Misdiagnosed as a UTI?

[idiot_du_jour]

I am a male, who had unprotected vaginal sex with a female partner 5 days ago. Yesterday, I went to a clinic to get tested for STDs. I had blood taken and a swab of my urethra. I was visually inspected for herpes, but was told I did not have this, and that symptoms would have manifested by that time. However, from what I've read, symptoms can manifest much later.
From the swab, I was told I had a bacterial infection, and was given a 1 g dose of azithromycin to clear up the bactrerial infection. Additionally, I was given an anti-fungal cream to apply to the head of my penis to clear up any aggravation that ocurred. Later that day, I felt incredibly tired and weary, as if a strong breeze could knock me over.
Today, I've noticed five or so small red bumps confined to the head of my penis. I've also had a headache all day.
I understand these all to be in line with the symptoms of genital herpes. My question is, given the above, could I have been erroneously told I have a bacterial STD when in fact I have herpes?
This is keeping me up at night, and driving me mad. However, I don't want to needlessly burden this country's health care system through unnecessary clinical check ups driven by hypochondria.
Any advice would be much appreciated
Any help is greatly appreciated

[Life360_Dave]

thats a very old post. if you have a question start your own thread.

[Caddy22]

Any update? I have this exact same situation

[Caddy22]

Any update? I have this exact situation

[caddie153]

Even if you found out u had it, its not like you woke up and said "hey I think Im want some Herpes today" and it is just a mild skin irritation that comes out every so often. Although it is contageous and something that will never go away, your not going to die from it and they do have medicine out that can keep it under control. Society has made Herpes such a big deal. Herpes itself in actuality really isnt if you think about it logically.

[rocksolid123]

Hi , I have an unprotected oral sex with a lady , I just knew. Around 4 days later , I develop pain on tip of my penis inside my urethral when I urine. For the 1st day , I have a very mild fever like 37.5 deg then after that no more. There is no sign of blister or cold sore on my penis. I thought I saw white blister inside my urethral as I open it up but when I show both my doctors , both say they see nothing. It has been around 6 days and I have started on second course for my antibiotic. The pain is lesser but when my 1st urine of the day or urine is yellowish then the pain is there.
Could it be herpes or UTI?
I am really worried, please help advise.
Thanks you

[ronswan]

I've pretty much had the same damn symptoms as you since an encounter about two months ago. I originally saw the doc about some itchyness in my groin, which he thought was Jock Itch. I applied that same fungal cream that you were for a couple weeks, with little to no results. I've been very worried about herpes because, like you, this sensitivity in my penis head has reoccurred since it's initial occurrence about two weeks ago. I've also had some faint spots and discoloration on my penis. I was hoping the Jock Itch fungus was causing this reoccurrence and not herpes. I'm now on a more powerful antifungal pill that I'm to take once a week for 3 weeks. I'm hoping this does the trick, and puts my herpes concerns to rest.

I'm glad you posted your results, because your symptoms are eerily similar to mine. Have you had any jock itch symptoms, or itching in your leg creases? Any further idea of what is troubling you?

[gracefromHHP]

glad you have been able to rule out herpes :)

[idiot_du_jour]

Thought I'd update with blood test results at 15 weeks after my encounter.

Herpes Simplex Antibodies
HSV I (IgG)     Negative 0.490 Index (Neg <0.9)
HSV II (IgG)    Negative 0.147 Index (Neg <0.9)

I thought these negative results might help anyone else who might find this thread after experiencing similar symptoms, under similiar circumstances as me. Unless someone can identify something from these results that I'm missing, I will continue to work with my health care provider to identify the cause of my problems with herpes ruled out.

Thanks for you help, Grace.

[gracefromHHP]

Their website does not specify if it's type specific herpes igg blood testing or not. I'd give them a call and ask .

[idiot_du_jour]

Thought I'd take some time away to try and more thoroughly address these symptoms with GUM clinic support. Grace, I apologize for my disregard earlier, and appreciate your feedback.

I am encouraged by your belief that my symptoms do not suggest herpes. I would, however, like to test now that I am past three months. I am in a new relationship, and do not yet feel comfortable engaging in intercourse until I have a bit more certainty.

I am looking to take a herpes serology test, and understand that the standard is the Herpeselect Type-Specific IgG antibody test. I have had trouble finding a facility here in London that offers that test specifically. Blood Tests London/Blue Horizon Medical offers the following blood test, which sounds similar:

Herpes blood test I/II Antibody Profile (IgG)

Is this the test that I need? If not, is there another facility that can provide the test for me? I approached Freedom Health, but they require I pay a consultation fee in addition to the testing fee. As I've had a few GUM consultations, I'd prefer not to pay for another.

