[Question #1770] Do these symptoms indicate herpes or other STI?

42 months ago
16 days ago I visited a sex worker and received condom oral sex except for 5-10 seconds of sucking/licking on bare scrotum. I'm worried that contact with my scrotum has lead to herpes/STIs. I have had no signs of sores, no itching out of ordinary, no painful urination, no nausea however there is some radiating pain in my thighs, down my legs and into my feet. Also I've had a cramped abdomen and some pain in my fingers/hand and across shoulder blades. I read online about herpes related nerve pain (herpetic neuralgia) but have no other symptoms to narrow it down. Absent more obvious signs, is this nerve pain indicative of a first herpes outbreak or am I getting myself worked up? Thank you. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
42 months ago
Good for you for using  condom while receiving oral sex!  The 5-10 seconds of mouth to scrotum are very unlikely to result in an issue, especially because scrotum skin is a bit thicker and a little less vulnerable to acquiring an STI.  If you were to get an STI from this encounter, which is about the same odds as being struck by lightening, it might be herpes.  But given that you have had no lesions or itching or pain with urination, I don't believe that you have acquired any STI, including herpes.  So many people report radiating pain down the thighs, legs and into feet, but in my experience, the vast majority of them end up testing completely negative for herpes.  And genital infection would not manifest itself with pain in areas outside of the lower part of your body.  While some people with genital herpes do have intermittent nerve pain, most often before or during an outbreak, it isn't as common as you might think anyway.  In answer to your question, due to you very careful safe sex practices, I think the nerve pain you are reporting has nothing to do with acquiring herpes from this encounter.  Hope that serves to reassure you.

Terri
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42 months ago
Do you know of any other infections (STI or otherwise) that would account for the pain in my arms/hands? Also, there was quite a bit of deep french kissing. Does that change your opinion of the symptoms? To what extent could some of these symptoms be chocked up to anxiety? Is there a chance I DO have herpes but the sores just haven't shown up yet and these nerve pains are actually an early sign? Or is it more likely that, given the length of time since I saw the woman, the more typical symptoms would have presented themselves by now (along with what I'm worried are early signs)? If I'm asking too many questions for one thread, please let me know and I'll pay for another. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
42 months ago
Most herpes symptoms, with new infection, appear with in 2-10 days, with 5.5 days being the average.  So yes, I think you are beyond the time when you would become symptomatic and most herpes does not start with nerve pain but rather lesions.  I don't know if you have herpes from before this encounter but there is no reason to think that you acquired herpes from this particular encounter.

Terri
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42 months ago
Ok, thank you for listening. Do you advise I wait and see if any sores appear over the course of the next few weeks? Also, I have swollen lymph nodes in my neck that I can feel in my throat. Does that indicate some other STI? Should I post another question to the other doctors? 
42 months ago
And, finally, does the presence of swollen lymph nodes in the neck on both sides change your opinion about genital herpes?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
42 months ago
No, you don't indicate in your post that you were the giver of oral sex to this person - if you were not, then there is no reason that the lymph nodes in your neck would have anything to do with this sexual contact.  From your report, the only contact you had was her giving you oral sex with a condom and a very short period of unprotected licking of the scrotum.  Nothing there would result in enlargement of the lymph nodes in your neck - if you had developed an STI you MIGHT have lymph nodes in the groin area but not the neck area.  I don't believe that you are at risk for any other STI and not herpes.  If you would like Dr. Hook or Handsfield to elaborate on that you are welcome to ask a separate question but I feel pretty strongly that they would also tell you this was not an experience that put you at risk for an STI.

Terri
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