Aa
Possible Herpes Outbreak?
I am a gay male and I have never engaged in unprotected anal sex but have engaged in unprotected oral sex.
Two weeks ago (August 1st) I had protected anal and unprotected oral sex with a new partner. After sex, I did not immediately shower and went to sleep. I mention this due to the combination of lubricant and sweat that remained on my body. No more than 2 days after I noticed maybe 4 soft, pink, painless, pimple-like bumps in my left groin. Sometime within the next week, I recall one instance of my scrotum being very itchy. Later that week (August 7th) I left for a vacation which included bathing in the ocean, lounging in a wet swimsuit, sweating in wet swimsuit, etc. By the 10th or 11th I noticed the bumps in my groin were gone and now looked like 4 ulcers, two one each side of my groin crease symmetrical to each other. I also noticed maybe 5 small ulcers on the left side of my scrotum. These ulcers on my scrotum were not clumped tightly and were no larger than a sesame seed. All ulcers were red and wet. By the 14th the ulcers in my groin had started to dry up and new skin was forming. I never noticed obvious scabbing or crusting over of the entire ulcer. The ulcers on my scrotum have not healed completely as of today (the 16th) though some have seemed to disappear and the remaining are still slightly wet. All ulcers were painless unless chafed or rubbed by clothing. All ulcers were slightly itchy but not constant or debilitating. I never noticed blisters or vesicles, and it seemed my symptoms went from bumps in my groin, to ulcers in my groin and on my scrotum. I never experienced any lymph node swelling or fever.
I was tested today for syphilis, gonorrhea, chlamydia, HIV (negative,) and the clinician swabbed what she could of the ulcers on my scrotum for a culture test. I understand that culture tests are prone to false negatives, and that antibodies in a blood test will not show for at least a few months.
What are your thoughts?
Two weeks ago (August 1st) I had protected anal and unprotected oral sex with a new partner. After sex, I did not immediately shower and went to sleep. I mention this due to the combination of lubricant and sweat that remained on my body. No more than 2 days after I noticed maybe 4 soft, pink, painless, pimple-like bumps in my left groin. Sometime within the next week, I recall one instance of my scrotum being very itchy. Later that week (August 7th) I left for a vacation which included bathing in the ocean, lounging in a wet swimsuit, sweating in wet swimsuit, etc. By the 10th or 11th I noticed the bumps in my groin were gone and now looked like 4 ulcers, two one each side of my groin crease symmetrical to each other. I also noticed maybe 5 small ulcers on the left side of my scrotum. These ulcers on my scrotum were not clumped tightly and were no larger than a sesame seed. All ulcers were red and wet. By the 14th the ulcers in my groin had started to dry up and new skin was forming. I never noticed obvious scabbing or crusting over of the entire ulcer. The ulcers on my scrotum have not healed completely as of today (the 16th) though some have seemed to disappear and the remaining are still slightly wet. All ulcers were painless unless chafed or rubbed by clothing. All ulcers were slightly itchy but not constant or debilitating. I never noticed blisters or vesicles, and it seemed my symptoms went from bumps in my groin, to ulcers in my groin and on my scrotum. I never experienced any lymph node swelling or fever.
I was tested today for syphilis, gonorrhea, chlamydia, HIV (negative,) and the clinician swabbed what she could of the ulcers on my scrotum for a culture test. I understand that culture tests are prone to false negatives, and that antibodies in a blood test will not show for at least a few months.
What are your thoughts?
MEDICAL PROFESSIONAL
Mupirocin would have no effect on herpes. It sounds like you have a new pimple. It still doesn't sound like herpes; in the first 24-48 hours, herpes lesions are filled with entirely clear fluid, not white material or pus.
That will end this thread. Your personal physician should be the source for additional answers.
That will end this thread. Your personal physician should be the source for additional answers.
MEDICAL PROFESSIONAL
Welcome to the STD forum.
On one hand, any genital area ulceration has to be evaluated for herpes. On the other, I doubt that's what you have, for at least a few reasons. First, the location of lesion is wrong. HSV infections usually don't take unless the virus is massaged into the exposed tissues -- for which reason initial herpes lesions usually occur at the sites of maximum friction during sex. That is, the penis in men, vaginal opening and labia minor in women, or the anus if exposed -- and generally not the scrotum, groin, labia major, etc. Second, "soft, pink, painless, pimple-like bumps" doesn't really describe herpes. The progression generally is from red bump to clear fluid-filled blister then to ulceration and saabbing. Third, as you seem to know, the initial infection with HSV usually is associated with lymph node inflammation in the groin and often with fever, headache, etc.
