[Question #3550] One-time encounter - Pain in the butt

37 months ago

Hi there,

Thank you taking the time to provide this service.

For the question; recently I engaged in protected vaginal sex with a potentially risky partner. There was brief protected oral as well, but I believe to be low risk. I didn’t see any sores but was pretty intoxicated.

About 10 days after the encounter I noticed a large bump just below my left butt cheek (almost on the bottom of it towards my groin). I have had ingrown hairs and irritation in the area between my genitals and anus before (I shave this area and sometimes workout using compression shorts which hold in the sweat).

Thinking the bump was just a pimple or ingrown hair; I re-shaved the area and I tried to pop it. And there was a mix of puss, clear liquid, and some blood. After popping it, it did relieve some of the pressure and pain, and I followed that up with an Epsom bath. The bump remained much like an inflamed sore from an ingrown hair…the next day I noticed about 3 additional bumps that are similar (2 on the inside of my left butt cheek about 3-4 inches apart, and one on my right butt cheek). Maybe this was caused by my constant touching in paranoia?

Now, the next day I felt a bit of burning in my anal area where I shaved. Almost like chaffing/irritation I have experience in the past, but much much more painful, especially where the bumps are. Especially when sitting. Also, I do have a noticeable hemorrhoid (dark blue veiny bump) and have had minor hemorrhoids in the past.

I have had 5 partners (2 in the last year – 1 in 2018), one of those being a monogamous partner for almost a decade (I am a 30 year old male – in Western Canada). I went through STI testing 18 months ago and all results were negative.

Could this be just a bad case of hemorrhoids or staph? What are the chances it is herpes? Do you recommend testing? As for the other symptoms, I have had a pretty bad headache the last few days and some pelvic pain.

Thanks,

37 months ago

Hi there, just an update on this.

I went to see a doctor after posting this question and he took a look at the lumps and immediately diagnosed them as a bacterial infection (didn't feel it was necessary to swab or test for herpes or staph). He explained the pelvic pain was swollen lymph nodes due to the infection, and the neck pain/headache could be caused by the infection or pain.

He prescribed clindamycin and fucidin; which seem to be working. The lumps did become severely painful, and since they were so spread out, it felt like my entire bottom had been hit by a truck. Eventually they did burst and have been draining puss/blood for the last 2 days. The pain and size of the bumps are subsiding, though I still get pretty bad headaches and neck pain late in the evening (a possible side effect of clindamycin?).

Based on the original message and update do you think there is a chance this is herpes? Should I look to get tested?

Terri Warren, RN, Nurse Practitioner

37 months ago

It would be really unusual for a new herpes infection to show up on the buttocks - glad to hear that your doctor felt that this was a bacterial infection causing the bumps. And normally herpes lesions do not develop pus. I do wonder if your STI testing included testing for herpes - do you know?

Terri
---

37 months ago

Thanks for the response.

The STI testing from 18 months ago did include testing for HSV (though, I believe it was specific to HSV2).

The symptoms are subsiding; the bumps still seem to have quite a bit of fluid left in them (2 of the three seem to still be bleeding/oozing 3 days later). The other symptoms are subsiding as well. The bumps are still there and are far from flat, they just have less pressure. I can sit almost pain free, headache wasn't as bad last night, and my lymph nodes are not nearly as sensitive.

I haven't had any sort of experience like this before (ingrown hairs were painful, but not nearly this painful and had far less puss and fluid).

I have read previous posts and it sounds like Herpes transmission is relatively low overall when using a condom, though still possible. And that the first outbreak is typically near the area exposed to the virus which does ease my stress a bit, but not entirely of course.

In your professional opinion, is it worth getting additional testing? Or can I get through my antibiotics and move on with life once this heals up?

Terri Warren, RN, Nurse Practitioner

37 months ago

I think you should have a swab done of the lesions for a bacterial infection to see what is growing there! You could also ask for herpes testing to be done from the swabs, just to be sure. But at least bacterial cultures, I would think

Terri
---