prodromal Symptoms

I am a male. Been in a committed and  faithful relationship for over 9 years. I had a very unfortunate indiscretion with Possible exposure 12 days ago; I was the recipient of unprotected oral sex from a woman. My pants never came off so the only area I would imagine would have exposure would be my penis.  The last 2 weeks have been horrific. I have had no symptoms other than various tingling sensations throughout my groin area. I truly believe that they are all in my head but I cannot be sure. I went for a STD Test and after a LONG 8 day wait, they came back negative for Chlamydia, gonorrhea and syphilis. But this tingling/sort of itching feeling comes and goes. AND, I've been checking for issues at least 5-10 times daily. Thankfully with nothing to report.

I have not had any of the following:

- discharge
- pain while urinating
- sores, lesions, blisters.
_There is no redness or blisters either

I am an overweight man. It is not uncommon to have symptoms of Jock itch and irritation in my groin area due to sweat and tighter clothing. But previously not having to worry about STD’s, I never really paid attention to itches and tingles down there. I would just adjust as needed and go on about my day. This feeling seems to be at the top base of my penis and the skin area above my penis,  it comes and goes throughout the day.

Could the tingling be prodromal herpes?

Could this just be OCD and Guilt?

Or, are prodromal symptoms only felt on recurring flares rather than the initial one?

I appreciate you taking the time to answer this. My life is in utter turmoil.

[Edward W Hook, MD]

I'm sorry to hear what you are going through and help I can help.  You have already done a good job of getting checked for bacterial STDs and so you can rest assured that they are not part of the problem,  So, what about the tingling?, could it be herpes?  The simple answer is no.  Let me tell you why I say this:

1.  As you point out, you have had no lesions and as you point out, you have certainly looked hard for it.
2.  The tingling is almost certainly not a prodrome.  While HSV prodromes can last a few ours before and outbreak, they DO NOT last for days.
3.  It is clear from your post that you are concerned, guilty and have been scrutinizing yourself far more closely than ever before.  This is not uncommon and, in doing so, you are far more likely to sense sensations that you have had for years but not noticed.

My advice, do not worry.  The chances you got HSV from your indiscretions are negligible.  I would not recommend testing in your situation.  Rather, do your best to return to your normal life.  I hope this helps.  EWH

[bobferoni]

Thanks Dr. Hook for you response it has made me feel much better.

I am still concerned and wanted to ask a few follow up questions.

For the last few days since your response, I have felt better and was not constantly checking for issues. It seemed like all was good. I was able to return to normal for the most part.

Now I have the some very mild irritation and Slight redness at the top base of my penis where I felt that tingling. It looks slightly red but only under very bright lighting (IE Direct Sunlight comming through my window) Being that I don't normaly look at that area under these conditions I'm not sure if I'm again entering that panic mode. Under normal lighting in my house everything looks perfectly fine.

To help give all the facts, due to my weight I have to bend over a bit to get a good look at my groin area and I have been pulling my penis out from my body to really get a good look at it.  Could all of that inspection and feeling caused the Irritation? I seem to notice more irritation after I shower.

I have been avoiding any sexual contact with my wife.

I was hopling that you could follow up your last comment and hopefully put my mind at ease even more.

If I do want to have herpes testing done and I have no sores or symptoms, how and what do I want to ask my doctor to do? I had a blood test done 4 days after the incident and the results are due to me on Monday the 23rd. Will that tell me what I need to know?

I appreciate you help. this forum has been the only relief I have really had in the last few weeks.

[Edward W Hook, MD]

The irritation you describe is likely to be normal and not something to be concerned about.  In addition, as you suggest, repeated inspection can lead to irritation.

The herpes blood test you had 4 days following your encounter will only tell you if you had herpes before your encounter.  It would be too soon for a blood test to be positive.  If you must be tested, you can get a blood test performed about 3 months after your encounter to rule out HSV.  At that time you need a type specific test such as the HerpeSelect and you should not get an IgM test as they are worthless.  Once again however, I really see no reason for testing.  EWH

[bobferoni]

Thanks for All of your help.

