help please

[rs81]

well i got oral sex from a girl, then two days later i had pain and burning in the urethra, so i went after five days from exposure and got test and for everything, gon,clam, and herpes,  the igm herpes test came back positive, i had no blisters, no itching, and no discharge, only thing is that after i urinate the urethra feels like its burning, so i went to my dr and told him about the test and he said its herpes and send me on my way, then around 20 some days in my left testicle started hurting, so i called my dr and he put me on ciprofloxacin for two weeks, during this time there is a foul smell down there, its not there all the time but some time, when i went to the dr he tested my urine and he said its clear,  now im on my 41 day post exposure and still i have burning after urination, i feel fine when i urinate, i still see no blisters or sores any were, the ciprofloxacin didnt work, if i eat spice food then the pain is more,  i think i can safely say this is a case of herpatic urethritis.  so please help me im going nuts with this pain.

[Edward W Hook, MD]

This will be your last answer.

People who have false positve IgM tests for herpes can have them repeatedly since may of the false positves are due to antibodies due to other past, related infections like chicken pox.

Herpes does not cause smells of any sort.

This thread is over.  Further questions will be deleted without comment.  EWH

[rs81]

hello dr
today i went to see my dr and he told me that this sounds like neuralgia caused by herpes,
he did a pcr swab test in the urethra, a igg and igm blood test and i will get the bad news during next week
one question if my last igm test was positive would this new igm test be positive also?  does herpes cause smell?  he also did a urine test which was clear for everything, before i went to the dr i saved my first urine to be tested just in cause and he also did a new one when i got there, everthing clear. thank you and let me know what you think.

[Edward W Hook, MD]

Understood.  Please let us know what your docotor says.  EWH

[rs81]

thank you so much DR
im just going nuts with this and cant seem to find out wats wrong with me and only thing i can come up with was that stuipd test and then in my head herpes was the # one thing,  thank you so much u been a great help, sorry if i got you mad with my question about herpes, will be going to my DR tomorrow and hope i will get some answers, which i most likely wont. i will let you know if i get an answer   THANK YOU.

[Edward W Hook, MD]

You asked me for my opinion.  I told you, based on nearly 30 years as a STD specialist and running research STD laboratories that this was not herpes and that HSV IgM tests are worthless and not recommended for routine  HSV diagnosis by ANY STD specialist.  You chose to not believe me or to follow my suggestions, that is your privilege.  I really have nothing more to say.  This will end this thread.  Good luck and I sincerely hope this will resolve soon for you.  EWH

[rs81]

thank you so much dr
well im at work to day and after i urinated the burning came and i had the pain for about 10 hours now and it seems like when i sit for a long time the pain becomes worse and when i sit my butt doesnt feel right, and any idea the smell down there, does herpes cause smell at all? i cant explain it, may be bad urine type of smell, by doing a swab test could my dr find out if i have herpes in the urethra, i know you said that theres nothing that says i have it but just to be on the safe side since my IGM test came back very high like 7.32, and my symptoms started after 2 days from exposure, just wat they say about herpes symptoms, which says symptoms will start from 2 to 20 days, does herpes cause smell at all, i know you said i have no symptoms of herpes but is it to early to test with a swab test for herpes(its been 41 days post exposure) thank you and im just going nuts with this pain

[Edward W Hook, MD]

Perhaps you did not read my answer.  I will repeat the citical points.

There is nothing to suggest you have herpes.

Ciprofloxacin does not cure NGU.

I would not send yout o a urologist.  I think you need to see someone who can check you for NGU.

Nothing more to say.  EWH

[rs81]

thank you so much dr
im going nuts, my dr gave me ciprofloxacin, doesnt that take care of NGU, i have checked inside the urethra and there were no lesions that i can see, sometines its the urethra is red, some times i feel like theres discharge and when i check theres noting there, but there is a weird smell down there, im so worried and i check my penis and urethera like 10 to 15 times a day for any signs,  if it was herpetic urethrits the lesions would be inside the urethra or outside, im reading alot of things online and im going nuts, and i also read about some guys who has herpetic urethritis without any lesions, sorry im just going nuts with this pain,what kind of test can be done to see if there is herpes in the urethera and is it to soon to check (41 days post exposure), the burning pain is constant, after urination, i have no pain during or after ejaculation, no pain meds seems to work, im going to see my dr again on friday hope to get some answers but i strongly dont think i will get any answers, he will most likely tell me to see a urologist, if it is herpetic urethritis does it infect the prostate and testicle.  sorry for so many questions im just going nuts with this.

[Edward W Hook, MD]

Welcome to our Forum. Here at MedHelp we try very hard not to disagree with the advice that our clients have received from their doctors.  I am afraid however that the information that you have provided me above brings me to different conclusions.  

The only exposure you describe is oral sex.  Oral sex is an inefficient way to transmit STDs.  Of the bacterial STDs only gonorrhea and nongonococcal urethritis (NGU) are transmitted through oral sex; chlamydia is not and without an obvious sore or lesion on your partner’s mouth, the chances of syphilis and herpes is likewise tiny.   I suspect you got NGU from the exposure you describe.  Many cases of NGU are not caused by readily identifiable bacteria and the problem is best diagnosed by demonstration of inflammation (white blood cells) either in a smear made from a swab specimen taken from the penis or in the first part of a voided urine specimen.  When people have NGU, they should be treated with either azithromycin or doxycycline.

Nothing you have said suggests that you have herpes.  You have not had lesions and many things, including NGU can cause the sort of discomfort you describe.  No experts recommend testing for HSV IgM because the test tends to have more false positive results than it does true positive results.  In general, a positive HSV IgM is a waste of time and money and positive results should be ignored.  

My advice is to seek a second opinion.  I would suggest you go to your local STD clinic.  Without lesions, this is almost certainly NOT herpetic urethritis.  EWH