Fear for genital herpes

[Gus68]

I am afraid I contracted Herpes.  About 8 weeks ago, I had unprotected sex (oral too) with a girl I barely know.
About 8-9 days later,my penis started to feel itchy. I also had to urinate frequently, but I felt no pain while urinating. I went to see a doctor and she gave me antibiotics (Ciprofloxacin).
The same day I started to take the antibiotics (about 2 days later), I passed out for no apparent reason. The medics couldn't find anything wrong with my blood pressure. Since it never happened before, I went to see a doctor again (not the same). He could not tell me why I passed out, but I told him about my symptoms and asked for STD tests. I got tested for gonorrhea, chlamydia, syphilis and HIV. All came negative. He gave me another antibiotic (Azithromycin).
Once I was done with all the antibiotics, I still felt the same symptoms so I went back to the first doctor and she sent me to a urologist.
I had my appointment with the urologist about a week later. By this time, the symptoms were not as strong as they were before, but I started to feel sensibility in my thighs. I asked again about herpes but he though it was a fungus and game me a cream (nystatin triamcinolone). After the appointment, I felt pain in my inner thighs for about a week. My legs still feel kind of weird today.
It's been three weeks now that I use this cream. The symptoms have come and go several times but are aren’t completely gone yet. That’s why I still think about herpes.
I never had the typical herpes blister, neither had I swollen lymph nodes or discharge in my penis. Here are my questions:
- first of all, do you think it can be herpes?
- do herpes symptoms include frequent urination without pain when urinating?
- can the symptoms be intermittent (typically, I felt the rash/frequent urination for two days, was better for a day and then it came back).
- what other disease could cause this symptoms?
- I know that herpes can cause malaise, but is it possible to pass out because of it?

[Gus68]

Thanks Terri,

just to summarize, do you mean that my symptoms could be herpes even though it is unlikely? I don't know if I've had HSV1 before, but I don't remember that I've ever had any cold sore so I would guess not.

Could you please give me an example of mild symptoms that could go unnoticed or not be diagnosed as herpes?

Also, I have had the symptoms I described for almost 8 weeks now, which seems pretty long for an herpes outbreak. It's been better in the last days, but I still have this weird feeling in my legs (feel kinda weak and sensitive). Could it be, in case I did catch herpes, that the use of Nystatin triamcinolone prevents it to heal? I have seen that corticosteroids can reduce the immune system.

I apologize for keeping asking you questions but you're right, it does drive me nuts... and I'm also a curious person so I usually keep asking questions until I fully understand a subject :-) I think it can help me when I go back to see my urologist next week.

Thanks again.

[Terri Warren, RN, Adult Nurse Practitioner]

The numbers are pretty close to that - 17% of the population between 14-49 have HSV 2, but lots more have HSV 1 genitally.  Most often, people with HSV 2 genital infection DO have symptoms, they just aren't recognized as herpes.  And most often, with new infection, for someone who is observing closely, they do pick up some symptoms.  The person least likely to notice symptoms is the person who is also HSV 1 positive.

If definitely seen pain with urination as a symptoms (dysuria) but frequent urination, rarely.  Interstitial cystitis is a disease state of its own.  

You can certainly do further testing to help get clarity here.  I know this is driving you nuts.

Terri

[Gus68]

Hi Terri,
thanks for the quick answer. If you don't mind, I'd like to ask you a few more questions.

Since I had these symptoms, I've done a few research on internet. But internet being what it is, it's sometimes difficult to separate right from wrong.

It seems like about 20% of Americans have genital herpes, and about 80% who have it are not aware of it (you can probably tell me if these numbers seems right). This makes me think that most people do not have any symptoms during their first outbreak. So, could it be possible to catch the herpes virus but only have a few of the symptoms like itch on the penis and leg muscle pain a week after the exposure, like I did?

Also, you said that herpes do not cause frequent urination. However, I've found a few web sites that talk about herpes causing frequent urination, in particular something called interstitial cystitis (I guess it has something to do with the virus affecting the nerves around the bladder). Don't give me wrong, I do not work in the medical field and do not want to question your knowledge, just would like to have your opinion on this.

Not sure if you'll have time to read it, but here's an example: http://www.ehow.com/about_5403232_herpes-bladder-infections.html

I'm afraid about herpes cuz' I'm running out of options. I have been treated for bacterial infections and fungus, but nothing the doctors gave me seems to work. I also felt tingling on the extremity of my tongue (I performed oral sex on her as well) but I sometimes wonder if that's not just in my head. Herpes has definitely a psychological dimension as well...

[Terri Warren, RN, Adult Nurse Practitioner]

Honestly, your symptoms do not sound herpetic to me at all, Gus.  And there is nothing about herpes, except perhaps the anxiety about contracting it, that would cause you to pass out.  Herpes also does not cause frequent urination.  You have been adequately treated for bacterial STI's so that seems unlikely at this point as well.  Herpes is intermittent, yes, but not on a schedule like the one that you describe.  It is more like an outbreak, then 3 months off, than an outbreak, etc, etc.  You could certainly be tested at 9 weeks and have a good deal of reassurance, though not certainty.  If I were you, I would probably do that.

Terri

[Gus68]

I have an appointment with the urologist in about two weeks. It will be 9 weeks after potential exposure. I will ask for a blood test to check for herpes type 1&2. Should I ask for a specific test? And is it worth to get tested after 9 weeks?
It's driving me crazy not to know :-(

Thanks in advance for your help.