual encounter mentioned, loss of appetite, feeling of fatigue, currently feeling pelvic pain maybe related to lymph nodes but I'm not sure. All penus and urethral pain is gone. Never any lesions or discharge, there was also never any detectable bactera in urine.

Could you also tell me what you think the chances of contracting HSV with the type of exposure that I had would be?  Thanks Doc

[lost344]

A few more things that may be of some help...
There were never any lesions just a little sensitivity at the opening my urethra was also kinda painful when urinating on a scale of 1-10 I would give it a 3, From the swab not sure. I have never had any issues like this before and I don't think it just happened to happen days after this encounter I had. I also have not had much of an appetite which in turne lead to a little fatigue but stress really messes me up and the lack of appetite has hung on so I feel that stress in to blame. Very scared here! Im still 5 weeks out till my 3 month mark and I dont know if I will make it that long. Would HSV cause these symptoms without lesions? I have read in one of Dr E's post that he has NEVER seen a initial urethral outbreak without external lesions. If it was in my urethra wouldn't it be VERY painful I would say that this pain is about 1/3 as painful as getting soap in your urethra. If that has never happend to you? Sorry its all I have to compare it too? Also how accurate should a 6 week test be?