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Diagnosis in doubt, one for Terri


26th July I had an encounter with a F SW, gave un protected oral for 10 minutes. I received oral which inc. rimming. Unsure re condom use. Never had a cold sore.

Next day had tingling in lips, few days later slightly swollen patch on my tongue.

Week later had sore throat w white patches, throat glands up, low fever and aching joints & Diarrhea. Had lower abdominal pains & spleen pain.  On the 20th August  the Diarrhea continues and I develop a small single sore close to anus, my testicles feel swollen, I also notice my tailbone is sore but it could be an old back problem. I also notice a red patch at the tip of my penis which develops a dry layer of skin which later flakes off. From that point until now my penis has been generally sore, no noticeable rash other than the tip which hasn’t blistered. A few days of cortisone crème seemed to help the redness as did washing after urinating.

Have all the symptoms of oral herpes but no outbreak. Nose is tingling, sore inside, eyes feel strangely sore from time to time. Had small swelling on my upper cheek, went down after a few hours and left a tiny blister.

On the 25th August I had STD screening inc. blood tests, apart from IgG, not offered in country, & scrape on the anal sore. Doc unsure whether sore was Herp or Syph.

Then got second opinion from a large teaching hospital with a walk in STI clinic. Professor there had a look at the sore and said not a typical presentation of Herp but did  blood & scrape anyway.  
Results: All tests were negative from both facilities.

The on / off daily pain in my penis continues, the on / off skin crawling in my anus is still there and I have some redness / swollen patch at the top of my penis young doc said is typical of a fungal infection and prescribed anti fungal cream.

What do you think of the continuous vague symptoms, opinions of the doctors, the way forward considering bloods are not an option. I normally have un protected w partner.
16 Responses
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55646 tn?1263660809
Hello,
I"m sorry that you don't feel that I helped you very much.   I will try again.
Giving oral sex to and receiving oral sex from a commercial sex worker is low risk but not without risk, especially given that you have no history of cold sores.  While the tingling and soreness and irritation may well by psychological, I remain concerned about what you describe as a sore (you specifically used the word sore) around the anus.  And you also said that she did rimming, which puts the area described at specific risk.  The dry patch of skin could be many things, of course - fungal infection , irritation from too much contact, very difficult to say about that.  And as always in these situations, very difficult to tell if the soreness and irritation are guilt and worry or something more medical.  When you described a second set of symptoms, like a rash that was coming up on the buttocks, I wanted you to go right in to have it evaluated, even though you had had the sore evaluated previously.  

If you did acquire HSV genitally, it would likely be HSV 1, since there was no genital to genital contact per your description.  It is possible that you already have HSV 1, and no history of cold sores, and it is also possible that your wife already has HSV 1 already as well.

You have thrown out a description of a semi-risky encounter accompanied by a herpes specific symptom, the sore.  I'm sorry that I can't sort out this more specifically for you.  I think your proposal of getting a type specific antibody test outside of the country is a good one.  However, if you are positive for HSV 1, you can't know if the infection is oral or genital.

I hope that is more helpful for you.

Terri
Helpful - 1
55646 tn?1263660809
So there is no way to know if you've been infected since age 4 or just now.  Wish there was a way it could be more clear for you.

Terri
Helpful - 0
Avatar universal
No Terri, My HSV status was unknown before this. Never tested.
I never had coldsores but do remember tingling feelings in my lips during my student days.

The IGG is available in my country via the Government Virus Reference Lab as a special order and the test is carried out infrequently. It took 3 weeks from time for bloods for the result and they ran the test incorrectly as an IGM the first time.
Helpful - 0
55646 tn?1263660809
And I don't recall - had you had a baseline HSV 1 test to know that you weren't infected before? I thought you had mentioned that you couldn't get the IgG test.  

Terri
Helpful - 0
Avatar universal

Terri,
Test result of the IGG back at 8 weeks, positive for HSV1 and negative for HSV 2.
Thanks for your help.
Helpful - 0
Avatar universal
Many thanks Terri. I appreciate your words. The contact with my anus can't have been more than a few seconds.

