[Question #3520] Red Spots

35 months ago

This is my second round of questions...sorry for anything redundant. I had an unprotected sexual encounter with a female 47 days ago (said she was clean). Seven days later I Had the flu, swollen testicle, swollen lymph node, and skin crawling/burning sensation. Had a 10 panel STI test at day 10 and 5 weeks post encounter which were both negative respectively (Including IgG for type 1 and 2) Additionally, had a urinalysis at day 18 which was also normal. Also on day 18 the doctor prescribe doxycycline and groin pain went away in 48 hours. It is important to note that on the 24th day post-encounter, I had one tiny red bump on the shaft of my penis which when away in 7 days.

Recently, I've had tingling urination for a week which resided five days ago, but now I've had tingling on the left side on my penis glans since. It's a similar feeling to my foot being asleep, but obviously in the glans. Also, I have 4 faint red dots on the glans which are not raised and don't appear to be painful. I'm not only confused about my symptoms, but at 47 days post encounter, Is this possibly the initial outbreak, the second, or something totally unrelated?

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
35 months ago
I think that is highly unlikely.  Herpes would not normally look like 4 faint dots and tingling only.  You could certainly repeat your testing if you wish being sure to only use IgG or western blot,never IgM or non-type specific serology.  Also, something that shows up on the 24th day post-encounter would not be consistent with a new infection.  My suspicion is that the tingling and faint red dots have nothing to do with herpes.  I'm sorry that you are still worrying about this now.

Terri
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35 months ago

Doc,

No need to apologize, it’s completely my fault that I one-time cheated on my spouse of 15 years and have to live with the guilt, anxiety, and stress. I’m really trying hard to believe that my symptoms aren’t herpes induced; however, it’s difficult since the symptoms are so moderate and noticeable in feeling.

The night of the previous post, I had more of an extreme tingling in my penis glans (like putting your tongue on a 9v battery when you were a kid). Additionally, this was accompanied with nausea and vomiting which occurred 6 times throughout the night. It is important to note that the last time I vomited was in college over 20 years ago and it wasn’t from any virus. The following two-days both symptoms faded. Maybe ironic, but the spots have disappeared as well. Today, I feel the best since the encounter.

That being said, I feel something is wrong as I’ve never felt these sensations or had nausea. It is hard to comprehend that my symptoms are coincidental and not a result of the encounter. Overall, my reason for excessive questioning is whether and when I can resume normal sexual activity with my spouse.

How accurate would you estimate my 5-week IgG test was? Outside of Mycoplasma and genitally focus anxiety, what could be the overarching issue?

By the way, not only Dr. HHH, but specifically your responses to me have greatly reduced my levels of insanity.

Thank you!


Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
35 months ago
So herpes doesn't really cause nausea (it's awful, isn't it?).  That sounds more like food poisoning to me.  The 5 week test is probably 65% good - that is, there is a 65% chance that the test will stay negative at the 12 week mark.  I am not concerned about the tingling in the head of the penis.  without any lesions and a negative 5 week test, I think herpes is very unlikely here.  I cannot tell you the risk is zero.  I know you want to resume sex with your wife but if I were in your situation, with an unprotected encounter, I wouldn't so it.  Not because your risk is high but because the consequences are so important.  If you are still negative at 8 weeks, I might reconsider.  There are probably consequences for not having sex too?

Terri
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34 months ago

Doc,

I'm at a complete loss in regards to the tingling urination and skin sensations. In fact, the last couple of nights I've had cases of night sweats and difficulty sleeping which continues to cause me to question my health.

Consequently, I visited my family doc again yesterday and he couldn't tell if anything (the red, non-raised irritation) looked like herpes on my penis. He also commented that they see a large amount of genital herpes cases which was reassuring.

We both agreed to try a round of syphilis testing and igG AB (8 1/2 weeks post exposure). You guessed it, all was negative. Overall, I feel more relived but I'm still apprehensive about feeling good about my overall health condition.

Where should I turn from here or what's another avenue to travel? Perhaps I need to visit your clinic in Portland and have dinner at Le Pigeon ;).


Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
34 months ago
I hear that you are at a loss to explain these sensations.  While dinner at La Pigeon would be wonderful, our clinic is closed so we could not see you nor could we really offer any other options than those that your physician has offered to you.  But I think that you should feel reassured by the testing and by the consultations with your physician.  If your concern is only "do you have herpes", I think this is very very unlikely without typical symptoms and a negative IgG at 8.5 weeks.  If you could know with 100% certainty that this wasn't herpes, how much would it really bother you?  I suspect it might be annoying but not terrible?  Have you tried anything like a topical antifungal medicine?  It might be worth a try, is available over the counter and is pretty simple, something to run by your doctor I think.

Terri
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