[Question #1731] Chances This Is Herpes

45 months ago
I had a one night stand, brief unprotected oral and protected intercourse.  No clue on her STD status.  About 10 days later, I developed a rash on my scrotum.  It was only my scrotum, there were 3 small whitehead pimples on it, but the whole scrotum was/is red.  Eventually, my thigh folds and anus also became red (that still comes and goes) I went to a dermatologist about 3 weeks ago and he wasn't sure what it was, but decided to try fungal, he took a culture (still waiting results) and gave me nystatin and gabapentin.  I guess it's a little better, not really sure.  Today, I found two pimples on my buttocks.  I am at week 10 since the encounter.  I took a full STD panel at 6 weeks and everything was negative.  I took a HSVI/II test yesterday and it was also negative.  However, scared of herpes, I have taken valtrex intermittently.  

My valtrex schedule was:
week 3 - 1000 mg/2x daily for 6 days
week 5 - 500mg/2x daily for 4 days
week 8 - 500mg/1x daily for 7 days

Can I be at all confident in these results considering the valtrex, I've taken.  Are these symptoms possible with herpes?  

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
45 months ago
There are several things working against a herpes diagnosis here, in my mind.  The first is that the first symptoms were 10 days later - possible with herpes but on the long side for symptom development.  The next thing is that symptoms first showed up on your scrotum - normally, new infection in men presents on the penis, with vaginal intercourse.  The next thing is that you used condoms and when condoms are used, transmission is greatly reduced (though not impossible).  The next thing is that herpes wouldn't make your entire scrotum red, nor would it make your thigh folds and anus become red - that sounds a whole lot more like a fungal infection to me 

Have you ever had pimples on your buttocks?  Most people have. Herpes on the buttocks presents as significant water blisters and generally hurt and are usually quite obviously different than pimples 

The next thing is that you are negative at 6 weeks.  According to research by Dr. Morrow at UW, a negative at 6 weeks has a 70% chance of staying that way at 12 weeks. 

Your Valtrex treatment isn't ideal for continued testing, but you've not taken way too much at this point - if you want the most accurate result though I would suggest that you stop it. 

Terri
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45 months ago
Terri, thank you for the prompt response.  Since the scrotum is not protected by a condom, I was worried that something got on there.  After finishing the encounter, I went home and tried to wash off in the sink before going to bed, I'm now concerned I may have massaged the virus into my scrotum.  Is that possible? 

I forgot to add a couple of things, not sure if it changes anything.  The line down the center of my scrotum (raphe?) is normal color.  Also, my penis seems really dry and the tip goes from bright red sometimes to white/flaky.  One other thing, since this started, my ejaculations have gone from very strong to barely dribbling out, I suppose this could be anxiety.  

Would herpes (or any STD) have anything to do with these?  

I've read that herpes doesn't cause such prolonged symptoms, Is this true?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
45 months ago
Herpes would have nothing to do with the color of the raphe of the scrotum nor would it have anything to do with ejaculatory volume, nope.  You are able to pee and poop OK?
Washing the area would not massage in virus, no.  Soap destroys the lipid layer of the virus which is a good thing!
And I agree that herpes would not cause such prolonged symptoms.  I don't think herpes is what is going on here.

Terri
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45 months ago
Thank you again Terri, you are making me feel much better.  Of course I'm still going to worry until I get a final conclusive test result.  Yes, I pee an poop just fine.  No pain during urination or ejaculation.  So you don't think dry penis and white penis head (circumcised) are anything to worry about?  Like I said, I was tested (Elisa IGG) yesterday (10 weeks) and got a negative result today.  This was about 2 weeks since my last valtrex pill.  If I test again in about a month (14 weeks) could I consider that conclusive, as long as I don't take anymore valtrex?  I understand this is my last question, but am I allowed to post an update with my results for other users later, or is this my last allowed post?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
45 months ago
Good news that you have another negative result today!  I am not worried about a dry penis and white penis head - I'm wondering if you might have a fungal infection as we previously discussed?  I'm sorry, but this is your last post on this subscription, but you can renew.  I feel quite certain that you'll stay negative but please don't take any more Valtrex is you want to get the most accurate result.

Terri
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