[Question #1870] Possible STD exposure

42 months ago
Just over 3 weeks ago received brief unprotected oral from a girl I met in a bar, don't think it lasted 30 secs at the most before I stopped her. 

Woke up approx 11hrs after with sore throat that lasted a couple of days. 

Days 2-13 anxiety got the better of me and I've been checking myself religiously everyday.  Had a few areas of concern, all in pubic area and groin, nothing wrong with penis, all subsided within 12-48 hrs. No discharge, fever, blisters or sores at all. 

Day 14 woke up and an area approx 1cm up and 1cm left of where the left side of penis meets the pubic area felt sore, kind of like when clothes cause friction on skin. 

Went on and off through the day, worse when lying on left side. Also a little swollen. 

It's been 8 days since and the pain is still there intermittently. Sometimes just a twinge others may last an hour or 2. May go whole day at work with nothin, then it's starts up once I get home. Feels more like a bruise now, not sore to the touch though. 

Not 100% sure if lymph nodes present in this area, can't feel any lumps anywhere in pubic area or groin. 

Also sometimes pain/sensation in fold where leg and groin meet and where penis and scrotum join, but predominantly in first area. 

No sores or blisters at all, the only thing is a small patch of red spider veins, but this is same as on other side of pubic area. Still no problems with penis. 

Sometimes sensation pronounced and other times I wouldn't notice if I wasn't so focused on it. 

I'm 99% sure that this area didn't come into contact with girl. 

Got urine test at 10 days, waiting for results. 

Can STDs cause these symptoms? Mainly worried about gonorrhea and HSV. 

Thanks in advance for your help and the great service you provide here. 
Edward W. Hook M.D.
Edward W. Hook M.D.
42 months ago
Welcome to the Forum.  I'll try to help. the symptoms you describe do not correspond to those of typical STIs (see below).  Receipt of oral sex only relatively rarely leads to infection.  When it does, the most common problems are either gonorrhea of non-gonococcal urethritis NGU) caused by mouth organisms introduced in to the urethra during sex.  This sort of non-chlamydial NGU is not clearly and STI in the traditional sense, is not readily transmitted to sex partners like other STIs, and in not associated with complications.  In the Unitized Kingdom, many specialists do not treat NGU associated with oral sex.  When treated, oral sex-related NGU typically resolves quickly.

With respect you the symptoms you list, addressing them in sequence:
1.  Receipt of oral sex would not lead to a sore throat and no STI would cause symptoms within 12 hours of sex.
2. Day 14.  Was this discomfort in the crease when the penis meets the pubic area of further to the side.  Was there an open sore or lesion?  What you describe does sound more like friction or a minor fungal infection unrelated to your exposure than an STI.  On the other hand, if the discomfort was more to the side and associated with a lump under the skin, this might have been an inflamed lymph node (which would still be a non-specific finding and could have arisen as the result of a long list of non-STI related problems).  That it is intermittent and not sore to the touch makes it less likely to be a swollen node.
3.  Swollen "spider veins".  Likely normal.

As you seem to suggest, this sounds unlikely to be an STI.  I anticipate that your tests for STDs will be negative 9BTW, those results should be available to you by now).  My guess is that there may be a local process such as a fungal infection present ("jock itch") but what is really needed is for someone to take a look.  I would suggest you have your regular doctor or, if you do not have one, a dermatologist or STI specialist take a look. 

Sorry I can't be more specific.  I hope this does provide some direction for you.  Feel free to follow up with clarifications or additional questions if you need to.  EWH
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42 months ago
Thanks for your reply Dr Hook. 

To answer your questions 

2. Day 14 Was this discomfort in the crease when the penis meets the pubic area of further to the side.

The discomfort is approx 1cm up from where left side of penis joins the pubic area and approx 1cm to the left. Also some discomfort to a much lesser degree in area where penis and scrotum join and in the fold between leg and groin. All discomfort intermittent. 

2b. Was there an open sore or lesion?

No sores or lesions at all in this or any other part of the genital area. 

2c. On the other hand, if the discomfort was more to the side and associated with a lump under the skin, this might have been an inflamed lymph node (which would still be a non-specific finding and could have arisen as the result of a long list of non-STI related problems).  That it is intermittent and not sore to the touch makes it less likely to be a swollen node.

I can't feel any lumps in the affected area at all. It is definitely not sore to the touch. 

Would a swollen node in this area be easy to identify?

Some more info for you. The area is not red or inflamed. As I said absolutely no blisters, sores or lesions in that or any other area. No other symptoms except the discomfort and swelling. 

I'm 99% sure that the girls mouth didn't come into contact with this part of my body. 

I suppose I'm mainly concerned about herpes and I've read that the virus has to be massaged into the skin to take hold, so 

1. would the area where it is, that she didn't touch this area and a lack of sores, blisters and lesions rule out herpes? 

2. If it were herpes would I be more likely to get a primary outbreak on the penis and not the pubic area? The area with discomfort is covered by pubic hair. 

3. If it were herpes how long after the symptoms I have would a blister or sore show up? It's been 8 days since it started.

4. How long would this discomfort need to persist for me to be able to rule out herpes. 

Thanks again for your help.  

Edward W. Hook M.D.
Edward W. Hook M.D.
42 months ago
thanks for the additional information.  It makes me more confident that this is not an STI, including herpes which is spread by DIRECT contact (and you state that the area was not contacted by the partner who gave you oral sex).  And yes, swollen nodes are pretty easy to identify- think about how the nodes under your jaw feel when you have a sore throat- these are swollen lymph nodes, reacting to the sore throat.

As for your follow-up questions:
1.  Yes, HSV is spread by direct contact of an infected surface which is actively shedding the virus with an uninfected surface.  It si not spread indirectly without contact.

2.   The pubic area would be an unusual location for herpes and if this were herpes, you would experience the appearance of sores at the area.

3.  Herpetic lesions typically show up about a day, at most, after the onset of discomfort.  Further with initial episodes, the discomfort most often resolves within two week of onset.

4.  See above. 

Hope this helps.  I sincerely doubt this is an STI or in any way related to infection acquired by the exposure you describe.  EWH
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42 months ago
Thanks DR Hook, you've really put my mind at rest. 

One last question with regards to HSV transmission. 

As I said, I'm 99% sure there wouldn't have been any contact at the point of where the discomfort is, however how much contact would be needed on the off chance that her mouth did touch this area? If there was any contact, it would have only been fleeting. And the whole episode only lasted 20-30 seconds at the most and I was standing and she was kneeling so I find it hard to believe her mouth would have been anywhere near that part of my pubic area. 
Edward W. Hook M.D.
Edward W. Hook M.D.
42 months ago
My sense is that you are correct and there is very little likelihood that any contact took place.  There are no data however on the relationship between duration of exposure and likelihood of transmission.  It is logical that the longer the contact with an infectious site, the more likely transmission is to occur and presumably, even brief contacts could lead to transmission. Having said that, it remains unlikely that what you are describing is a manifestation of herpes acquired through the exposure you describe.  EWH
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42 months ago
Thanks Dr Hook. 

You've really reassured me and I feel that I can get back to normal. 

Keep up the good work. 
Edward W. Hook M.D.
Edward W. Hook M.D.
42 months ago
 Thanks for your thanks. As per Forum guidelines you have now received three replies to your questions. This question thread will be closed later this evening. I wish you well. EWH ---