[Question #7257] HSV Urethritis concern

7 months ago
Hey there, just preface I have pretty bad ocd over stds , but this is something I’d like some clarification on , and I’ve seen you guys answer somewhat similar questions.

So about 5 years ago I woke up one morning 30-60 hours (can’t quite remember) after receiving oral sex .. which I also received from the same person about 2 weeks before this and had a slight burning with urination. I thought it was from soap or something, but it persisted the next day.. if I drank a lot of water it didn’t burn. I went to an urgent care and they gave me azmithrozin and dococyline... didn’t change anything 3-4 days after this I went to a urologist who says he sees this all the time, I expressed my concern with herpes and he said there’s almost no way.. (only symptom still slight redness in urethra when opened, dysuria, nothings ever tho.. no meatitis or tender lymph nodes, no discharge) all urine tests were negative and he gave me ciprofloxcin.. maybe 3 days after that my symptoms were gone. I was tested recently for HSV2 but was advised against hsv1 testing as if it came back positive there’s no way to tell the sight, and I never get oral or genital outbreaks.  I’ve read that normal Ora bacteria can cause this but the girl I was with later told me she occasionally gets cold sores and I’m just so worried that this was HSV urethritis.. but I can’t find anyone who only had dysuria as a symptom. Do you think this is a legitimate concern or should I put the HSV worries behind me? Thanks for everything y’all do 
7 months ago
I’d say the dysuria was a  1.5/10 if I drank a lot of water and maybe a 4/10 at its worst, and this was my only symptom.. the urologist when he opened my “opening” up said it was indeed a bit red. But no pain/discharge while not urinating and no inflammation of the meatus
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
7 months ago
The dysuria that I've seen from HSV 1 genital infection is quite remarkable, certainly not a 1.5 out of 10!  I also think if you do not already have HSV 1, if you acquired new HSV 1 I think it is more likely that your symptoms would have included external sores.  Also, if you have new herpes, the symptoms would normally last longer and certainly not respond to antibiotics, as your symptoms appeared to do.  I understand that you have OCD about STD's and in this case, I think perhaps you are overthinking these mild symptoms. What do you think?

Terri
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7 months ago
I mean there’s no doubt my anxiety is playing a role .. this is an issue I had 5 years ago.. and yeah the dysuria was pretty mild .. I’m just struggling to find an instance on the internet where it is the only symptom... I know it was a little confusing .. but In total the symptoms lasted 9ish days .. and I’m not sure if they responded to the final round of anti biotics coincidentally or if the symptoms cleared up In the 2-3 days after I took the cipro because of the medicine ... but yes either way the dysuria was never severe.. and I never had any lesions (I had them check)
7 months ago
My symptoms didn’t really change from the first antibiotics I took  
7 months ago
8-9 days symptoms lasted, and were steady the whole time .. mild to medium dysuria 
7 months ago
There’s not much info but I thought any antibiotic would clear it up In 24 hours .. is it possible for one. Not to work and the next antibiotic I took was effective in 2-3 days? I know that like 30-50% of cases of NGU are idiopathic .. but there is Nothingggg on the internet about the clinical courses of NGU with no identifiable pathogen.. my ocd is struggling because of the lack of information .. and I just like to KNOW things 
7 months ago
Also I had a whitehead/infected follicle on my scrotum I noticed 2 days ago, and I stupidly took a thumb tack to it, it bled a lot, but some thick white pus came out too. I squeezed it really hard and broke the skin .. bled a good bit from poking/squeezing .. squeezed again today and a little more thick white pus came out.. it’s not bleeding anymore but when I shine a light on the spot a very small  circular area looks shiny and ulcery.. do you think this sounds at all like an hsv1 flare up or a wouldn’t from my squeezing/poking (never had anything suspicious since that mild urethritis) I know I’m hsv2 negative. Had igg test recently .. no new partners .. sorry for the separate question but I’ve spent a fair amount of money here , I thought I’d ask since it’s worrying me :) thank you for everything 
7 months ago
To clarify a bit.. this little spot on the bump is only noticeable if I stretch the skin and look very closely with my phone light 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
7 months ago
Yes, it is possible that one antibiotic might not work and then another work far more effectively.  I think it is far more likely that the dysuria that you experienced was due to a bacteria you acquired while receiving oral sex and either it cleared on its own or the Cipro took care of it.  the idea that this would be herpes is not likely as 1) you had no lesions that sound like herpes and 2) the dysuria associated with HSV 1 new genital infection is not mild AND is very often accompanied by lesions externally.

You are correct that often we don't know what causes NGU - and by the way, I see nothing that indicates you were tested for NGU and tested positive (white cells found from a urethral swab).  That's a different diagnosis than simple dysuria.

A herpes lesion would not appear as whitehead from a lesion on the scrotum - not at all. Herpes lesions most often present as water blisters or ulcerations in the skin - not what you describe at all.  I would suggest that you be very careful about using a thumbtack to open a lesion on the scrotum - or anywhere else.  A real infection could certainly occur.

Terri


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