[Question #1775] Any risk of STIs?

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. There was also quite a lot of deep french kissing. I'm worried that this encounter lead to contracting an STI. 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. The most recent symptom is swollen lymph nodes on both sides of my neck. Nurse Warren has suggested it does not sound like herpes (my original worry). In your professional opinion, do I sound symptomatic of any other STIs? Could some of these symptoms be attributed to general anxiety about STIs?
Edward W. Hook M.D.
Edward W. Hook M.D.
42 months ago

Welcome to the Forum.  Having read your earlier interaction with her, like Ms. Warren, I will start by congratulating you on the practice of safe sex.  Also from having read your earlier interchange with her, I will agree with all that she said.  Your exposure was essentially a no risk event.  Condom protected sex is safe sex and neither French kissing, nor having your scrotum licked and sucked place you at risk for any STI.  Further, the symptoms you describe are coincidence and do not suggest any STI.  There are no STIs which would cause radiating pain down your legs at this time, nor abdominal cramping, nor discomfort in your hands.  Discomfort in your shoulder blades could well be anxiety related cramping as this is a common area for stress to "show up" and for anxiety to cause such symptoms.  Finally, none of the exposures you describe would be expected to lead to infection that would cause lymph nodes swelling in your neck.

I see no reason for concern, and no reason for STI testing of any sort,  I hope my comments are comforting and will allow you to move forward without concern.  EWH

---
42 months ago
Thank you for your advice. One other thing that was bothering me was a spot on my scrotum. I have white bumps on my scrotum which, upon examination, are simply the point where a blade of hair comes out. There is, however, one that is much more noticeable to the eye than the others. Do you believe it's probably just another follicle point? Would a herpes sore begin as a white dot or something else? I will re-submit this question to Nurse Warren if herpes is not in your purview. 
42 months ago
And finally, a doctor I visited did notice a swollen lymph node in my inner thigh. This was about 8 days ago. Would the node be painful if it was related to herpes?
Edward W. Hook M.D.
Edward W. Hook M.D.
42 months ago

White bumps are common findings on the scrotum when the scrotum is looked at closely.  Some of these bumps are benign, normal cysts- they tend to be there and not change much with time. In addition there cab be cysts and swelling around hair follicles (at the site where hairs come out of the body).  These hair follicles commonly become inflamed to cause folliculitis, the medical term for an non-STD swelling and/or pimple at the site where hair follicles enter the skin.  Folliculitis lesions can swell and even burst and when they do they are typically filled with whitish material.  What you describe could well be folliculitis and does not sound AT ALL like herpes.  Similarly, folliculitis can cause swollen, even tender lymph nodes.

In addition, lymph node swellings are non-specific and when a careful examination is conducted, most people have lymph nodes in one location or another that are slightly swollen.  The most common areas of such findings are either the top of the legs or under the jaw or in the neck.

I hope these comments help.  I still see no reason for concern about any STI.  EWH

---