Thanks again.

[gracefromHHP]

reread my previous posts to you - how many times have I said this doesn't sound like herpes now?

[idiot_du_jour]

Thanks again, Grace.
I had a checkup earlier today and another urine test came back negative. I was essentially told that I was likely experiencing residual discomfort from issues I had with my NSU, which was resolved in early February. I was told to come back in a month, or if I got a blister before that. These instructions were somewhat discouraging.

I was told I didn't need to use Clotrimazole anymore. Now that I've stopped, the itching/tingling on the head of my penis is amplified and quite intense. I understand this to be a prodrome symptom, that may or may not preceed a blister outbreak. Because any spots that have appeared so far have been minimal, I'm concerned this tingling is herpetic in nature, but may not involve the manifestation of full-on swab-able blisters. I was told the clinic "did not believe" in blood testing for herpes.

I'd like to resume unprotected sex with my regular partner, but will not engage in sex, protected or otherwise, until I know I'm not an asymptomatic shedder. What are my options at this point, and what is my outlook vis-a-vis symptoms implying herpes?

[gracefromHHP]

changes in urine odor can be due to foods you are eating as well as dehydration.  Just a change in smell without burning with urination probably isn't std related at all.  

no reason to avoid using the antifungals for urine testing.

[idiot_du_jour]

This makes sense, and it is the limited (at best) improvement I've seen while using anti-fungals that has me concerned. Just yesterday, after about a week-and-a-half of Clotrimazole use, I have a recurrence of pungent urine. I will go for a week or so with clear odorless urine, then will experience slightly cloudy urine with a distinct smell. An additional itching/tingling sensation on my glans/foreskin and seemingly inside my urethra accompanies this. These type of recurring issues are troublesome. Can herpes cause these issues, or should I consider something else? If I am asked to re-take a urine test, should I refrain from using Clotrimazole beforehand?

[gracefromHHP]

as long as it continues to respond to antifungals, typically no testing is done other than visual.  

[idiot_du_jour]

Thanks for your opinion, Grace. As my symptoms aren't clearing up, when I return for evaluation I'd like to encourage testing for the source of my problem instead of reliance on visual diagnosis. Should I request a swab of the red areas on my glans and foreskin? Is this the most appropriate way to test for fungus, if anti-fungal ointments don't seem to be working? If so, should I abstain from using Clotrimazole beforehand?

Regarding the swab of the cut, I called today and they said they wait about 2 weeks to see if herpes is cultured. I am to call back on Monday, but as I haven't head from them yet I was told it is unlikely herpes has been picked up. I hope this to be the case, and representative of my herpes status.

Thanks again.

[gracefromHHP]

fungus sounds far more likely than herpes. herpes doesn't cause most of the symptoms you keep having.

[idiot_du_jour]

Not sure if anyone is still monitoring this thread, or if my situation is particularly puzzling, but I thought I'd update in case this gets picked up and anyone can comment on the timeline of my symptoms.

A couple days after my last post, I noticed a 1/4 inch longitudinal (parallel with penis) cut on my glans, just above the frenulum. It corresponded to particularly dry and red skin in this area. I went and had it swabbed that day. The doctor did not have herpes swabs available, but used a regular cotton swab to check. Not sure how valid this is. She said it did not appear herpetic, but that my symptoms may be fungal. I was given a second dose of Fluconazole and more Clotrimazole, which I've been applying twice daily for a week-and-a-half. I am presently waiting on the swab results.

At times, application of the Clotrimazole helps, and the itching, irritated feeling is lessened. At other times, it seems to induce a dull ache in the head of my penis. I notice that redness tends to increase when I wash off the Clotrimazole with Aqueous Cream before re-applying more Clotrimazole. I also notice redness increases moderately when my foreskin is retracted with my glans drying, and increases substantially during and after masturbation. Masturbation was only twice in the last 5 weeks, both times with foreskin retracted to eliminate any surface contact with the glans, and both times resulting in redness.

I will be returning for further evaluation on Thursday, 2 weeks since initial suspected thrush infection, though the doctor then did not seem to have many ideas as to cause or treatment should the Fluconazole not work. It does not appear to have. I remain concerned about herpes due to the persistence of symptoms, and their manifestation as red spots that dissipate within a 24-36 hrs followed by itchiness and irritation of the glans and foreskin.

As always, any input is greatly appreciated.

[idiot_du_jour]

Another update on my symptoms, in case anyone can offer any further advice.

