Oral Transmission?

[Slimkid]

I received brief unprotected oral sex at a massage parlor on 6/24.  

At approximately 9 weeks post exposure, what I assume are the lymph nodes under my armpits became tender and sore to the touch.  I also began feeling irritation and slight burning sensations in my urethra and at the very tip of my penis.  I feel like I need to urinate more than normal and when I do it seems to slightly intensify the burning sensation, but not always.  The head of my penis definitely looks a bit more irritated, scaly and discolored than normal but there are no obvious blisters, sores and or lesions… the opening of the urethra just looks really red, and I have been experiencing clear/watery discharge as well. I have also been having a lot of itching in the anal area.

I went to my local STD clinic yesterday (9/2),  because my doctor was out this week.  Anyway, I explained my situation and was examined by the doctor.  After examining me and doing a urethra swab, he said he did not think it was herpes as he did not see any sign of outbreak and said he believed it was NGU either chlamydia and or gonorrhea or possibly Trich.  He prescribed me with 2 big pills of Zithromax and 4 smaller pills of Metronidazole which I finished taking today. Unfortunately they do not do any herpes blood work at the clinic.

I should also mention that I’ve never had any type of cold sore that I can remember on my lips, and have never experienced irritation and pain like this in my urethra.  Also, despite this recent episode I have been in a committed monogamous relationship with my wife and have not had sex of any kind with anybody else.  She is pregnant and we haven’t had any sex in 9 months.

1.) Can this be an HSV 1 genital outbreak?  2.) Do you recommend me doing HSV related bloodwork and if so which ones should I be getting?  I really feel that something isn’t right down there and do not want to infect my pregnant wife. Please share your thoughts, thank you for your time.

[Slimkid]

Thanks for your reply. I do not recall ever getting a cold sore anywhere on my mouth, lips or anywhere on my face.

Healthy baby arrived on Monday.

[Dend]

Hi,

Your post caught my eye...
I have been going through something something similar to you, I did have urethra pain as you describe, I cut out the coffee over the last few days, de stressed with a more positive outlook and took a breather. It has now passed thankfully.

I also have some young children and would hate to be going through these negative thoughts/ symptoms as such an important time in my life. A child coming into the world is to be enjoyed and you will never have this chance again.

Take some time to yourself, get some exercise, talk to a friend and think positive, you will get through this. Enjoy the moment for what it is..

[Terri Warren, RN, Adult Nurse Practitioner]

Sometimes herpes sores can be small, yes, but as I always say in these situations, if the words "magnifying glass" comes up, that's too small to worry about.  

I forget - have you ever had a cold sore in your lifetime?  If yes, the it is highly unlikely that you would acquire HSV 1 genitally after you have it orally already.

Any baby yet?

Terri

[Slimkid]

Thank you for your reply.  Yes, my wife is due any day now. The discharge seems to be less but the discomfort/irritation is more or less the same. The STD clinic doctor gave my 5 pills, all of which I finished on Friday.

I did have flu like symptoms roughly 2 weeks post exposure that I explained to Dr. HHH in an early post as with the absence of any visible sores I never suspected Herpes and thought maybe it could be HIV:

http://www.medhelp.org/posts/HIV-Prevention/Unprotected-Oral---Scary-Symptoms/show/1580344?personal_page_id=2297427#post_7177205

Is it possible that some of those symptoms could be related to HSV-1 and I'm finally having an outbreak now?

Are the sore/lesions associated with sometimes difficult to recognize? I do have a small spot on my penis that looks a bit raw like a tiny rash but again, nothing that definitely looks like all the pictures I've seen online. Do the sores usually hurt to the touch?

I'm going to see my doctor on Tuesday unless the baby arrives before then. What would you recommend as far as any specific tests if there is still nothing present to swab?

Thank you.

[Terri Warren, RN, Adult Nurse Practitioner]

Well, I'm glad you aren't having sex with her right now, but if you haven't had sex in 9 months, then I would say you have a baby due any moment, and probably aren't going to have sex for a while anyway.  

You can get an antibody test for HSV 1 and 2, but the problem is, if it is positive for HSV 1, you won't know if they infection is oral or genital since you've never had a cold sore.  

Did the antibiotics make any difference in your symptoms?  The literature suggests that about 3% of NGU is caused by HSV, so the chances are really small that that is the case with you, but it isn't zero.  I'm not sure what you should actually do here.  First, I would give the antibiotics a good chance to work - at least two weeks to see if the symptoms go away.  If they go away with treatment, then I think you can relax.  Your symptoms aren't classically herpetic to start with, you know.  

How about you see how you feel in two weeks and then, if you still have symptoms, we can talk more about it?

Terri