Atypical symptoms

[pburrightMember]

Hello Terry,

I apologize in advance for the lengthy post but want to give as much detail as I can which I hope will be helpful.

I am a 56 year old male in generally good health (as far as I know) with no previous history of sexual illness or disease.

10 weeks ago (on Sept 19th) I engaged in sex with a CSW (female escort). This consisted of brief unprotected oral sex (1-2 minutes perhaps max)and semi protected vaginal intercourse (also brief maybe 2-3 minutes). I say semi protected as the condom apparently split sometime during the act or perhaps immediately after as I was having some difficulty staying erect (due to guilt/fear) and was stretching the condom repeatedly as I was somewhat flacid. This was a single act and other than this I have been faithful to my wife of 27 years. I have high confidence that she has been faithful.

Sometime between 2-4 days after this risky exposure I began to feel a burning/stinging sensation or discomfort on one small spot on the left side of the shaft of my penis. The area is next to a skin tag about 1 inch below the glans which I have always had since I was a child I believe. I have had no other symptoms. At day 5 I went to urgent care and confessed the situation to the doctor. He tested for UTI (negative) as well as Gonorreah and Chlamydia. Both tests came back negative. He mentioned Herpes as a possible cause and advised me to come back if I got a rash or sores etc.

Since that time I have had almost constant discomfort in that one small area (about 9 weeks now). The severity of the discomfort has varied from day to day but I am always pretty much aware of it – sometimes as little as a pinching sensation to often a significant burning/stinging sensation which I would imagine a sore to feel like if one was truly there. I am usually somewhat pain free at night but then it normally bothers me more as the day progresses (at least when it flares up)-clothing seems to irritate it? I have been on very active crotch watch daily during this time and have not been able to find any evidence of blisters, sores or lesions which would explain the discomfort. The discomfort has been limited to that one small area and I have had no other symptoms and absolutely no discharge that I am aware of. I will say sex/masturbation seems to make it worse afterwards but not immediately afterwards (by the next day). The area MAY be slightly redder than the same spot on the other side but not realty all that noticeable or significant.

To finish the timeline. As I was still having symptoms I retested for Gonorreah and Chlamydia on Day 25 and both were negative again. At day 33 I tested for Trich which was also negative. At day 36 I went to my family GP. I mentioned the painful irritating spot (without going into any details on the encounter) and he took a look but didn’t see anything. I had been having some jock itch symptoms in my leg crease (no rash just itching which I had had for months off and on mostly at might or when I sweat) and he said the discomfort on my penis could be related to that (although the area on my penis does not itch at all). He suggested I put over the counter anti fungal cream on it which I did for a couple weeks but it didn’t help really. He also diagnosed me with a hernia (opposite side) but did not think that could cause the pain in my penis. He also did a Urine Analysis and found nothing.

As my symptoms have continued I finally pursued getting an antibiotic in case I had some type of NGU. I was prescribed a 1 gram dose of Zithromax (generic equivalent)on day 68 – on 11/12 approx. 2 weeks ago). It seemed to help reduce the symptoms but they have since returned but maybe somewhat lessen than before. One last thing – I tested myself yesterday for HIV (Oraquick Swab test) and it was negative. I know not conclusive at 10 weeks but reassuring to me.

So my question is – do these symptoms sound Herpes related? Is it possible to have on going discomfort for weeks without end with no visible sores/blisters etc? I am reluctant to get tested with all the false positives as it will only add to my confusion if I get a positive result and if this is not the cause of my symptoms. If you feel it is likely not Herpes related do you have any other thoughts on how I might follow up to determine the cause? At this point I don’t know whether to go to a dermatologist, urologist or neurologist. The only other possibilities I can think of at this point are that it could be a fungal or bacterial skin infection or possibly prostatitis. I do know I am not imagining it.

I do appreciate any help or advice. Thank you.

[Terri WarrenKeymaster]

So the odds of getting genital herpes at a single encounter are extremely small. They are not zero. However, your symptoms that persist and persist do not sound anything at all like herpes to me. It is unfortunate, in my view, that you did not obtain a baseline herpes antibody test because now, if you do test and you are positive, you cannot know if you’ve been infected for years or just got infected at this encounter.

Did you have other sexual partners before you married your wife? If yes, then you could have been infected for years or she could have been infected for years (if she had other partners before you.)

Whether you test at this point is your call. Only 5% of people test in the low positive range when they test for herpes so you are likely to have a clear result but I wonder if you will be able to relax about this without testing. What do you think?

Terri

[pburrightMember]

Thank you Terri. It is very helpful to have access to a knowledgable resource that you can trust to give honest answers and opinions which are based in fact and experience.