So my bet is that the culture/swab tests will be negative. If so, and if your clinician believes herpes is a reasonable possibility, you could have a blood test in a few weeks. However, if an HSV blood test is to be done then, it should also be done now. The most definitive blood test results come from an initial negative test that becomes positive. If positive in a few weeks but no baseline test is done, it will be difficult to know whether you have experienced a new infection or just uncovered an old, asymptomatic one.
All things considered, I am very doubtful this is herpes; a superficial bacterial infection, like folliculitis due to staph, strep, etc seems much more likely. But follow your clinician's advice after the HSV culture test has returned. Feel free to return with a follow-up comment once a diagnosis is confirmed or if there are questions about your test results when they become available.
Regards-- HHH, MD
On one hand, any genital area ulceration has to be evaluated for herpes. On the other, I doubt that's what you have, for at least a few reasons. First, the location of lesion is wrong. HSV infections usually don't take unless the virus is massaged into the exposed tissues -- for which reason initial herpes lesions usually occur at the sites of maximum friction during sex. That is, the penis in men, vaginal opening and labia minor in women, or the anus if exposed -- and generally not the scrotum, groin, labia major, etc. Second, "soft, pink, painless, pimple-like bumps" doesn't really describe herpes. The progression generally is from red bump to clear fluid-filled blister then to ulceration and saabbing. Third, as you seem to know, the initial infection with HSV usually is associated with lymph node inflammation in the groin and often with fever, headache, etc.
So my bet is that the culture/swab tests will be negative. If so, and if your clinician believes herpes is a reasonable possibility, you could have a blood test in a few weeks. However, if an HSV blood test is to be done then, it should also be done now. The most definitive blood test results come from an initial negative test that becomes positive. If positive in a few weeks but no baseline test is done, it will be difficult to know whether you have experienced a new infection or just uncovered an old, asymptomatic one.
All things considered, I am very doubtful this is herpes; a superficial bacterial infection, like folliculitis due to staph, strep, etc seems much more likely. But follow your clinician's advice after the HSV culture test has returned. Feel free to return with a follow-up comment once a diagnosis is confirmed or if there are questions about your test results when they become available.
Regards-- HHH, MD
Another update, this time somewhat troubling.
Today I noticed a small vesicle in my left groin right next to the previous lesions which are almost completely healed. The vesicle is raised, not tender or painful and appears to have white matter inside. It is not located at the base of a hair follicle. Is it possible for a single herpes sore to appear in the same area in which an outbreak seems to have already begun healing? I applied the mupirocin to the entire area in hopes of some reaction, positive or negative.
Seems like a setback to me, and I'm feeling very discouraged.
Today I noticed a small vesicle in my left groin right next to the previous lesions which are almost completely healed. The vesicle is raised, not tender or painful and appears to have white matter inside. It is not located at the base of a hair follicle. Is it possible for a single herpes sore to appear in the same area in which an outbreak seems to have already begun healing? I applied the mupirocin to the entire area in hopes of some reaction, positive or negative.
Seems like a setback to me, and I'm feeling very discouraged.
Quick additional question:
If what I have is indeed herpes, what would the mupirocin do (if anything) to the area? Things have definitely improved, but I'm trying to gauge if it's a fluke or not.
Any information will help. Thank you.
If what I have is indeed herpes, what would the mupirocin do (if anything) to the area? Things have definitely improved, but I'm trying to gauge if it's a fluke or not.
Any information will help. Thank you.
Thanks!
MEDICAL PROFESSIONAL
I don't think that was a risky decision at all; it was a wise one. As I said above, a superficial bacterial infeciton seems a pretty good bet. But whether the mupirocin resulted in such rapid improvement is questionable. Inflammation due to staph or strep could start to improve within a day (reduced weeping and redness, etc) but actual healing cannot be so fast -- that takes a few days. So most likely those lesions were well on the way to healing anyway.
In any case, glad to hear things are getting better. Keep up the local hygiene, loose clothing, etc -- and it probably can't hurt to keep applying mupirocin for a few days as well.
In any case, glad to hear things are getting better. Keep up the local hygiene, loose clothing, etc -- and it probably can't hurt to keep applying mupirocin for a few days as well.
Thank you so much for your quick response. I have an interesting update. Since there is confusion as to what this is, I made a somewhat risky decision and applied Mupirocin ointment USP, 2% to the remaining ulcers on my scrotum that had not yet healed. After an overnight application and two applications today, there is a dramatic difference. The sores have stopped weeping and are almost completely healed. I also have been wearing loose lounge pants which may promote healing in this area, but is there any chance that if this was bacterial the Mupirocin would be able to act that fast?
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