After a period where my issues had largely subsided, I have recently had a recurrence of symptoms. Symptoms that did persist were on my penis head which was either skin-colored and extremely dry or red and irritated, a little bit of white material is under the foreskin, and I had particularly pungent urine.

Yesterday, I woke up and found three red spots on my penis head. If they were raised at all, it was very minor. They did not appear to blister or contain fluid. I returned to the clinic and was told it didn't look like herpes, but could be thrush. I received 150 mg of Fluconazole. From 24 to 36 hours later, the spots have all but disappeared. I still have a sensitive and red penis head. Additionally, I have a recurrence of pain, irritation, and discomfort in the urethra in the head of my penis.

One reason I remain concerned about herpes is because these symptoms seem to largely clear up, then flare up again. Another is that these flare ups manifest as skin conditions, in addition to my understanding that herpes can manifest differently in different people, if it's noticed at all.

Lingering questions:
Can thrush present like this; coming and going?
How long should I expect the Fluconazole to take effect?
Does thrush show up on a urine test?
Does herpes present as spots that disappear within 24-36 hours?

Any input is greatly appreciated.

[idiot_du_jour]

I took your advice and returned for evaluation. The irritated region under my foreskin looked as if minor blisters were forming, but went away about 24 hours after I noticed the symptoms and before I got to the clinic. The clinician looked at my penis and said it appeared healthy, aside from some minor redness. A urine sample and swab of my urethra showed no bacteria, a regular white blood cell count, and other measures generally implying regularity. In fact, during the evaluation, my penis felt okay; not too dry or irritated with minimal burning, as I describe above.

Today, the redness, irritation, dryness, and a general dull pain in both the head of my penis, and the region in and around my testicles has returned. I'd like to identify what this is, but am unsure how to proceed as my last visit ended with the clinician's assumption that all was probably okay. It is difficult to be evaluated when I am experiencing symptoms, as the walk-in hours for the clinic are between 12:30 and 2PM on weekdays. I understand from other posts on this website that a multitude of things could cause symptoms such as these. If my urine tests are coming back clear, what causes does this leave? I think this is one of the primary sources of my anxiety regarding the possibility of herpes; the elimination of other potential causes.

Thanks, Grace, for your input to this point. I'm trying to avoid the psychological trap that seems to afflict many, of assuming herpes despite a clinical evaluation to the contrary. To do this, I believe I need to properly identify the cause of my recurrent symptoms. When I inquired about herpes blood tests, the clinician regarded them as misleading and unnecessary. This, I understand, is a fundamental difference between American and British (where I am right now) means of treating STDs. Should this cause me concern regarding the initial diagnoses? At 3 or 4 months when i would like to do a blood test, is anyone aware of any options for this in the UK?

Thanks again.

[gracefromHHP]

this doesn't sound like herpes.

return to be seen again for further evaluation.

meanwhile, try something as simple as applying a barrier cream to your genitals to soothe the irritated skin as well as protect it - i.e. desitin, aquaphor, a&d etc. Even just powdering your genitals once or twice a day is often helpful to reduce friction and irritation.

[idiot_du_jour]

A follow up to my issue:
I continue to have persistent symptoms that include burning inside the head of my penis, a sensitive penis head, and very dry skin on the head of my penis and foreskin. This morning (15 days after encounter), I noticed a red irritated area under my foreskin. I cannot tell whether this is irritation from chaffing, or the initial stages of blistering. What is the progression of blister development, and do my symptoms suggest herpes or something else?

[idiot_du_jour]

After I found out that I tested negative for gonorrhea and chlamydia, I received no supplemental treatment. I was told to wait for the results of the swab test, and then return in two weeks to get re-tested for gonorrhea and chlamydia. I had thought the azithromycin was considered the treatment for NGU, but am unsure.

I was also given an anti-fungal cream, clotrimazole, to apply twice daily in small doses. It was variably effective in diminishing the small bumps on the head of my penis. However, sensitivity on the head of my penis, and an intermittent burning sensation in the same area, are lingering.

I suppose the message is to 'wait and see', but I find this course of action to be frustrating as it fails to address my persistent symptoms. Especially considering how often I've read the statement 'everyone presents differently with herpes.'

[gracefromHHP]

A genitally focused anxiety is a real issue for many of our posters :(

you have to wait 6 weeks post encounter for syphilis blood testing; 3 months for herpes igg, hepatitis and hiv testing to be accurate.

did they treat your ngu?

nothing you've mentioned sounds suspicious for herpes. If they diagnosed you now with ngu, that means they see bacteria in your urine yet.