[Question #1612] Herpes

44 months ago
Hi.  I have another question.   I was introduced to a girl and we had protected sex 3 times and oral sex unprotected 5 times . She would also give oral pleasure to my scrotum.  Last time I had sex was November 15.  About November 22,  I noticed 1 bump on my scrotum.  At first it was under neath my skin and the next day there was a visual bump. It itched a little bit .   For some reason I put an ointment for ingrown hair on it .  I didn't think much of it it and went to work .  When I came home at night scratched my balls and I forgot I had the bump.  Due to the scratch the bump came off.  There was some clear sticky fluid and blood.  It didn't hurt much.   2 days later I went to my general doctor and he saw the ulcer .   He assured me it was not herpes.   He said the ulcer was too deep.  The ulcer did not really scab and it went away in a week. It hasn't come back again but i always think my testicles are tingling .

1. Can a doctor tell visually it was not herpes

2. Was this herepes.  Worried bc of the clear fluid 

3.  Can herepes go on scrotum.  What if she had oral herepes.  I didn't see anything but she said she gets them sometimes 




44 months ago
After the initial fluid and blood ,  the ulcer was dry 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
44 months ago
The CDC says that all herpes diagnosis should be made by a lab test because a visual exam in wrong about 20% of the time, according to one well done study.  Errors are made in both direction - calling things herpes that are not and saying things are not herpes when they are.  I'm assuming from your post that no swab testing was done of the ulcer?  Condoms certainly reduce the risk of acquiring herpes, but they aren't perfect and the unprotected oral sex is also a risk for acquiring HSV 1 if you don't already have it.  Have you ever had a cold sore on your lip? If yes, then the risk of getting HSV 1 from receiving oral sex is tiny tiny.  If you were my patient with this history of an ulcer lasting about a week that showed up about a week after sex, I would recommend that in about 12 weeks you get an IgG test for HSV antibody and if it comes back again before that, immediately have it swab tested.  Now the good news is that herpes on the scrotum as a first outbreak would be uncommon.  I don't know what's going on here, but I think following up with testing in this situation is a good idea. 

Terri
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44 months ago
I think I had cold sores on my lip when I was a kid .  2-3 times.  Last time I was in high school . But I have not had any as an adult the last 20 years .  Now I'm double guessing if I had them before.  Is it common for cold sores not to reoccur?  Does it mean I have hsv 1?  If so getting hsv 1 in genitals is tiny chance ? 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
44 months ago
If you have EVER had a cold sore, you will have an immune response including a positive antibody test, for the rest of our life.  And yes, that means you do have HSV 1 and the change of getting it genitally through receiving oral sex is tiny. You got it!

Terri
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