Dear Doctors -- I did something really stupid, and had sex with a woman I met on-line. It was protected vaginal sex and unprotected oral sex. This was 18 days ago.
About 24 hours after the encounter, I started to have flu symptoms, including high fever, chills, coughing, and night sweats. This lasted about three days, then I recovered. During this time, I did not have any other symptoms...no painful urination, no sores, no tingling, nothing. I did, however, have a lot of muscle pain in my back and neck, and some congestion and coughing, which persisted more or less for about 10 days. On day 16 after the encounter, I noticed a small red bump (I wouldn't call it a pimple, nor would I necessarily call it a "lesion") on the area that is right in the crease where the shaft of my penis meets my scrotum, near the hairline. There is no fluid on the top of it that I can see, and this is the only "bump" that I have. Two days have passed, and the bump has not changed very much, except perhaps getting a bit flatter and a bit redder.
As you can probably tell, I am sick with worry and anxiety over this thing. I have read many posts in which anxiety can cause a lot of symptoms and magnify issues and discomfort. Based on what I've noted, do you think this is herpes? Should I just wait for the bump to heal, and stop worrying?
Congratulations on having safe sex during an encounter of this sort. You used a condom for vaginal sex -- that's the important part. Oral sex is safe sex for practical purposes -- not completely risk free, but with essentially no risk for HIV and certain others, and low risk for all STDs.
Your "flu symptoms" are not due to the encounter you are concerned about. No infection starts to cause symptoms in under 24 hours; 2-3 days is the minimum for almost anything, including the common cold and influenza. Almost certainly whatever virus you had was already incubating at the time of the sexual contact. And anyway, there is no STD (including herpes) that causes "high fever, chills, coughing, and night sweats" or muscle and back pain. You give almost a textbook story of the symptoms of influenza, which is probably what you had.
As for the skin "bump" you describe, several aspects also argue against herpes: wrong location for new HSV infection; only a single lesion; and no change over two days, especially no evolution to blister-like lesions.
I don't think your symptoms are caused primarily by anxiety -- but I am also confident they aren't caused by herpes or any other STD. From the standpoints both of your risk and your symptoms, it isn't even necessary to test for STDs -- but of course you are free to do that if some negative lab results would help reinforce my reassurance. If somehow I found myself in your situation, I would not be tested and I would continue unprotected sex with my wife without fear of transmitting anything to her (except my influenza or other respiratory virus).
Thank you very much, Doctor, that makes be feel a whole lot better.
One more thing I would like to add (and I should have said it in my original posting):
About three years ago, I had a case of genital warts (not exactly in that area, but close), which were successfully treated with Aldara and also with some freezing. It is possible that this red bump is the GW coming back, in some fashion? On the other hand, I have had an occasional pimple over the years, in that area, too.
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