[Question #4664] possible herpes after 31 days

26 months ago
I had protected vaginal sex with a CSW 31 days ago. Unprotected oral. I have had diagnosed jock itch type rash in my groin since then. I also was diagnosed with balantis on my penis. I have been using anti fungal cream and it has been helping. However today the rash got more red on my right side of my groin and itches. I applied anti fungal cream today and since then it has been red and still itches with what looks like hives. I just recently applied OTC hydrocortisone cream to it. Now, immediately I developed red dots on my penis and on the left side there is a cluster that is raised. I am freaking out as I don’t want to believe this is herpes. However I also have a swollen lymph node in my neck. Is it possible for the rash to have been a symptom of herpes for this long with Out lesions until now? And is it possible these bumps on the top of my penis is raised balantis or the start of herpes? At the time of the exposure about two weeks after I had felt fatigue, swollen lymph node in my neck, loss of appetite and tingling and burning sensations in my groin. Yesterday day 30 was fine with no problems. Until today. Please help I have extreme anxiety for the past 31 days. 
26 months ago

I wanted to provide a follow up. Also wondering if this question fell out of view. But in regards to the above post, I applied anti fungal cream to the bumps on the penis and they disappeared within 30 mins. However, I am still concerned as I still have the rash in between my groin/thigh, no lesions and balanitis. I was tested approximately 10 days after exposure for the normal STD’s (gon., trich., HIV, chlamydia, syph.) all came back negative. However I had frequent urge to urinate with burning and saw a urologist who diagnosed me with prosititius. Currently taking medicine. I was on doxycycline hyclate for  folliculitis, a 10 day 100mg 2x a day prescription between days 19-29. I have a few questions still though:


1.)I’m wondering if herpes lesions would not come up because of taking anti inflammatorys, the medication, or because of anti fungal creams or hydrocortisone cream? 

2.)What are my chances that I contracted the virus from my one encounter with the CSW and what are the chances my symptoms are the herpes virus that just hasn’t progressed to lesions at this point? (Day 34). 

3.)Would you recommend blood testing for HSV?

4.) Did I test too early for the STD testing to come back negative?

Hopefully this post is seen. Thank you. 

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
26 months ago
A rash in the groin/thigh area is usually fungal in nature.  That location is warm and moist and dark - the ideal environment for fungi to grow. 
The anti-inflammatories and antibiotics and creams would NOT impact herpes lesions.  If anything the steroids would make a herpes outbreak worse.
The chance of you getting HSV from this encounter of oral sex only is HSV 1.  Have you ever in your life had a cold sore on you lip or in your nose?  If yes, then you already have HSV 1 and would be extremely unlikely to get it in a new location.  The chances that you would acquire herpes a single encounter are quite small.
I would not recommend antibody testing at this point particularly since your risk was HSV 1.  The HIV test was done too soon for accuracy as well as the syphilis test.  I would suggest repeating those at 6 weeks out.  But HIV is not a real risk here and syphilis from oral sex would also be extremely uncommon.

Terri
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26 months ago
Thank you, this post will be at 7 weeks post exposure with no sexual activity since. I currently still have a rash (though not as red) in between my thighs that sometimes burn when I haven’t applied antifungal cream (which I have been for 6 weeks now).  I’m still confused and stressed. I don’t know what to think I have but I would like to ask you a few follow up questions again. 
1.) I read about herpes rashes as a symptom, is it typical that a herpes rash, if this is one, would last this long? I read post #4698 that describes he gets a rash and burning as his break out, pimples but no blisters, is this actually common or can this happen for a herpes outbreak!?
2.) You say my biggest risk here is HSV 1, due to the u protected oral sex, however due to the protected vaginal sex, how likely would it be that I could acquire HSV2? 
3.) I am still using steroid cream to fight the balanitis and it has been better, but still not gone. You said the steroid cream would aggravate a herpes outbreak, should I assume since I don’t have any lesions and have been applying this cream liberally without blisters that this is all in my head and truly a fungal infection? 
Thank you. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
26 months ago
1.  A herpes rash would definitely not last this long and would not appear in this way.  Your symptoms most certainly sound fungal and you might want to touch base with your regular provider again and let them know what's going on - there are pills that work quite a bit better for this than topical medicines.
2.  It is unlikely that you would acquire HSV 2 using a condom.  if an infected woman has sex 104 times with a man who is not infected, using condoms, about 1-2 men in a year would acquire herpes under those circumstances.
I think you can assume logically that this is far more likely to be fungal than herpetic, yes.

Terri
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