Likelihood of HSV infection

[dgziger]

Hello, I have some symptoms I’m worried about.

Background: To my knowledge, no HSV1 or HSV2, but never been tested.

I had an encounter with a CSW, unprotected oral sex, protected vaginal sex.

Approx. 14 days later, developed some small, itchy bumps in legs, buttocks.
Two visible red pimple-like bumps in bottom of left butt cheek, in the fold where it meets the leg.
They hurt,not in a sharp way, but in a tender, blunt way. Some mild redness/rash in the same
area. None of it looks like typical images of herpes on the web.

In the following two days, I develop a warm sensation in the back of scrotum. Then this turns
into intense itchiness, redness and swollen scrotum. Two of those days I also feel a headache.

In the day after that (today) the itchiness, redness and swelling have subsided, but
are still present. The pimple-like bumps persist but I feel them less. It bothers me a little
when sitting down. There is also a little bit of itchiness around the anus.

No visible sores or blisters in the genitals. No noticeable discharge or burning when
urinating. There is a slight discomfort in the tip of the penis, but it may be the foreskin.

I am being tested for chlamydia (results not back yet)
and will get tested for HSV in a few weeks.
Meanwhile, what is the likelihood of me having HSV1? HSV2?
Is it true that in my case the primary outbreak would be in genitals?
What may be causing symptoms? About a week before
itchiness started I also had a massage where there was a hot tub.
I’ve heard about “hot tub folliculitis” — could that cause all these symptoms? I’m also worried about gonorrhea now.

[Terri Warren]

Honestly, those symptoms do not sound like herpes to me. The lesions as you describe them as just not what we would normally see with herpes. It sounds a little fungal to me.
As for gonorrhea, 95% of men with gonorrhea have remarkable discharge – I always know when a man has gonorrhea when he comes in with toilet paper in his underwear – hardly need a test! But seriously, I doubt that as well. You said you were tested for chlamydia – why not gonorrhea?
If you are going to do a herpes test, wait about 12 weeks for the most accurate IgG antibody test. Testing too soon can give you a false negative result. You might also consider getting a baseline herpes test now, just to see where you stand before the waiting begins. Eighty percent of those infected with HSV 2 don’t know it.

Terri

[dgziger]

Hello, an update:

Two days after my post, I went back to get my results; they were all negative (hep, chlamydia, syphilis). I had developed some pain in the urethra, and told this to the Dr. She scraped my urethra (said it seemed irritated) and examined with a microscope. She said no WBC or gonorrhea, but did see some bacteria; suspected NGU and prescribed a 7-day doxyciclin and one dose of something starting with C. I followed instructions and the genital symptoms quickly subsided in a day or two.

However, throughout I still felt slight irritation/pain in the butt, as when one gets a big pimple. In the last week, (so 3-4 weeks after exposure), I started giving it a closer look and taking pictures.

There are 2-3 inches along the left butt-leg fold with light red blotches, and scaly skin. It is not well defined in the edges.

There are two or three bigger (~5 mm diameter) pimples, almost gone. They are reddish. There is a smaller red new one from the last couple of days, and I suspect, another one forming in my perineum. (I felt some tingles in the area before they appeared, too). They do not look like classical herpes blisters, but more like mosquito bites/pimples. They are round and don’t have well defined bases. So far all seem to have formed around hairs. (I am pretty hairy though). They cause a dull pain. They have not blistered as far as I can tell, but the older ones have scabbed by now.

There are some very small (2mm diameter) bumps that are not red at all, and do not hurt or itch. They most closely resemble pictures of “heat rash”, but they’ve lasted for at least a week.

I will get to my country in a couple of weeks, then I’ll consult a dermatologist and get tested. As a side note, given my very limited sexual history I doubt I have HSV2. In the meantime your opinion on whether this is consistent with herpes would be appreciated.

[Terri Warren]

Glad to hear everything is negative. Great news. The bumps that you describe do not sound like herpes lesions to me. It does sound like you might have folliculitis? And when you say scabbed, how big are these? I also doubt HSV 2 but do get checked out when you get back to your own country, just to be sure.

Terri

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