Btw I have been looking through these threads and I have to say there is a very familiar pattern, Man meets SW, gets symptoms, goes through all the tests, scares himself silly, posts about 5 times here, waits three months and is eventually diagnosed with HSV. ( and in a few passes it to tier wife) Most likely HSV1 which prompts another round of questions. It amazes me how many there is like this, which of course have fuelled my anxiety no end.

I don't mean to scare the wits out of future readers but there is a fair of this type of thread on these boards.
Helpful - 0
55646 tn?1263660809
That all sounds like a good plan.

Terri
Helpful - 0
Avatar universal
3 potential prostate trouble that should have read!
Helpful - 0
Avatar universal
Met the Consultant at the STI clinic today, this was the third specialist in STI's that I have seen. He feels the urethritis I have is due to 1. psychosomatic origin, 2. Dehydration and too much coffee. 3. prostate trouble
He said Herpes has a much more distinct presentation that what I have experienced. The plan is to come in for a swab if more blisters present and come in in three months time for an IgG which is available as a special request due to cost and the fact they diagnose HSV by symptoms.
Other than that he said I have nothing to worry about.
Helpful - 0
Avatar universal
Hello Terri,
Just thinking about the above and tried to edit my post above this morning, hope you don't take offence. I am sure you will appreciate anxiety is running high at the moment. I have another appointment this week with an Infectious Disease specialist, there alas is nothing to swab. Bloods are not an option because they don't ever do IgG here in .....

It would help to get some closure on this, my wife will expect things to be as normal ie. Intercourse without protection. My results so far are all negative but I still have symptoms.

Reading some replies from Dr. Hook on the Sti forum he seems to maintain symptoms like mine in the absence of a significant breakout is most likely psychological.

So what I would like to ask you is:
have you seen Herpes present as a red patch (later dry and flaky) on the head of the penis and some intermittent redness on the foreskin and shaft. With.
As as single sore near the anus with the above symptoms as listed and
A near daily sorenes and irritation in the penis and itchiness in the anus.

With no blisters / ulcers in the pelvic region other than the one sore on the anus as described.

Thanks for your assistance in providing this wonderful service to the Global community of unwell well.

Helpful - 0
Avatar universal
Terri,
Sorry to have to raise this but I was going over this again and may I say how disappointed I am with the level of response you have provided me with. If you see your initial response you will see this answered in my first post. In your second reply you refer to swab but you will see I refer to a scrape of the sore.

I appreciate the time you have given to this but essentially you have told me to go get tested which I think anyone could have told me.

Medhelp is a great service, I referred this question to you because I felt you had significant expertise in this area, this has not been reflected in your response to me I'm afraid to say.

Thanks anyway.

d.

Helpful - 0
Avatar universal
Problem is Terri, there is nothing to swab, the rash on the buttocks was like a heat rash it's no goneq. Do you think I should be on Valtarex with no positive swab or blood test. I have investigated bloods outside country.

Today for instance I have had times where I experience a lot of tingling / burning in my uthrea and anus. All with neg bloods and STD tests.

What do think is going on here from the description I have provided?
Helpful - 0
55646 tn?1263660809
They may not have IgG testing there, but I"m sure they have herpes swab testing, don't they ?  If you have questions about the rash on your nose on your buttocks, please go in right away and have these areas swab tested.

Terri
Helpful - 0
Avatar universal
Terri,
Woke up this morning with a constellation of tiny red dots on the tip of my nose. Yikes.
Helpful - 0
Avatar universal
Terri,
Thanks for the reply, I live in a country in Europe, they don't have IgG, really I have investigated extensively.

I did have protected intercourse for a few minutes but couldnt keep my erection and stupidly gave and received oral. The oral I received I am nearly certain I had a condom on for but cant be certain as I was drunk, I do remember her rimming me and tongue to groin contact on me also.

So that's it, while I'm here my buttock feels like there is a rash about to come up and my penis stung/burned periodically during the evening. The red patch on my penis has calmed down and now just looks like slightly redder thicker skin.
Helpful - 0
55646 tn?1263660809
Where is it that you live that you can't get an IgG antibody test?  Did she give you oral sex?  Did you have intercourse?  If you answer these questions, I can help you more.

Terri
Helpful - 0

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