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Avatar universal

another herpes question

Firstly, many thanks for the service you provide!
Aug 18th - 1 night stand with girl I met at bar while on vacation in usa; cunnilingus, protected sex using condom.(some unprotected genital contact).  sept 4th, developed tingling which turned into blotchy areas on head of penis and foreskin after a few days (especially on left side of ridge area at base of head where foreskin covers - red, purple in colour-there were some bumps but they didn't appear blister-like to me and don't seem to have crusted over since) .started to experience a cold numb pain in penis area+aches, joint pain. Went to g.p. (in ireland - sept 7) examined me, suggested it was a urinary problem, prescribed ciproxin. Pain got worse over next 4/5 days - inflammation around left side of head of penis got slightly worse- skin did appear cracked when penis was flacid but when I examined area closely I couldn't see blisters or significant break in skin, rather inflamed red skin with some bumps.
attended std clinic on Sept 17th. Rash and pain had subsided for the most part at this stage.results came back ok a week later(sept 24th).I was informed that they would not test blood for herpes as testing in ireland doesn't distinguish between type 1 or 2 (cold sores since childhhod).   Meanwhile on Sat 22nd Sept. I noticed a markedly isolated red circular area on shaft of penis near pubic area which has faded in colour but is still visible a week later -area didn't seem overly sore or itchy. For 2 days subsequent to std clinic visit, penis pain worsened and tenderness where leg joins groin.
1.Is it possible that a yeast infection explains symptoms described?
2. When you refer to lesions or ulcers, does this always mean that the skin will break or can they be so small that they're not all that obvious to the untrained eye?
3. Is there any situation where herpes causes genital pain, a rash and bumps but these bumps do not turn to blisters which burst then heal over?

4 Responses
239123 tn?1267651214
Your description doesn't really sound much like an STD.  I cannot rule it out, but apparently your GP didn't think an STD was likely.  That said, you also don't describe anything that sounds like a "urinary problem" and I have trouble understanding what the GP thought was being treated with ciprofloxacin.  To your direct questions:

1) Yes, your description sounds compatible with a yeast infection, or a related fungus.  However, it could be any number of other skin conditions; most of the things that cause rash anywhere on the body sometimes can affect the genitals.

2) The term genital ulcer, as used by STD experts, usually means discrete open lesions involving skin or mucous membranes that otherwise are normal.  In other words, we would not normally use that term for the cracking lesions or fissures that are typical within a generally red or irritated area, as occurs with yeast infections and other things.  In theory, a genital ulcer might be so small that it would be hard to see, but generally if the skin looks normal, you can be confident no ulcer is present.

3) Herpes lesions sometimes heal without going on to form overt blisters or open sores, but it is uncommon.  Most important, the fairly diffuse sort of rash you describe, it's initial "blotchy" appearance, and its duration are very much against herpes, which almost always heals completely within 2-3 weeks.

My bet is that whatever you have, it is entirely unrelated to your sexual adventure on this side of the Atlantic.  But I suggest you get follow-up care to figure it out.  Consider a visit to a GUM clinic, which most likely is available nearby, at least if you are in or near a metropolitan area.  In the meantime, I wouldn't worry about herpes.

