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Avatar universal

Possible genital herpes exposure - in boxer area

Dear Dr. Firstly, I have viewed you website over several years and it has been most helpful. This is my first post. I searched for this on the forums and couldn't find any answers. I am going to a clinic first thing tomorrow morning (am) as it's night here (Asia).

I had sex with what I later found out was a professional sex worker (I was unaware she was until after intercourse hence my added concern) from Indonesia. I used a condom but it broke I believe at one point and I replaced it with another - although I know condoms are no absolute protection against this std. This was around 5 days ago.

Today or yesterday I discovered 5 or 6 pimple like sores around the stomach area just below the waste but in the 'boxer zone' where there is pubic hair. They were discomforting so I squeezed them and some puss came out. I have some tingling in the head of the penis but I think this is due to a small abrasion due to masturbation.

Fyi in the past I have noticed flat lumps on around my penis but they have never erupted like these ones. I have generally written them off as penis pimples.

I am not aware if gentile herpes can form on parts other than the genitals but have read it can be the case.

Finally, while it may be anxiety or stress I have had flem and tiredness although no fever.
18 Responses
101028 tn?1419603004
going to be seen is the best course of action. these don't sound like herpes but obviously something is going on.

since you had a condom break, follow up with proper testing at the proper times. you can get for trich, ngu, chlamydia and gonorrhea any time after 1 week post encounter. syphilis after 6 weeks. herpes, hiv and hepatitis after 3 months.

grace
Avatar universal
Thanks grace - it turns out it was herpes and a form of HPV (which I had no idea about) from an encounter 6 months or so ago. I've had the HPV treated straight away (freezing 3 small spots) and medication for the herpes.

I'm now scared ******** of HIV having never previously had any STDS. I have had a blood test and will have another in 3 months. Finding it very difficult to function and very shameful as I am married but estranged from my partner who I have had to inform of all of this. *sigh* Christmas is going to suck.
Avatar universal
Oh and another point. On the herpes the GP misdiagnosed it thinking it was more a skin rash. The dermatologist who I saw that same afternoon however diagnosed it. Just something to take note of.
101028 tn?1419603004
what testing for herpes was done?
Avatar universal
hi grace no not done. Just clinical diagnosis but I will ask for a herpes blood test upon return to HK. I've been on antivirals since then and antibiotics too and it has more or less cleared. In fact I've completed the antiviral course. Not sure what the next course of action should be. Probably to go back to the D for a review. My main concern now though is HIV and I've posted in Medhelp about this. Scared about that now more than anything else.

Having read more about HPV I'm not too concerned about that (as were the drs) and it seems I caught it in it's early stages and I understand it 'may' pass from the system between 8 to 24 months after infection.
101028 tn?1419603004
visual diagnosis of herpes is never adequate. it's really unfortunate that no lesion culture was done or anything helpful.   At this point, you need to follow up with a type specific herpes igg blood test 3 months post encounter. should symptoms reoccur, be seen within 48 hours for a lesion culture and typing.

they didn't treat your warts?

none of your symptoms sound like herpes and I have to wonder if your rash was molluscum if it wasn't a bacterial folliculitis.
Avatar universal
Thanks GracefromHHP. I have a few other questions for you I'll post later based on the assumption it is herpes. Dr Hook has agreed with your point (http://www.medhelp.org/posts/HIV---Prevention/Serious-HIV-concern/show/1867413#post_8657381) I raised in a HIV forum. You'll see the timeline and treatment I was proscribed there. Guess I'll wait or get the culture test if it happens again.

The sores have basically healed over now except for some redness as detailed above most of the six sores were in the pubic area on the left and a few on the (2) on the right rather than the genitals. 1 small sore was on the penis but it didn't look like the others and may have been due to masturbation - the Dr however said it was also herpes. It has disappeared  completely when I checked yesterday. I'm not sure whether to start suppression therapy now or later - as at the moment I have an actual HSV2 diagnosis.

As for the HPV that was confirmed also by the GP and dermatologist who recommended I freeze them off. There were 3 smallish bumps on the penis. We checked behind the foreskin and in the urethra and there was nothing so I went ahead and had the 3 frozen there and then. Nice before getting on a flight I tell you! The dermatologist's prognosis for the HPV was encouraging saying a re-inspection in the new year and maybe 1 or 2 more treatments might fix it as it didn't seem that advanced. I have since read the virus sometimes passes out of the system between 8 and 24 months later but there is no way to confirm this.

Finally to my layman's eye it did look like the first pic in this page - http://howshealth.com/infected-hair-follicle-causes-symptoms-pictures-treatment/

- except there were 6 and it's in the pubic area. The other 2 or so on the right were lower down near the base and more blister like. God. The GP initally said they were part of the same thing as the other 6. So annoying. FInally, as I mentioned there was a small open sore on the head of the penis that looked different to this and the Dr identified it and everything else also as herpes. It has gone now.

