[Question #2884] STI/HSV

39 months ago
I’m a male in my mid/late 40s.  Had fully protected oral and vaginal sex with an escort while on a holiday in London.  About 4  1/2 days later I noticed a single bump on the underside of my testicle.  Looks similar to other bumps in that area which I assume are hair follicles but this bump seems a little larger and was a little red when I woke up (although some of the redness went away when I took a bath).  No other symptoms. Concerned about HSV.   Would HSV present that way in that spot as a solo bump?  Am I overthinking this given condom use and no other symptoms?  Thanks.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
39 months ago
I think you are overthinking this yes.  Good for you for practicing safer sex at your encounter.  If you had, by some very strange circumstance, acquired herpes from the sexual encounter, I would expect to see first infection symptoms on the base of the penis, not the underside of the scrotum and with more than one bump or blister.  There are lots of bumps on scrotums - hair follicles and cysts are the most common. Neither of these is related to herpes.  I do believe you are in the clear in regards to this bump.

Terri
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39 months ago
Thank you.   That original bump seems to have cleared up but this morning I saw another bump (lookes like a small pimple) on the underside of the shaft close to the base and near the Testicles.  I couldn’t resist the urge to squeeze it and a small amount of white gunky stuff came out.   Looks like an area that could have been uncovered, or maybe covered by the thick ring of the condom.  Still no fever, aches or flu like symptoms (although I do have a little post-nasal drip and feel like I’m fighting off a sniffle).  It’s been about 8 days since the encounter.  Still overthinking or  is this something to be really worried about.  Seems like more than a coincidence to have two of these after an encounter.  Thanks again. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
39 months ago
Interesting.  White gunky stuff sounds like it could possibly be something called mollusucum contagiosum.  These lesions have a small indentation in the center, are skin colored and have white gunky stuff inside.  Or it could be a very simple pimple.  I think sometimes we forget when we have very close body contact with another human, we can pick up skin bacteria that they have but perhaps we don't.  These are both possibilities though I really don't think this sounds like herpes. 
When we describe flu symptoms we aren't talking about  sniffles or cold symptoms - we are talking about aching muscles, severe headache, light sensitivity, possible fever. 

Terri
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39 months ago
Thanks.  I don’t think it was a molliscum. Looked more like a pimple, but it cleared up.  But, I just noticed another similar single pimple a further down but on the testicle.  Weird to keep having these- it also expressed some white gunk when I squeezed it.  Also, a couple of days ago, I started feeling minor irritation / burning on my penis and general weirdness in the boxer shorts area.   Seems like some random pimples.  I took some Advil and azo and an antihistimine which helps with the penis irritation and burning to some extent.   Still no flu like or other symptoms (and my sniffle cleared up).  Any thoughts? My questions at this point:

1.  If the bumps are herpes, would white gunk come out when squeezed (I think herpes are clear fluid but not positive). 
2.  Is the general burning/itchiness/weirdness a symptom of hsv or another std that I should worry about?
3.  It’s been over 10 days since the encounter.  Would a more obvious outbreak have surfaced by now?  How much longer before I’m in the clear?
4.   Should I get tested before resuming sex with my primary partner?

Thanks again.  
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
39 months ago
No, white gunk does not come out of herpes lesions - the fluid in a lesion is generally clear or cloudy at worst
General burning and itchiness could be many things including a fungal or bacterial infection or sensitivity to something you came in contact with - herpes is very unlikely without lesions.
Yes, I think you would have likely had  more dramatic symptoms by now if you were infected
I don't tell people when they should resume sexual contact with a partner but I can say that neither your symptoms nor your contact with the escort and the way you protected yourself present an incredibly low risk for herpes infection.  I suggest testing perhaps more often than my colleagues do but in this case, I don't think testing is necessary but if it provides you more reassurance, you certainly could.

Terri
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