Possible genital herpes

[djcurt25]

Doc,

I posted the about 2 days ago in the STD section.  Dr. Hook told me I had basically no risk.  However my symptoms have gotton worse.  

Let me fill you in.  About 4 days ago I had a lapse in judgement and went to a massage parlor.  I had protected oral and protected vaginal sex(Vaginal sex lasted no more than 30 sec.)with the worker there.  She did lick my scrotum with no protection on as well as my anus.  A few minutes later after I got home that day I could feel a burning sensation on the tip of my penis, scrotom and anus.  This proceeded to a tingling or burning sensation throughout my body, but mostly on hands, feet and face.  My genitals are still tingling or burning and now my scrotom is a bit red.  I have no visible lesions on my scrotom or penis.  I do have about 4 red dots looking like very small mosquito bites on my right butt cheek.  I know anxiety can cause tingly or burning sensations but the redness is what has me worrried.  I am gonna go get tested on monday.  I know that will be too soon, but I will still do it anyways.  Please offer me your advice on this.  I am absolutely terrified that I picked up an STD.  Thanks.

[Terri Warren, RN, Adult Nurse Practitioner]

I completely agree with Dr. Hook that you have extremely limited risk, if any, from this encounter.  Your symptoms sound nothing like herpes, honestly.  I believe that your anxiety and worry over this encounter is getting the best of your head, and that you are very likely noticing every little symptoms on your body, things you would have previously never noticed at all if you had not had this sexual encounter.  Redness can be cause by many things, including fungal infection and irritation from too much checking of the genital area.  Stop checking frequently, if you are.  If you want to test, go ahead to put your mind at rest, but if you test for herpes, test only for IgG, not IgM.  And remember that over half the population is positive for HSV 1, so don't be freaked out if that comes out positive, particularly if you've ever had a cold sore, or even if not.
That's my advice.  I hope you will add it to Dr. Hook's advice and try to stop worrying.

Terri

[Terri Warren, RN, Adult Nurse Practitioner]

Yes, I think a dermatologist would be a good option now as you continue to feel symptomatic and are very concerned.  Let me know how that goes, OK?  A good antifungal over the counter is Lotrimin

Terri

[djcurt25]

Hmmmm.  I had the red ring before they gave me the antibiotics.  The urologist gave me Nystatin and Triamcinolone Acetonide cream.  I have been using that, but it doesn't seem to help.  My anus has been a bit itchy as well.  I am unbeliveabley scared as to what this could be.  I really appreciate your opinion.  Would you recommend going to a dermatologist?  What further testing would you recommend?  Thanks for your help.

[Terri Warren, RN, Adult Nurse Practitioner]

My opinion doesn't' change on possible herpes, no.  I am guessing that you might have gotten the "shotgun" approach to STDs.  They treated you with everything, hoping that whatever you might have contracted gets treated.  With all those antibiotics, I'm wondering if you might have a fungal infection (a common side effect of antibiotic use).  Have you tried anything like an antifungal cream around the anus?  It needs to be used for about 10 days to be effective.

Terri

[djcurt25]

Just wanted to get your opinion once more on my situation.  I have been to the doctors and have tested numerous times for std's and it has come out negative.  I only tested for herpes the first week after my exposure and it was negative.  I still have this red ring around my anus and also my urethra tip is red and burns at times.  I originally given antibiotics (4 pills twice a day for 2 days).  Went to the urologist at week for and he gave me a shot in the butt, doxycycline, and cipro.  I will finish taking those on saturday.  He also gave me some kind of antibiotic cream for my anus.  I don't think it is helping though.  It has now been over 5 weeks since my exposure and over a month since the symptoms appeared.  Would you recommend me going to a dermatologist?  Also, does your opinion change on possible herpes?  I'm so scared! Thanks inadvance for your reply!

[Terri Warren, RN, Adult Nurse Practitioner]

I would be more suspect of a fungal infection, given your symptoms, than herpes.  Herpes just doesn't cause that kind of symptom around the anus.

Terri

[djcurt25]

I have gone to the doctor to ***** my situation.  It is so bizzare to me that he doesn't think I have herpes.  However, the two areas that the CSW licked were both my anus and my scrotum and both my anus and scrotum are red and inflamed.  If I look at my anus I can see a bright red ring around it.  It definately looks irritated.  I have a burning sensation there still. He did a test for herpes and it came back negative.  I asked him if that would be accurate because of the window period and he insisted that it was.  I find that hard to believe.  I am going for a second opinon on Friday.  These symptoms popped up 2 days after the exposure so I feel in my heart that it is an STD and probably herpes because I have never had any anal irritation before that I can remember.  Do you know symptoms of anal herpes and what does the redness around my anus mean?

[Terri Warren, RN, Adult Nurse Practitioner]

No, anxiety doesn't cause redness.  You could try some antifungal cream on the scrotum to see if that helps, it is available over the counter.

Terri

[djcurt25]

Thanks Dr. for your feedback.  It has now been 6 days since the incident happened.  My scrotum is still red and burning, but with no leasions.  I do have a great deal of anxiety right now.  Thank you very much for your advice.  Just want to ask one final question.  Can anxiety cause redness or irritated skin?  Also I went and got tested yesterday for Herpes, ghonorea and chylmidea.  I will test all again at 6 to 8 weeks to confirm.