Good luck--  HHH, MD
Avatar universal
Many thanks for your prompt response doctor. I'm concerned that I wasn't accurate enough in my description as space didn't allow. I'll attempt to be concise.
AUG 18TH- sexual encounter.
AUG 28th(possibly irrelevant to current problem) -visited doctor in usa after 7 days of genital pain(similar to having been kicked in groin), joint ache and stiff neck.(no rash) Urine tested for stds-all clear. Verdict - prostatitus + seperate viral infection. Prescribed doxycycline 30 days
SEPT. 7th. Visited Irish GP after 3 days of rash and numb pain specific to penis. Visual examination. Urine sample dipstick - doc mentioned something about white cells. Verdict- 'urinary problem, couldn't be herpes as it'd be severe burning pain and would have come earlier'. Taken off doxycycline and put on ciproxin 10 days.
SEPT. 17th. STD/GUM (think they're the same?) clinic as pain and rash got worse over 5 days, then faded by time appointment came around. Blood, swabs and urine test.(came back all clear 1 wk later). not tested for herpes for reasons mentioned above. Verdict - 'come back if physical symptoms return'.(clinic held once fortnightly).
SEPT 22nd. Rash(on penis head) returned(with less pain than previously). New isolated bright red circular area on shaft, near pubic area appeared(not overly sore or itchy, but still visible after 6 days)
SEPT 26th. Visited dififferent GP. Informed him of history of problem. Physical/Visual exam, swabs taken. Verdict - 'possible Epididymitis-come back in a week when results available'. Given anti-fungal pill and cream to 'clear up candida'.
SEPT 28th;posted query to forum as very confused by experience and can't have herpes type 2 blood test done. not normally so concerned health-wise - cant remember last time i'd been to doctor prior to ths experience.
1.Rash seems to be fading(3 weeks after first appearing) -consistent with herpes?
2.Re:item 2 above. Skin did not look normal - it was/is red and inflamed. blisters not obvious to me but this does not rule out herpes - correct?
3.Concerned about atypical symptoms -likely?
4. Is pain associated with herpes always a burning sensation?
5.Understand that once-off encounter is low risk but confused by statistics - If statistics suggest that couples who have sex 3 times weekly where one has the virus and the other doesn't results in transmission rates of only 5% yearly, assuming we all start off without the virus, why then is it estimated that 1 in 4 carry the virus if transmission seems so unlikely?
Many thanks once again. If you get the chance to readdress my concern/queries, I 'd be greatly appreciative!

239123 tn?1267651214
This site is not a substitute for in-person medical care, and anyway no distant expert can add anything when 3 or more health professionals have evaluated a problem without clear answers, especially when the include STD experts like those at an STD/GUM clinic.  In any case, there is nothing in all that additional information that changes my original opinion or advice. Clearly herpes does not explain your symptoms.  Let it go.
Avatar universal
Doctor, thanks for your previous advice! I understand entirely the argument which suggests that you cannot contradict from afar the judgment of doctors who have seen me in close quarters. I also imagine that when you read that someone has seen 3 doctors and that none have given me any kind of positive diagnosis of herpes, then you have to be dismissive of it as a possibility. However I'm currently experiencing symptoms again which trouble me greatly and it appears that no one locally can tell me whats going on. I have reason to believe that the two GP s I've attended aren't particularly up to date in their knowledge of the area as both were adamant that symptoms would appear within days after exposure and that I would have obvious herpetic blisters. My understanding from what I've read here is that this isn't necessarily so? The std doctor I attended said that the only way she could diagnose it was through visual inspection where obvious lesions were present.(My understanding therefore, is that if I had herpes, I would have at best, a 20 percent chance of having it diagnosed properly as the figures she quoted me were 60 percent - no symptoms, 20 percent - obvious symptoms and 20 percent - atypical symptoms.) She didn't tell me that it was unlikely I had it but that she couldn't tell at time of examination. The reason I'm writing again is that over the past two weeks I've experienced the following (for me, worrying) symptoms:
Rash on penis cleared up somewhat with skin peeling, but returned again.
I experienced pain on left side of groin and all down the inside of my left leg last week for 5 /6 days.
Similar pain in elbows, wrists, stiff neck as experienced previously, for a few days at a time.
In the past three days, there's been a very thin paper cut-like crack on the right hand side of base of head of penis which stings considerably. It hasn't responded to daktacort cream or sudocream.
I've also had very tingly lips suggestive of cold sores upon which i've applied zovirax. This happened a few days after initial incident and once more subsequently. I didn't think it was significant at the time but fear it may be now? (Regarding cold sores on the lips - I rarely get blisters, but rather tingling tight cracking lips which I treat with zovirax immediately. I can also distinguish between a cold sore and just cracked lips from being exposed to elements.)
1.As i've had a regular blood test done with nothing abnormal showing, been prescribed antibiotics which haven't really done anything for me and had limited success with an anti-fungal cream, am I justified in still suspecting herpes is at play?
2. It is possible for me to travel a distance to have a type-specific herpes blood test conducted. Is it necessary and if so, is ten weeks sufficient time for something to show up on it?
I hope you'll be able to address my concerns at what is a dificult time for me. Sincere thanks again!
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