May 12, 2015 at 2:32 am #6641
Hi, I’m a 31 year old male with no history of STDs, including HSV-1.
In August 2014, after ending a 5 year monogamous heterosexual relationship, I met a new partner. I slept with her once, and we had unprotected oral sex and protected vaginal intercourse.
One week later, I noticed discomfort at a single spot the size of a quarter on the skin of the right side of my penis shaft. I would describe it as a cross between an itch and a burn. There was no rash or redness that I could see. This has remained the only symptom for the duration of my story.
This gave me a lot of anxiety. I already felt uncomfortable about the single encounter, and I went into full, but suppressed panic. I immediately scheduled an appointment at a local sexual health clinic.
They saw me 1 week later, and because I had no symptoms except for the itch/burn, they tested me only for gonorrhea and chlamydia. The nurse performed a visual inspection and saw nothing.
These tests came back negative. As I was still experiencing the discomfort, I scheduled an appointment with my PCP.
I saw him a few days later. He did not perform a visual inspection but ran a urine culture, the IGG serologic tests for HSV 1/2 and an HIV test.
These all came back negative, but I knew it was early for HSV 1/2 and HIV. He recommended I wait if I wanted another test to ease my mind, but said he guaranteed it would come back negative. He said if the discomfort persisted, see a urologist or a dermatologist.
At 7 weeks, the symptoms persisted: just an itch/burn with no visible rash. I had an appointment with a urologist, and explained to him my recent history. He said it didn’t sound like anything he could identify, but would run tests if it would give me peace of mind. He prescribed the IGG serologic test for HSV 1/2.
These came back negative.
Because the same itch/burn with no rash still persisted, I scheduled an appointment with a dermatologist. He gave a visual examination with magnifying glasses, and said he saw very mild irritation, but it didn’t sound or look like herpes to him. He prescribed Cordran to reduce the irritation. Within hours of applying it, the burning sensation became much worse, and the next day there were two small red bumps around hair follicles in the folds of the skin where I applied the drug. I immediately discontinued use, and within about 2 days the bumps were gone and the itch/burn remained at its original level. The dermatologist said there was nothing else he could do.
At 12 weeks, the itching/burning persisted and I saw my PCP again. I asked for a final HSV 1/2 IGG screen. He obliged and it came back negative.
After that, I became convinced it could not be herpes. The sensation remained, but as I became less focused on it, it was easier to ignore. When I would randomly feel anxiety about it, the feeling would flare up, but as I moved on again it would fall back down. I was very concerned about it, but after 3 doctors, multiple examinations and negative test results, I could only move on with my life.
A few months later, I began sleeping with a new partner. The first months were fine, but a few weeks later she began to complain of vulval pruritus. She has no other symptoms (no discharge, no redness).
My question is: what causes an itch/burn as the only symptom, can’t be diagnosed visually, through culture or serology, yet appears to be contagious?
Or is her issue unrelated entirely?
My itching/burning remains, but I had assumed it was a random nerve defect. Now I’m very worried that I’ve passed something on to an innocent person.
What could it be?
May 12, 2015 at 4:31 pm #6659
My thought is that her itching and your itching are indeed unrelated. You’ve had very good testing, thorough medical evaluation and have done all the right things. Good for you. A single itching and burning spot with a negative IgG HSV test and no lesions does not suggest herpes to me, honestly. And your contact that raised the red flag was protected for intercourse, correct? So that is very low risk in itself.
Do you know if your newest partner has been tested for herpes or not? If not, and you are negative, she likely should be tested.
May 12, 2015 at 6:15 pm #6676
Thank you for responding so quickly.
I agree that it doesn’t appear to be herpes, but the symptoms have been extremely unusual. If it weren’t for all the testing, I would think it could be post herpetic neuralgia caused by HSV. Not a lot explains 10 months of mysterious itching/burning.
The single encounter that raised the flag was indeed protected.
My new partner said she was fairly certain of her negative HSV status. She has had few partners and absolutely no indication of infection in her life. However, she will be following up with a physician.
As far as my continued symptoms, do you have any suggestions? Could it be post herpetic neuralgia? Would you recommend a WB test? I know this is a herpes centered forum, but physicians have been unable to help me with the symptoms. Could it be fungal or bacterial with no rash? Or could the rash be so mild I can’t see it? And if so, is it possible to pass a bacterial or fungal infection?
May 12, 2015 at 6:24 pm #6678
PHN does not present in exactly this way. A very small area of skin with sensation that is odd, itching and burning is a bit different than PHN which tends to be more extreme and over a larger area.
Regardless of your partner’s opinion of whether she has herpes or not, testing would provide a more secure answer, I believe. Eighty percent of those infected with HSV 2 deny any history of symptoms consistent with herpes.
I seriously doubt that this is bacterial or fungal. it sounds more like some sort of weird nerve thing to me, in that particular area, but what weird nerve thing it might be is unknown to me.
May 13, 2015 at 1:41 am #6683
Okay, final post. Thank you so much for all of your help!
During that initial “red flag” one time contact, there was some rough activity, including an accidental extreme bend of my shaft and rough oral sex. Could that have caused nerve or tissue damage that only presented as discomfort a week after the encounter? Can tissue/nerve damage present itself as intermittent/variable intensity burning and itching for months?
Would you recommend a Western Blot to confirm my negative HSV results?
Finally, if my partner is negative for HSV, are there many non infectious causes of vulval itch with no discharge or rash that don’t involve an STD?
Thank you again!
May 13, 2015 at 2:33 pm #6686
Well, yes, a severe unintentionally bend or even break of the penis could certainly cause some nerve damage. I couldn’t speak to whether this would continue to be an issue of changed sensation on the skin, but I think it is a possibility.
I would recommend the western blot only if it would help you but this behind you and you don’t mind spending the money to get it done. Sometimes it can be very helpful for that reason.
Yes, there are certainly things that could cause her itching, primarily yeast, that is not originally infectious. Sometimes women can have low levels of yeast colonization that cause them irritation, even if the yeast can’t be seen on exam. And it doesn’t always cause a discharge. Over the counter treatment or the appropriate amount of time may be a good diagnostic tool in itself for this issue. She could be sensitive to the kind of condoms used or to the lubricant or the spermicide.
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