Persistent Lesions

[jcmoney55]

Hi Dr,

Its been about a year since I last posted and I have another concern. Sometime around Jan I had unprotected sex a few times over the span of a few weeks. No noticeable symptoms at all until late Febrauary (definitely none within the first two weeks to a month).

In late Feb, however, I had a sore develop on my scrotum and thought nothing of it because I know herpes, and especially initial outbreaks, do not generally occur there. Then this past May the same bump occurred so I figured I would get the IGG test just to be sure. It came back negative and I let this go (the female said she was not aware of any std's she has and that she gets tested, although herpes is not usually done unless sores are present.)

Here is when things get a bit weird. Last Thursday I felt awful (fever, loss of appetite, etc.). Then I went golfing Friday and at night I noticed a tick on the very tip of my penis (I know, weird, but it happened). On Sunday, I noticed a red bump that is very near where the tick bit me but not exactly, and I don't remember if it was embedded or not as I didn't waste much time getting it off obviously. it def. wasn't very deep in.

Now the bump looks just like a herpes blister. There is a raised red portion with a scab right in the middle. I still have loss of appetite, fatigue, and noticeable weekness. Is there any chance the bloodtests are still showing a false neg after this much time has passed? I wouldn't worry about the bump so much as obviously I had a tick in almost the exact same spot, but the symptoms I am having plus the bump have me concerned. But then rationally I think, what are the chances that a herpes bump shows up a day or two after I get bit by a tick in the exact same spot coupled with the neg test after about 4 months.

I'm hoping a little more rationality on your part will help me. Thanks so much.

[jcmoney55]

Thank you for your prompt reply. I actually went to my dcotor today and she said that the lesion did in fact look like a bug bite, and they are running subsequent Lyme disease tests. I currently live in Maryland.

I guess the herpes came into my mind because I was feeling the symptoms on Thursday, which is before the tick was on me as I am sure I got it from playing golf on Friday, but I believe I let enough time go by when I had the IGG to have a conclusive result as I know by 3 months 95%  are positive, unless I am the 5% that doesn't develop antibodies. I have had no sexual activity since the female in Dec/Jan.

I'm am currently on antibiotics and awaiting the Lyme tests, but I just wanted to clear my head from the herpes. Thank you again for your help and replies.

[H. Hunter Handsfield, M.D.]

Welcome back to the STD forum.

Lots of inflammatory skin lesions can look like herpes, including insect bites or an inflammatory reaction to the tick.  You know for sure you didn't have genital hereps as of a month ago, not to mention you were not at apparent risk for STDs.  I guess I don't understand why you suspect anything other than the obvious, i.e. the effect of the tick bite.

So I'm not worried about herpes.  However, I am definitely concerned by the combination of your systemic symptoms (fever, etc) combined with the tick.  Depending on what part of the country you are in, Lyme disease or Rocky Mountain spotted fever may be possibilities.  Both can be quite serious.  You should see a health care provider right away.

But I see no reason to be concerned about herpes.  If your doctor disagrees with me and is concerned about herpes, follow his or her advice and I will be happy to comment further.  But I won't have anything more to say unless and until you report the result of your doctor visit.

Regards--  HHH, MD