[Question #4712] Worrying Symptoms.

28 months ago
I had sex with a prostitute about 5 years ago.  After I remember feeling sick and having one red bump appear on the head of my penis.  It went away and I never got tested.  I had a normal sex life for about two years then the red bump returned in the same place.  I got tested for everything (blood and urine igg specific) and came back negative.  The next 3 women I had sex with got sick shortly after having sex, complaining of severe neck pain (possible lymph node swelling).  I got tested again and nothing.  The next 2 women i slept with got sick too.  One with bad stomach pain that also had liver pain, joint pain and nausea, and some pain around her vagina (shortly after we began having sex) and was diagnosed with a blood infection.  The other had similiar symptoms at least with severe stomach pain (months into our relationship.  One woman we had unprotected vaginal sex and once and one that had neck pain we had unprotected oral, otherwise I have used condoms.  I have been tested about 6 times in total, and diagnosed negative visually when symptoms have presented, but am unable to figure out what i have.  Herpes seems the most likely but have multiple negative blood tests.  Also LGV seems possible.  What do you think and recommend?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
28 months ago
Neither neck pain nor stomach pain has anything to do with herpes.  If you live in the US, LGV can be taken off the table.  I have no idea actually why these women are getting sick but with herpes, one would expect sores in the genital area.  It's good that your IgG tests are negative - not sure why anyone would use urine for herpes testing though.  I think you can believe that you don't have HSV 2 with 92% certainty.  The red bump on the head of your penis could certainly be a fungal infection, called candida balanitis, but if it shows up again, you might want to consider having it swab tested for greater certainty

Terri
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28 months ago
Thank you for your response Terri.   Specifically concerning Herpes I'll take your advice and assume it is not that.  No one has told me that they had a diagnosis either which leads me to believe it's something more rare.  I left out some details about the connection with the time I've been sexually active and inpending sicknesses of my partners that make me sure it's not a coincidence.   What type of specialist should i seek to try to get a further diagnosis?  Are there more tests for lesser known infections than what is on a standard 10 pannel test?  I am seeing a general practioner this week and was thinking about trying to get referred to an infectious disease specialist as my regular doctors in the past have been a bit perplexed but have never done anything but the basic testing. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
28 months ago
I guess you could talk to an infectious disease specialist but honestly, these symptoms in your partners just don't fit well at all with anything that I know that could be transferred between people.  You could certainly discuss these concerns with your primary care provider if you wish, that might be helpful for you.

Terri
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28 months ago
A few days  (about 5) before I saw my general practioner I noticed a few bumps appeared on my penis.  He referred me to a dermatologist but I decided to see one immediately as when I've had bumps in the past but they've gone away in a week.  Both said it didn't look like a typical presentation of herpes.  My doctor ordered labs to try to see what kind of infection i may have (other than normal std tests).  The dermatologist suggested they could do a biopsy on the bumps.  Is this a good idea / will be effective at this point at least 5 days after i noticed them.   The dermatologist said the problem almost certainly is fungal or viral as anything bacterial would be gone by now as I have had doctors looked when I've noticed anything before and prescribe different creams.  I just don't want to do a costly biopsy if it's likely past the point of detection.   Do you have any thoughts about this?  Or anything that could help me get further to the bottom of this issue?  
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
28 months ago
I don't think so.  If this IS herpes, and is recurrent, virus may well be gone from lesions by 5 days out.  Biopsy is not a great way to try to diagnose herpes - PCR swabs from new lesions are far more effective.
If you want the greatest reassurance that you are not infected, you could obtain a herpes western blot from the University of Washington.  You can work with you own provider to obtain this specialized test or I can facilitate that for you. 

Terri
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