My Nightmare continues...

I now have a slightly painful small red bump, looks like a small pimple on the shaft of my penis. It could be an ingrown hair, I don't know.

Dr. Hook, Is it possible that this is normal? I was finally feeling better about this situation and now this shows up. I never before this had to worry about STD's, so I never paid much attention to stuff like this before. The irritation I mentioned in my last post seems to have gone away.

Should I put some neosporin or antibiotic cream on this spot? or should I leave it alone and see how it plays out?

Thanks again.

BF

I don't mean to be a bother, but I am so scared.

[Edward W Hook, MD]

Your guilt has you focusing on virtually every sensation that you can find in and around your genitalia.  If what you describe is towards the base of your penis, it is most likely folliculitis, a non-STD infection of hair follicles.  The best therapy for such lesions is soap and water.  EWH

[bobferoni]

Hello Dr. Hook.

It has now been 40 days since my possible exposure. A couple of weeks ago I had a single sore next to my penis and I had gone to see an urologist and he told me that everything looked fine.

This morning I woke up a have 3 or 4 of what look to me to be infected hair follicles in the pubic hair above my penis. They are red but they do not hurt and don't really look like sores. they all seem to be around a hair follicle.  As you haver suggested I am probably still overreacting. If this were a herpes outbreak, what exactly will be happening? and in what sort of time frame?  In case you don't remember I was the reciepient of unprotected oral sex from a woman on March 5.

I have found much conflicting information on the internet and before I go running to the Dr again, I was hoping for somemore advice and information from you.

What you guys do on this site is great.

I hope that your response will put my mind at ease as this has been the worst experience of my life.

Thanks in advance.

BF

[Edward W Hook, MD]

The internet proves itself again and again not to be a good place to go for information on STDs.  There is more mis-information and more opportunity for mis-interpretation there than just about anywhere else.

For a herpes outbreak to occur 40 days after expsoure would be most unusual.  The location and description you provide is more suggestive of folliculitis than anything else.  If your prior blood test was negative, you could have a repeat at this time.  That would address, once and for all, whether you got HSV from the exposure you describe.  If it is negative, then there is just no reason for further concern.  EWH

[bobferoni]

Dr Hook,

I went to my urologist and he confirmed that those redspots were not an outbreak. He reiterated that herpes is symptomatic and the issues that i've had were more likely other issues.

I have one more question for you and I hope that you do not feel that I'm taking advantage of your knowledge because it is slightly off subject.

I found out that in all of the testing that I went through back in March none of it tested for HSV. So I would imaging that when I get tested with your recommended Herpes Select it will let me know what I need to.

From time to time I will irrittations around my upper lip. I have always believed that they are pimples or ingrown hairs as they often appear after shaving. they would seen to last a week or two and then be gone. I recently got one about ten days ago and more closely watched it's pregression.

It a single sore that became red and slightly raised. It did not blister or ooze. nor was it made of more than one small sore. I believe it was an ingrown hair so I went at it with a tweezer and broke the skin. It appeared to be a single pore that was inflamed. it bled a little and then scabbed over and has remained red. This has been I believe that case with all of these occurences. The area is still red which seen to happen. it normaly takes a few weeks for them to completely disappear.

I don't really want to see another Dr. right now as my mind is relatively at ease.

I never before immagined that these could be cold sores. Based on what I telling you,  What do you think?

I know this is off subject from my original post, and If you would like my to pay for another post I will gladly do so.

I do want to thank you for all of your guidance during this ordeal. you really made a difference for me during a very scary time in my life.

Thank you Dr. Hook,

BF

[H. Hunter Handsfield, M.D.]

Dr. Hook is away from the forum for a few days.  But you are correct that your follow-up quesitons are off topic.  Also, questions about possible oral herpes aren't appropriate for the STD forum, so please don't start a new thread here.  The MedHelp herpes forum or dermatology forum are better options.

HHH, MD