Symptoms help – very worried

[wc211]

Hi Terri,

I am a 23 yr old male and on Feb 24 I had protected vaginal intercourse with a new partner, on March 8th I had unprotected vaginal and oral intercourse with a different partner, and on March 10th I started to get a burning feeling around my genitals and anus.
I have had a ton of different symptoms on and off over the last 4 weeks and am extremely stressed. I have done 3 urine tests that all came back negative and blood tests that showed I was healthy with no concerning results. I asked my partner from March 8th to get herpes tested and she had negative IGG and IGM results. She was negative for other STD tests, but did test positive for a yeast infection. I tested negative for IGG and IGM as well. I texted my partner from February 24th and she told me she was “clean.”
My major symptoms have been on and off burning around my genitals, on and off very irritated and sensitive skin around my butt/thighs especially when I am sitting, a bright red scrotum, right testicle pain, on and off tingling in my legs and feet (not as often), and some lower back achiness. I noticed some red patchy looking skin + paler spotty skin on the tip of my penis and some flaky skin on the shaft of my penis that seemed gone in a couple days. I had the burning around my genitals and anus for about 2 weeks straight and since then I have only felt it a little in the back of my testicles. I also did notice irritation and dry skin in my groin area. The symptoms are intermittent and seem to keep changing.
I got 2 ultrasounds done – one said I had a cyst on my right testicle and the other said I did not. I went to my PCP, a dermatologist, and a urologist and they all said this is highly unlikely to be herpes. I have tried 2 antifungal creams, and now am trying fluconazole and a mix of steroid cream and antifungal for my testicles.
I am very worried and very confused. I am worried the first partner could have given me herpes even with a condom. Please let me know what you think. Thanks!

[Terri Warren]

I think herpes is really unlikely in your situation. Condoms do reduce transmission by 65% so that’s good and the other partner tests negative by IgG and so do you ( I assume from your post). You could do another IgG at about 8-10 weeks out and if negative, try to let it go. Your symptoms really don’t sound like herpes to me.

Terri

[wc211]

Hi Terri,

Thank you for the quick response and all that you do. This has been very stressful so thank you for the reassurance. I am hoping it is maybe something fungal related as the 2nd partner had a yeast infection and the dermatologist said there could have been something fungal that was mostly gone by the time she saw me due to the redness she saw and the pictures I took earlier to show her. What has been unnerving is how the symptoms seem to keep changing. Yesterday I felt almost normal and today I am back to lower back pain, testicle pain, and irritation of the skin in my boxers area when I am sitting (its been about 4 weeks of symptoms).

What worries me is the off chance that I contracted genital herpes from the first partner and then the outbreak was caused by the friction of intercourse with the second partner. Does this seem like a possibility? I have had some other symptoms: a couple times I felt a stinging in my urethra, dry skin throughout my body, potentially aching knees and a moist feeling around my anus. Again they have all been changing so it is hard to keep track of them and I’m not sure if that is normal or if some of that could also be my stress. Is it normal to have so many symptoms that keep changing like that?

Thank you again Terri.

[Terri Warren]

Low back pain and testicular pain are not really herpes symptoms. Also, herpes wouldn’t give 4 weeks of continuous non-lesional symptoms.Dry skin through your body, aching knees and irritation of the skin in the boxer shorts area are also not herpes symptoms.

Terri

[wc211]

Last follow up,

I am still having a tingling/pins and needles/burning feeling on and off in my legs and feet. I have also noticed multiple muscle spasms/twitches in my: thighs, feet and toes, and my calves. Could herpes have affected my nervous system to cause any of these symptoms after 4 weeks? It is definitely unnerving. And should the IGG test be 8-10 weeks out from exposure or from start of symptoms?

Thanks again Terri

[wc211]

Hi Terri,

Just adding onto my last post. Today I received IGG test results. My HSV1 was negative and my HSV2 was equivocal. The value is 1.070 and the equivocal range is 0.90 – 1.10. I am still waiting on my IGM test results. This is a change in my 2 negative results on my IGG from about a month ago. What should my next steps be? Am already thinking about setting up a consult with you.

Thanks so much

[Terri Warren]

There is absolutely no point in waiting for your AGM test results. They are very frequently falsely positive and the CDC says never to use them. I think with your equivocal result infection is highly unlikely but not zero. If you want to be more certain, do a herpes Western blood test. I sort of doubt that you will get the reassurance that you need from continuing to do IgG test but that’s your choice.

Terri

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