HERPES OR FUNGAL PROSTATITIS

IN EARLY FEB I NOTICED A REDDING OR RASH ON BOTH SIDES OF MY SCROTUM. I HAD PROTECTED SEX WITH A PROSTITUTE APPROXIMATELY ONE WEEK PRIOR BUT PREFORM UNPROTECTED ORAL SEX ON HER.
THINKING I HAD A SIMPLE RASH I BEGAN APPLYING 1% HYDRCORTISONE CREAM AND WITHIN TWO WEEKS THE RASH WAS UNCHANGED AND I HAD DEVELOPED A FEW RAW SKIN AREAS(LIKE BURNS OR ABRAISIONS BUT NOT BLISTERS) ON MY FORESKIN AND THE TOP BACK SIDE OF MY PENIS THAT WERE QUITE SORE.
I SAW A UROLOGIST AND HE THOUGHT I HAD I SEVERE FUNGAL INFECTION AND SAID THAT THE HYDROCORTISONE CREAM ACTUALLY MADE THE CONDITION WORSE. HE PRESCRIBED A OVER THE COUNTER 1% CLOTRIMAZOLE CREAM.
THE ABRAISIONS HEALED RATHER QUICKLY BUT TWO MONTHS LATER I STILL HAVE A REDDNESS ON BOTH SIDES  OF MY SCROTUM. ABOUT THE SAME TIME THAT THE ABRAISIONS APPEARED I BEGAN TO EXPERIENCE DISCOMFORT IN MY URETHER AND LOWER ABDOMEN THAT SEEMS TO MIRROR PROSTATITIS.MY QUESTIONS ARE AS FOLLOWS.
CAN ON GET HERPES FROM UNPROTECTED ORAL SEX AND WOULD IT THEN MANIFEST IN THE GENITALS?
WOULD A HERPES RASH HANG ON FOR TWO PLUS MONTHS?
CAN A SEVERE FUNGAL INFECCTION(BALANITIS) CAUSE BURN LIKE ABRAISIONS?
CAN ONE GET PROSTATITIS FROM EITHER A FUNGAL INFECTION OR FROM HERPES AND WHAT WOULD BE THE TREATMENT IN EITHER CASE?
IS MY UPCOMING PSA TEST(PAST RESULTS 0.9) LIKELY TO BE AFFECTED BY PROSTATITIS?
THANK YOU
P.S. IN A FOLLOW UP WITH THE UROLOGIST HE PREFORMED A PENAL SCOPE WHICH WAS NEGATIVE AND PRESCRIBED A WEEKS DOSE(500 MG/DAY) OF LEVAQUINN TO TAKE CARE OF ANY INFECTION

[Kevin Pho, MD]

Hello - thanks for asking your question.  

To answer your questions:

1) It would be very rare for oral herpes to spread to the genitals.  Spread is usually to adjacent areas.  If you have herpes lesions in 2 different places, it is likely because of 2 primary infections.  

2) It is possible for herpes to last past 2 months.  There are cases where the primary herpes infection lasts 5-10 weeks.  The longer the lesion stays, the greater chance for recurrence.  

3) Without seeing the lesions, I cannot be sure what it is.  Balanitis is caused by a fungus (Candida).  If not properly treated, it is possible that the inflammation caused by the fungus can manifest as burning.

4) It is possible to have either herpes and fungal prostatitis - although they are uncommon.  The treatment would be the appropriate antiviral (if herpes) or antifungal (if fungus) medication.  Diagnosis should be performed with appropriate antiviral and antifungal tests on the urine and prostatic fluid.

5) Your PSA absolutely could be elevated because of prostatitis.  The PSA should be rechecked after appropriate treatment.  

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.

[nurse12hr]

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[kevinmd]

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[nurse12hr]

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[ammar413]

A related discussion, does fungal prostatitis exist ? was started.