On another note I'm so worried this will ruin the rest of my life. I'm a 34 year old guy and I have been separated from my partner for over 7 months. I would like to piece that back together (long shot but there are kids involved) somehow but it would seem this will lay waste to that even if there was a reconciliation. *sigh*

I should also mention I am HSV1 positive and probably have been since a I was a kid.

Sorry to spew all these facts out in a fairly incoherent fashion and thanks so much for your help to date.
101028 tn?1419603004
absolutely no reason to start suppressive therapy. should you get a return of symptoms, be seen within 48 hours and if they visually diagnose herpes, make them get cultures to confirm.  You don't want to risk delaying seroconversion if indeed you do have herpes - can't have you posting here on the forum for the next 6 months - 1 year anxiety ridden over your test results because you were on suppressive therapy :)
Avatar universal
Just I lead a super busy job and I hate the idea of being inconvenienced through having to go to the DR regularly or being in discomfort. In all honestly the symptoms weren't that bad what ever it is. I suppose other infections could also take up to a week to heal too. I'll follow your advice anyways.

I might come back later with practical questions for living with HSV2 in relation to my post above if that's ok. How I manage it in a committed relationship/if I can. I keep thinking my sex life is over at 34! Anyway - this is a huge wake up call for me irrespective of anything.

Thanks again.
101028 tn?1419603004
worst case scenario that you do have genital herpes, your sex life isn't remotely over dear.
Avatar universal
I'm just wondering - if - and it's a big if - I get back with my partner who is herpes free, how could I possibly resume a intimate relationship without risk of infecting her? I have read a lot already and it seems there is no sure way :( I guess I could wear boxers and protection together with suppressors and watching out.
101028 tn?1419603004
the risks of transmission to a partner are incredibly low if you are taking precautions.  much more info in the free herpes handbook we recommend.
Avatar universal
Thanks Grace. Having read a lot of posts on here and about herpes and pubic folliculitis I feel more and more I may have been initially diagnosed correctly (not herpes) and then misdiagnosed by what was to my mind was a cursory visual examination by the second dr who specialises in dermatology (he hold a diploma in dermatology but I don't think this qualifies you as a true dermatologist from what I have read). My referral by the way was due to the HPV for treatment - not the herpes.

I don't mean to be disparaging about the dermatologist's qualifications but there is an issue in HK (which has excellent medical services) with people calling themselves specialists, hence terms such as 'Specialising in Dermatology'. Anyway I am disappointed he didn't think he needed to take a culture considering all bar one small lesion (on the head of the penis which I thought was a scratch from masturbation) presented itself in the pubic area as puss filled sores that 'felt deep' and when I squeezed them - and what appeared to my eye puss and blood flowed after I lanced them. I am also puzzled as from what I read sores tend to occur on the genitals being the place of maximum friction and even if the 'cut' on the penis was a herpes sore lesions should have occurred in that same region rather than the pubic area irrespective of condom breakage.

To be fair I turned up at the clinic with no appointment on direction of my PCG and I guess he was rushed for time but I don't see why he as so sure of his diagnosis considering the above and that the PCG had a different diagnosis and you have said there is a 20-25% misdiagnosis rate on visual exam only.

Having said that the antivirals seem to have worked although I was later proscribed penicillin which works on strep - but if it was pubic folliculitis infected with strep that would help too.  There is still some redness there though I stopped all meds last Wednesday (ran the full course).Anyway venting at New Year! I'll do as advised. I might post one further question for the Drs in this point although I don't want to waste their time.

Finally, I have to say this is by far the best med site, certainly as far as STDs go on the net. Access to the best medical professionals for 22 bucks and helpful knowledgable people such as yourself. All the best for 2013.
101028 tn?1419603004
definitely follow up on the testing at the 3 month post encounter mark. should your symptoms reoccur before then, be seen promptly for a bacterial swab and viral swab if they feel it's herpes when seen again. a recurrence of herpes wouldn't present with multiple lesions though - just a single lesion.
Avatar universal
hi Grace - I will do the follow ups and have asked the Drs a few questions too but basically I need the test in 2.5 months time *sigh*. I can't get this off my mind. It's really weighing down on me. I'm going through a painful separation atm and I feel this will completely scuttle any chance of putting my family back together. Can't get it off my mind. Any common sense suggestions? Thanks
101028 tn?1419603004
can't recommend talk therapy with a professional enough. so much to process when separating even without issues like this.  
Avatar universal
Thanks Grace. I meant more the anxiety from this. How would you recommend I dal with that.
Avatar universal
Bump.

Worried about this, HIV and if it was a latent exposure I exposed my separated partner. Need to get it out of my head.
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