I don’t think I will be able to relax truthfully until I can determine what is causing my symptoms and/or they resolve completely. It seems unlikely to me at this point that they will resolve completely without an identified cause and treatment given they have been ongoing for over 9 weeks now. I will say the symptoms MAY be slowly improving. This ordeal has taken a significant toll on me emotionally and is affecting my sexual health as well so I am very much concerned. My biggest fear is that this will have a long term impact on my health in some way as well as my marriage.

Your feedback on the low percentage of low/false positives is helpful and encouraging. I agree with your assessment and that it is an issue now that I am unable to set a baseline test result. I did have other long term sexual partners prior to getting married.

I was looking for your input in really 2 areas. First from what I have read it appears very unlikely that a Herpes infection could be the CAUSE of my symptoms. If I understand correctly Herpes pain is the result of sores, blisters or lesions. Ongoing pain or discomfort by itself with no visible sores especially over a period of so many weeks seems very unlikely to be Herpes related. Really I have only had a day or two during this whole stretch where that area has felt close to “normal”. So again just looking for confirmation – maybe not impossible to be herpes but certainly highly unlikely? In that case I don’t gain much from testing now and should probably follow up elsewhere as if I am positive I have been positive most likely for a long time. On the other hand if I tested negative I could cross it off the list of suspects with certainty I guess but not sure I want to risk it if symptoms are not caused by Herpes.

As far as where else to look for an explanation do you have any thoughts based on your many years of clinical experience? It is hard for me to accept I guess that this has nothing to do with that recent encounter given the timing and location of the discomfort etc but I know it is possible. As I’ve said I have been tested twice now for the usual STD’s and UTI. I also took a dose of Zithromax to minimize the chance of some unidentified bacterial infection. I never had any discharge. My symptoms are limited to a stinging/burning irritation or inflammation in a localized area on my penis. At times the discomfort is significant (at least to me – feels like something is cutting me there at times for example) and at other times it is just a nagging inconvieience. It does not appear to get worse for example with urination. There is nothing visible to me in the area except possibly some slight redness but family Dr looked at it and seemed unconcerned. I do have a fairly significant hernia causing me pain which I will have a surgical repair done on 12/18 but that is on the opposite side from where the penis discomfort is. I also did have some jock itch which largely has subsided (and I never had a rash only itching in a totally separate area consistent with jock itch). I do have a skin tage in that area but have had it for many years and it has never bothered me.

Based on your clinical experience have you seen any cases like this and if so where might I logically consider going next to explore for a possible explanation? Could a fungal or bacterial skin infection as a result of my exposure be a potential cause? Or could I have pain like that from prostatis again caused by this exposure (my family doctor did not do a DRE but said my PSA was fine). Any other logical explanations given my exposure and limited symptoms? I am not prone normally to unreasonable fears so don’t think this is a case of anxiety although I have been feeling extremely guilty and fearful about this so it could be magnified some I guess but I know it is not just anxiety based.

Any thoughts or feedback on this is sincerely appreciated. Thanks again.

[Terri WarrenKeymaster]

Correct, symptoms that you describe as going on for a long time are highly unlikely to be herpes.
I’m wondering – has anyone done a prostate exam for you the course of these visits? That could be a possibility.
If you are still concerned about herpes – is it possible to contact this person and pay for them to get tested? If negative then you could relax. I doubt if she is positive you would worry any more than you already are.

You have one more opportunity to post with this membership. Let me know if you still have concerns that I can help with on this forum

Terri

[pburrightMember]

It really sounds like it is very unlikely I have Herpes with no visible blisters, sores or lesions present so cause of discomfort is probably something else.

Other than my prostate is there anything else based on your experience that may explain my symptoms based on the exposure and symptoms I have described as well as the negative test results I received thus far? For example is a fungal infection or bacterial infection on the skin a possibility? Any other possibilities I could pursue checking? Really I just have no idea what makes the most sense at this point. If not Herpes caused then what?

[Terri WarrenKeymaster]

I doubt that either a fungal infection would cause your symptoms. If it is prostate involvement, that would likely be bacterial in nature. If you already had a prostate exam and it was normal, then I don’t really know what else this might be, especially since you’ve already been treated with antibiotics. But what you took is likely not effective against prostate infection.

Yes, it is very unlikely that herpes is causing your symptoms, I think.

We’ve exhausted your three posts. If you have other concerns, please feel free to renew your subscription.

Terri

[BurningupParticipant]

Atypical – I have had a very similar atypical experience post a 9/22 exposure to a CSW first neurological in extremities, but now just as you describe. Waiting to test HSV at 16 weeks, but treated for prostatitis with Cipro for 28 days with no change to variable local pain. I am interested to read what you are able to determine and will post my results.

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