[Question #1261] STD

47 months ago

i met a ukranian girl a month ago and we spent a few days together.  first time we had sex i got a bruise because of dry humping.  it hurt for a while and did not heal for 2 weeks.  and then a couple of weeks after that incident i was masturbating at home and afterwards i noticed these weird bubbles on my penis around the bruise.  i started noticing that my lymph nodes in my groin are a bit swollen and i got a fever the next day that lasted for 2 days.  i was told that it might be lymphoceles and that i should not worry.  i popped these bubbles myself and they hurt a bit but have now healed but my lymph nodes are still swollen.  i dont think i have other symptoms.  she is not a sex worker (or at least i dont think so) and she looks perfectly healthy and claims that she gets tested.  she is from eastern ukraine and i know this is a high risk area and also the fact that i had a bruise while having sex is high risk

Edward W. Hook M.D.
Edward W. Hook M.D.
47 months ago

Welcome to our Forum.  I'll try to help.  The bruise that you experienced during what I expect was vigorous dry humping is not much of a surprise and the changes you describe in the bruise may be normal as well- they certainly do not suggest an STI of any sort.  The other possible STI which comes to mind when you describe "bubbles" on your penis is, of course herpes which can be transmitted by persons who do not know they have the infection (the belief that everyone with herpes has painful lesions is incorrect).  If these "bubbles" were due to a first episode of herpes, I would have expected them to form shallow ulcerations and then gradually resolve over at least a week or so following their appearance.  The country of origin of your partner does not particularly concern me.  That said, I would recommend that you have a urine test for the most common STIs (chlamydia and gonorrhea) since these infections may occur in women or men without symptoms and we recommend routine testing for any person who has sex with a new partner.   If the penile lesions ("bubbles") are now gone, there is no good test to tell if they were herpes of not but should you have recurrent of the "bubbles" in about the same location, I would suggest that you seek a PCR test for herpes to be taken from the lesion.  Even if the bubble open and break or are clear in appearance, such lesions can be tested for herpes using the PCR test (I mention this as many health care providers are not clear on this fact).

If you are seen at an STD or sexual health clinic, you may be offered HIV or syphilis blood tests as well and while I do not feel they are essential following a single exposure of the sort you describe, whether or not you get them is, of course up to you.  Having raised the possibility of herpes, I should also tell you that in situations such as yours, we strongly recommend AGAINST herpes blood tests.  They are commonly falsely positive and results can be misleading.

I hope these comments are helpful.  EWH

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47 months ago

what is worrying me here dr is the swollen lymph nodes in my groin area... they have been swollen for a couple of weeks now and do not seem to be getting any better. could this be due to an infection in the bruise (although it has healed now)?  i live in cairo egypt and i went to see a dr about 10 days ago and he said that these sores do not look like herpes and asked me for a blood test (CBC) and a CMV test.  he is a general practitionist and not a specialist. 

i would also like to add that it was not a single exposure, we had sex numerous times during those few days with the bruise on my penis. i have been trying to upload a pictue of these sores / lesions here but there is something wrong and keeps failing.  if you have an email i can send you the pictures to take a look at them and maybe could be useful in assessing the situation.

Edward W. Hook M.D.
Edward W. Hook M.D.
47 months ago

I'm sorry, we do not look at pictures on our site. The are too often misleading.

Swollen lymph nodes are a non-specific finding.  Swollen lymph nodes in the groin can be due to infections or inflammation anywhere in the legs as well STIs.  I may have mis-read your earlier post.  I note that you did not mention using condoms when you had sex with this partner.  If you did not use condoms for all episodes of sex with this, woman, then I would recommend that you be tested for STIs, particularly chlamydia (gonorrhea as well) which can be present without signs of penile infection.  Revising my early suggestions based on multiple exposures and no condom use, just to be sure I would also do a blood test for syphilis and HIV, just to be sure.  I apologize for missing that you had unprotected sex with this partner.  This could certainly be a chlamydial infection which you partner was unaware of.  EWH

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47 months ago
Hi dr Edward. So I went and got a full sti screening (blood test) including hiv 3rd generation test, syfilis, chlamidya, cmv igm igg and hsv 2 igm and igg. I tested negative for everything except hsv 2 igm. I know that you strongly recommended against herpes blood test but it was part of the package so I went ahead and did it. Now that I tested positive for hsv 2 igm, I would like to know in what sense can this be misleading. Also the hiv 3rd generation test was done 4 weeks after the incident...how accurate would this negative result be?
Edward W. Hook M.D.
Edward W. Hook M.D.
47 months ago

Sigh.  the HSV IgM is not recommended by us or by official bodies such as the CDC because it has an unacceptably high false positive rate, causing unwarranted anxiety and misleading anxious persons such as yourself.  I would ignore this result if I were you. 

At 4 weeks a 3rd generation HIV test would detect over 90% of recently acquired infections, perhaps close to 95%. 

As you know, we provide up to three responses per question.  This is my third response to you and therefore this thread will be closed later today.  I wish you well.  EWH

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47 months ago
Thank you dr Edward for your help and reassurance ... Very much appreciated