concerned about possible herpes infection

[postage14]

hi

a little while ago I had an unprotected oral encounter that lasted approx 10 minutes off and on. I had anal intercourse (unprotected) with my boyfriend. a few days later I was totally fine for the day, then masturbated, and suddenly a couple hours later I was peeing razors. Next morning I took 2g azithromycin, and that didn't help with the pain at all. now today (8 days later) the pain has slowly begun to reduce, but then I noticed a single hard flesh-colored lump about 3mm diameter right underneath my penis glans on the shaft that had NOT been there the day before. it didn't hurt at all until I (stupidly) tried to use tweezers to pop it. no fluid came out, but the top came off and now has been sore ever since (probably cause i aggravated it).

at the same time, this last thursday my partner began having throbbing pains on his anus, and inspecting it looked like a flesh (red) colored lump jutting straight out from the sphincter, but I also noticed yesterday he had two small (about 4mm) flat red scarred over areas about 8-10cm from his anus.

the internets tell me that i quite likely have herpes, but i don't know. thoughts?

[H. Hunter Handsfield, M.D.]

Yes, azithromycin (Zithromax) could well give negative resutls even if you had gonorrhea or chlamydia.  Had you asked ahead of time, I would have advised not spending money on those tests once you had been treated.  Azithromycin also would abort syphilis if you had been exposed.

[postage14]

Thanks Dr for the reply. As of now my dysuria is continuing but diminishing, though my partner is also complaining of dysuria now. I had an STD test last Friday (three days after taking the zithromax) for chlam/gonn/syph/hiv and those have all come back negative. i'll keep you updated. would the zithromax produce a potential false negative in the naat urine test at 3 days later?

thanks!

[H. Hunter Handsfield, M.D.]

I saw this before replying above.  It does not change my opinion or advice.

[H. Hunter Handsfield, M.D.]

Welcome to the forum.

The main problem here is that you are apparently hoping for a clear diagnosis without ever visiting a doctor or clinic.  It was a BIG mistake to treat yourself with azithromycin (or anything else) without professional guidance.  That may have screwed up any chance of learning what's going on.

That said, the severe pain ("peeing razors") immediately after masturbation suggests to me that you may have gotten something irritating into your urethra.  For example, if you used soap as a lubricant.  Soap is very irritating and painful in the urethra.

As far as the penile lesion you describe, a pimple probably is most likely.  Here too, you screwed up by trying to treat it yourself by manipulating it with tweezers.  I'm inclined to believe that no STD is the explanation, but I cannot tell with certainty.  I'm not going to try to speculate on the causes of your partner's anal symptoms/lesions.

My advice is that both you and your partner cease any attempts to manipulate your lesions, and that you both visit a doctor or clinic -- preferably together -- for professional evaluation.  Please return with a follow-up comment to let me know the outcome.

Regards--  HHH, MD

[postage14]

Also: I have pain when ejaculating (subsequently after the urination pain started), a tender/painful feeling on the right side of my groin if I press / walk quickly, and general muscle aches and pains. So, before the random lump/blister/whatever it was formed, I thought perhaps prostatitis.