Really Concerned about Herpes/other STD from sexual encounter

[helpneeded341]

thanks for doing this,

Last Friday night I made the mistake of drunkenly having unprotected sex with my friend.  I talked to her the next day and she told me I had nothing to worry about in terms of STDs, but I know she has had multiple sexual partners and so was worried.  Then, Sunday morning (about 35 hours after sex) I examined my penis and discovered 20-25 red blotches/bumps on the shaft - when I pull the skin tighter they appear to look like small veins.  So I went to the doctor on Sunday afternoon, where there I also noticed really small red dots on the head of the penis. (about 10-15)  There was no itching or pain - the only reason I noticed them was because I examined my penis.  the doctor did a swab on me for Herpes, but since then the dots have remained the same and are not sensitive or painful or tingling.   (it is now tuesday evening, the 5th night since I had sex)   What do you think these dots are from?  could they jsut be from rough sex?  I am not using to having such long nad rough sex

If my culture comes back negative, that does not mean I am free from my herpes I believe.  Those dots could be something else, and I could still have picked up herpes through the encounter.  Now, the 4th day since sex I think I am feeling shooting pains in my penis from time to time, but this could just because I am paranoid.  I also think I may have flu-like sypmtoms and am urinating more (althought it is not painful), but that again could be paranoia.  Other than those red dots that have not changed, I have no visible symptoms or sensitive areas, (the red dots are not sensitive either)  So, if the culture comes back negative, should I still be tested at some point for herpes again?  like a blood test?  Also, in general, given the history of my encounter what other STD's should I get tested for and when/how should I do these tests?

thank you so much, and sorry about the lenght.

[Edward W Hook, MD]

No reason not to go get screened, there is always value in knowing where you stand, health wise.  The tests you mention are all reasonable.  The likelihood you have syphilis or HIV is vanishingly low but, still worth knowing.  There is an outside possibility of HSV as we've discussed.  Since you were recently tested for gonorrhea and chlamydia, there is little to be gained by re-testing.

Doubt you need hepatitis testing. If you have not been vaccinated for hepatitis A and B however, you like everyone else, should be. EWH

[helpneeded341]

I decided just to take this opportunity to go get tested in general,  Im going to a STD clinic and am going to get these following tests:

-Herpes 2 IgG ELISA Test
-HIV-1 EIA Test
-Syphilis RPR Test

1.  Do they all sound good?

2.  Do I also needed to get hepatis tests? I have had no symptoms or reasons for concern, I jsut know it is another STD

3.  I tested negative for ghonnorea and chlamydia about 5 days after the encounter,  and have not had any symptoms since.  Does that mean I am good for them and do not need testing?

[helpneeded341]

ok, thans for the quick reply.  So then I should go ask for a type-specific herpes blood teset?

I figured that since i have only been with two women - one a virgin, and the other justed tested negative for herpes, it would be impossible for me to have herpes?  but you believe I need to get the test to be sure?

[Edward W Hook, MD]

The likelyhood that your lesions are herpes is low but you should already know that.  

Yes the blood tests, if they were type-specific tests are reliable.

Can you be SURE that you don't have herpes, no.  Not without the test. EWH

[helpneeded341]

thanks Doctor,

it has been almost 9 weeks and I was planning on getting a blood test for herpes (i already got tested for gonorrhea and chlamydia and they came back negative).  However, first I talked to the girl and she told me 2 weeks ago she had got tested for all STDs (including a blood test for herpes).  yesterday, she called the doctor's office and they said she was fine for everything.  
So can I be sure now that these red marks were not herpes marks?  are those herpes blood results accurate and thus I have no need to be tested?  (the only other girl I have been with was a virgin, so I know I did not have anything previous to this experience)
the marks went a way after a few days - I applied some cream to them that my Doctor gave me, but Im not sure if that is what caused them to go away.

Thanks so much Doctor

[Edward W Hook, MD]

the fact that your culture is negative and that the lesions you describe have not changed make the diagnosis of herpes rather unlikely.  I think seeing a dermatologist is a good idea if they can see you.

No, gonorrhea and chlamydia are the important ones.

Please let us know what the dermatologist says.  EWH

[helpneeded341]

OK thanks very much Doctor, I am not sure if you reply to another post, but I do have a few more questionis.

Fortunately, my swab test came back negative for herpes.  How accurate is this?  and even though these bumps seem not to be herpes, should I still get tested at some later point to make sure I did not pick up herpes in the sexual encounter?

Second, the red marks on my penis are staying about the same - still no pain or itching, just red dots and areas (look like small veins when I stretch my penis) Do you have any idea what this could be?  I am trying to schedule an appointment with the dermatologist, but am leaving the country soon, so might not be able to see one for a while.

Finally, I am going to get the gonorrheam and chlamidya tests you advised me later today,  but are there any other STD tests that I should do even though I am not exhibiting any symptoms?  If so, when shoud I do them?  

Thank you so much, and sorry for the long question.

[Edward W Hook, MD]

Your doctor did the right thing.  If this was your first episode of herpes, the culture should be positive.  The fact that the rash did not evolve to form small blisters, makes it somewhat unlikely that this was herpes.  In terms of sorting this out, there are many different things that could casue such a rash.  I would think that that seeing a dermatologist would be a good idea at this time.  The sooner the better.

As for a blood test, it is a bit early for the test to be positive.  If you have a blood test and are found to be herpes, it is somewhat more likely that you acquired herpes at some time in the past rather than during the exposure you describe.  In turn this would make it unlikely that your rash is herpes.

I'm a bit surprised to hear that you were seen by a health care provider and he/she did not take other STD tests.  If not, the tests I would advise would be a swab or urine test for white blood cells (to diagnose nongonococcal urethritis), gonorrhea and chlamydia.

Hope this helps.  EWH