[Question #1581] Could this be herpes?

44 months ago
I am a sexually active male and always use protection. Was tested back in February including HSV, all negative. At the beginning of December I entered into a monogamous relationship where my partner has assured me she is clean of any STIs so we have been having unprotected sex.

Last Weds we had pretty vigorous intercourse and went to sleep. I woke in the middle of the night with a sharp stinging on a spot on the right side of my penis, almost like a bug had bitten me, but went back to sleep. The next morning at that spot there was a large, hard, pussy looking pimple. I squeezed it but didn't get much out of it and then the spot basically ulcered and scabbed over with a dark scab by the the end of the day. This Monday evening, after several days of that spot looking like it was healing I notice a few small, clear fluid filled blisters surrounding the ulcer. I went to my GP the next day who said it didn't look like herpes and herpes would be very painful especially when touched, I'm not in any pain only very mild itching, but took a swab to be tested. Still waiting for those results. He had me start using cortisone as he thought it was dermatitis/allergic. I think the cortisone made things worse. Since then there have been more of the small vesicles appearing gradually further away from the initial large pimple moving toward the base of my penis. Each day I see 2 - 3 new spots where these are popping up but they all quickly turn into small ulcers with scabs.

I know my GP said not to worry, and not likely herpes in his opinion, but now I am starting to panic. Does this sound like herpes to you and if not, what might it be?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
44 months ago
Unfortunately, your symptoms sound like herpes to me but I wasn't there for your exam so I can't be certain of course.  And using cortisone would definitely make herpes worse, taking away the cellular immune response that is so important in managing herpes.  Was your physician able to do a swab test of the blisters, broke them open and gathered the material in a swab?  Was your partner the giver of oral sex to you?  The timing of about 5 days from sex fits closely with when herpes would show up.  Has your partner actually been tested for herpes, do you know for certain?  Most STD screens don't include herpes testing.  When are you going to get your swab test results?  Do you know if was a culture or a PCR? 

Terri
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44 months ago
Terri,

Thank you for your initial reply but I think maybe the way I phrased my initial question/concerns may have been confusing. There was no oral sex involved. My partner and I have been together and intimate for several weeks now. So this 'episode' would be about 20 days from our first sexual encounter. The thing that really doesn't add up to me is the initial large pussy looking pimple that showed up. It was hard and definitely not something I would describe as a blister. Almost more of a really badly infected ingrown hair, even though there is no hair there, that showed up the very next morning after our most recent encounter. I did use a towel to clean up after that night that was probably used and not washed for several days. That 'pimple' I squeezed pretty hard but never got any of the puss/white material to come out. Shortly after that it turned into a crater with a dark scab for lack of a better description and looked red/infected around it. Then about 4 days later is when I noticed small clear vesicles that began appearing around that pimple. No pain, or soreness or flu like symptoms and the vesicles I saw, and the pimple, looked nothing like any herpes pictures I have found online. And I've looked at a LOT as you can imagine. The only other X factor here is that I did have a one night stand with a friend of mine who also says she has been tested recently and is clear of everything 2 days after the 'pimple' appeared while it was scabbed over, so the first clear vesicle would have been 2 days after that. I have spoken to my partner and she was tested in September and says she asked to be tested for everything, no issues.

My doctor did pop one of the blisters and swabbed it for labs which he hopes will be back tomorrow. Not sure which tests he is running. Again, he said he didn't think it was anything to worry about mostly due to my blisters not looking like typical herpes and my complete lack of pain/discomfort even when he touched the blisters and around that area. 

So does this change your opinion that it is likely my first herpes outbreak? And assuming it's not herpes, do you have any thoughts on what it might be? As of today 5-6 days after the first vesicles I have no more blistering only typical dark scabs. None of the vesicles ever crusted over or caused a wet ulcer which I have read are also typical stages of an outbreak. Thanks!
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
44 months ago
I agree that the bigger pimple thing doesn't sound herpetic. 
Even if your partner asked to be tested for everything, it doesn't mean that herpes was included.  I would encourage you to ask her to get her records to see for you. 
It could certainly not be herpes, I'm hoping it isn't, but few things look like water blisters in the genital that aren't herpes. 
Let's see what the swab test shows - if positive, be certain to ask that it be typed, OK?
Let me know please, what the test shows.

Terri
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