Dr. Hansfield,

I had condom protected sex with a stripper/sex worker 27 days ago. We did some rolling around without condom so there may have been some direct skin to skin contact. I did not have any symptoms until day 23 when 3 or 4 stinging red bumps appeared at tip of penis. Bumps appeared suddenly upon return from swimming in ocean. At first I thought maybe it was a jellyfish sting. One bump is slightly inside penis hole and other small 3 bumps are to right and below hole.

Bumps stung a good bit for about 12 hours (stinging urination for several hours). Since then there is not much stinging or pain (no itching) and appearance of bumps has not changed much. On 25th day(this Wednesday) I had full STD work up and was negative for everything  (IGg less than 0.91). It is my understanding that result is about 50% accurate after 3.5 weeks.

I went to see doctor today. She examined bumps. She could not rule out herpes, but seemed to think it was more likely fungal/yeast (sitting in wet bathing suit). She said herpes site would typically hurt first and then a bump or blister would form. She also said bumps were very small and appeared to be healing (3 days following onset). On a side note I have been itching a good bit lately. That is not that unusual as I have frequently had jock itch and dry skin.  I had shingles once or twice. Doctor prescribed me one fluconazole pill and clotrimazole cream.

Based upon this information how likely do you think I have herpes? Doctor acknowledged 23 days is a long time for initial symptoms, but said I could have been asymptomatic or not noticed irregularities. Any other ideas as to cause of bumps? If it is fungal would it have been acquired through sex 23 days before onset? Also, please confirm accuracy of IGg test at 25 days.

Thank you for your help. Your online postings much appreciated. If I manage to come out of this episode I am giving up alcohol and sex.Please respond as soon as you can. Needless to say I am very concerned.

Chris

Hi Terri,

When I had shingles I was not given any tests. An area on my chest was extremely sensitive to touch (very painful). My dermatologist made diagnosis based upon my symptoms. I did not have much of a rash. I was given medicine (don't recall name) and got better in fairly short order. I did have chicken pox as a child and then again in my early 20s (now 47).

The fungal medication was given to me by another doctor at a clinic I visited on Thursday. In her opinion most likely diagnosis of bumps is fungal/yeast infection on tip of penis.

I noticed bumps about an hour or so after swimming in ocean when I was taking a shower. I do not recall any stinging or pain while I was swimming.

Today (5th day) bumps are less red with basically same shapes. After initial onset stinging gradually subsided. However, today I am getting some stinging with urination.  There has not been any  itching and bumps are not really painful to touch. I have not noticed any water filled blisters, but the stinging concerns me. I have been using fungal cream (clotrimazole) for almost 3 days. Are these symptoms consistent with yeast/fungal infection? Do you still think herpes is unlikely? Any thoughts are much appreciated. 

Hi Terri,

I was concerned about stinging and went back to clinic. Doctor thinks I got anti-fungal cream in opening of penis. Doctor said bumps are almost certainly fungal infection or general skin irritation as opposed to herpes (late onset, lack of change in bumps, no water blisters, lack of painful ulcers). Doctor checked my urine for infection (negative), gave me a stronger oral anti-fungal and told me to be more careful applying cream too close to opening.

The stinging has mostly gone away. I feel a whole lot better all around (glad I went back for second visit) and anticipate getting back to normal shortly. I'll drop you a note here when I do. At some point I may get a final STD test although it probably isn't necessary.

There is so much generalized STD information on internet that tends to lead people to think the worst with any ailment. Reading the questions and answers on this forum gives some real world perspective as to STD transmission. Keep up the good work.