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Fever, red marks on penis after sex. HERPES?

Resolved Question:

I am worried i may have contracted herpes. I had sex unprotected and within 30 hours, i felt feverish and had several red marks on the shaft of my penis.

The only reason i think it might not be is that it was rough (dry) sex and lasted for approximately 2 hours so there was some definite abrasion at the base of the penis and pubic area as well. I had also just recently shaved so that may be some of the irritation.

Also i was already feeling sick at the time so the flu-like symptoms could be a coincidence. None of the pictures ive found online for herpes look similar to the condition im experiencing. 


Category: Sexually Transmitted Diseases(STD)Specialist

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Dr. Deepu Sebin Sebastian is online now

Expert:  Dr. Deepu Sebin Sebastian replied 4 Days.

Hello,
Thank you for your query at DoctorSpring.com
I understand your concern.
There could be two reasons for what you're having right now. Let me start my reassuring you that it does not look like herpes and also herpes starts after an incubation period of at least 7 days. What it does look like is an allergic reaction/ folliculitis which can be due to your shaving. It can also be due to minor injuries suffered from sex due to friction.
I will advise the following :
1) Tab. Claritin 10 mg once daily at bed time for 3 days.
2) Calamine lotion to soothe the affected areas.
Once you take the medicines it should resolve within 3-4 days. If it does not send me an image of how it looks like after applying the medicine and i can help you further.
Let me know if you have other queries,
Regards.


Patient replied :

Hello Doctor,
It has now been five nights since this encounter and i am still experiencing some strange symptoms.
I feel like my pubic area (the glands?) is swollen and irritated.
I also have a non-stop itch and slight rash all over the pubic area. Could five nights later this still be an irritation from contact or a fungal thing?
I am also somewhat worried because in your previous email you said herpes takes 7 days, but everywhere else i have read said 2 days is the minimum time.
Please let me know when possible.

Thanks


Expert:  Dr. Deepu Sebin Sebastian replied 3 Days.

Hello,
The pictures that you sent last time definitely had nothing suggestive of herpes, and seemed more like folliculitis.
Yes Herpes can start even in 2 days, but mostly in people with good immunity it takes slightly longer time.
If it has not subsided even after taking Claritin though, it is better you get yourself checked for herpes. The issue is herpes does not have the typical cold sores presentation in some cases, and presents as a rash.
The pubic lymph nodes can be enlarged secondary to even folliculitis/ bacterial infection.
Once you have the results, upload it and based on that i can guide you further.
Even if it is herpes, though it can't be stopped from manifesting itself, the outbreaks can definitely be limited with proper anti-viral treatment. So get yourself tested and let me know,
Regards.


Patient replied :

Doctor, Here is several photos of my current condition. As you can see it has changed quite a bit. Would this be common still of folliculitis or a bacterial infection?

Would a herpes outbreak be quite this spread out through the entirety of the pubic region?

Would it be normal to feel the "prodrome" symptoms for this many days without an actual blister?


Expert:  Dr. Deepu Sebin Sebastian replied 2 Days.

Hello,
Thanks for the additional pictures.
Yes it still looks like folliculitis. Did you apply calamine as i asked you to? Also you can apply Mupirocin+ Hydrocortisone ointment in the affected area for 3-5 days based on the severity.
Normally herpes outbreak is limited to the scrotum and the area between the end of scrotum and your anus. So this definitely does not resemble herpes. And yes some people even on contracting it, never actually develop the disease, until way later due to low immunity. So it will be difficult to predict how long it can take to manifest.
I will still advise you to get yourself tested for it, to have more of a conclusive evidence. But to me, it still looks more like folliculitis.
Regards.


Patient replied :

Thank you for the response doctor.

One last question, in the first picture i sent you, the base of the penis was extremely red and irritated. this since has gone away and there was actually a small amount of dry skin that fell off (very minor). Given that that problem went away so quickly, would it suggest that the "rough" sex was actually that distruptive to my body and the folliculitis is still just lingering?

I wasnt able to buy the remedies you suggested but i did try some cortizone. Would this help or make things worse? I know that added "wetness" to the area may not be the most helpful if it is something that needs to be dried out.

Also, given that the encounter happened 5 days ago now, does it make sense that the folliculitis could still be getting worse? Does it take that long for it to go into effect?


Expert:  Dr. Deepu Sebin Sebastian replied 1 Day.

Hello,
See i told you even earlier, if you were not able to take Claritin and apply calamine this won't go away. It is available OTC, so please contact your pharmacy. Also if Tab. Claritin is not available then you can take Tab. Levocetrizine instead. Cortisone will be helpful, but i will recommend using Mupirocin+Cortisone mixed ointment. It will absorb and hence the wetness won't be there.
Yes it is possible that rough sex+ folliculitis is the cause here.
If you don't take medicine, folliculitis will get worse. It gets infected by bacteria and hence you need to apply Mupirocin antibiotic. Please get the medicines and start using them. You will feel much better.
Regards.


Dr. Deepu Sebin Sebastian
Category: Select Speciality
Experience: 
MD, Internal Medicine - Stanley Medical School
Medical School - MBBS - Govt. Medical College, Kottyaam

Diagnostic Prediction - Stanford School of Medicine
Received Specialty training in Critical Care, Cardiology, Neurology, Gastroenterology, Nephrology from Stanley Medical College and in Endocrinology, Rheumatology.

Hematology and Geriatrics from Madras Medical College.
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