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Scrotal itching, tingling after sexual encounter. STD?

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Scrotal itching and tingling. Sometimes it can be severe. It started immediately after a sexual encounter two and a half weeks ago - protected vaginal intercourse, no oral, no kissing.

GP has prescribed Clotrimazole 10mg with steroid and I have been using it for 4 days now, 2 X a day with no improvement. All STD test resutls came back negative, still waiting for Herpes.

Pics attached.



Category: Family Physician-GP

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Category: HIV- AIDS Specialist
 23 Doctors Online

Hello,
Thank you for your query at DoctorSpring.com
I understand your concern.
Your images are suggestive of severe fungal infection.
You need to keep applying Clotrimazole ointment. Its definitely taking longer than usual, and that also shows your immunity is low.
Please keep applying the ointment. Since the infection is so severe it is causing the scrotal symptoms too.
Regards,
Dr. Jay


Patient replied :

Thank you, Doctor.
So you don't think it's a Herpes infection?
Clinic told me this morning I was positive for Varicella (chicken pox) virus and I know it's similar to Herpes Simplex. Don't know if this is a new/recent infection or old. If that is the case, my Herpes IGM test would likely be positive but not necessarily for HSV 2 (could be anything).
I will continue with the Clotrimazole cream. Scrotal itch is pretty intense now. Leg/ankle/foot pain is virtually gone this morning, as is the finger pain.

And it seems I got some of that fungal infection on my tongue, which explains the intense burning for so long. Do you think the fungal infection on tongue got into my system somehow which caused the systemic pain at leg/foot/fingers?

Should I continue taking an oral antifiungal drug?


Hello,
Fungal infections do not really manifest systemically.
But yours is a little perplexing that it still is not controlled.
It will be better if you can continue the oral dose too. Maybe for another 3 doses.
Regarding, varicella you need to confirm with them, if it is a recent infection. Varicella infection can rarely present with such symptoms too. And no, it definitely does not look like herpes.
Regards,
Dr. Jay


Patient replied :

Bacterial infection? If so, it would have shown up in one of the labs right?

The woman was from out of the country - South Korea. Now the vision in my left eye is starting to have flickering lights. I saw the opthamologist and he didn't see any issues, although this may be an optic nerve issue because the flickering occurs when I close my eyes too. I don't know if this is related or not but it's a new symptom.

The joint pain comes and goes. On some days it doesn't affect me much, on other days I don't want to move.

I talked to a nurse and she said if it was a new Varicella infection it would show up all over my body, and if not (shingles) it wouldn't take place in the exact place I had skin contact with her.

Generally speaking, suppose someone licked something really dirty or contaminated, would it not work itself into the bloodstream?



Hello,
Thank you for the follow-up.
The new symptoms again is unrelated and an ophthalmologist can guide you better. Is it possible you're being very stressed and anxiety does produce a lot of different symptoms.
If there was a bacterial infection, the CBC would have shown some indication.
I will also suggest you to take Tab. Claritin 10 mg once daily at bed time till the rash subsides. But don't take it more than 3 days. Let's see if it improves.
Regards,
Dr. Jay


Patient replied :

Thank you as always for your input, Dr. Jay.

I talked to the ophtamologist again today, the one who examined me when I first had the left eye flicker. He assured me he saw nothing unusual (he was very thorough, dilating etc) in my eye and saw no damage to the optic nerve. He has over 50 years of experience and is not shy about telling patients how it is, so I trust him.

So you're saying Claritin for the scrotal rash? I tried apple cider vinegar on the scrotum last night as a cleanser and although it did sting a little it wasn't too bad. I iused aloe vera gel afterward to soothe.But I am back to the Clotrimazole cream all the way, applying 3-4 times a day, or every few hours. This scrotal infection is pretty severe.

I keep thinking it's a systemic infection because it really feels that way. Like something is coursing through my body affecting me at different parts at different times.

One doctor has offered an ultrasound or EEG of my hand and leg to determine the possible cause of the pain. Is this something that would work?


Hello,
Yes, an EEG will be helpful. It will also indicate any nerve related problem.
The eye problem, I feel, is more due to stress and is nothing serious.
You should Claritin for a couple of days and update me if it works.
Feel free to discuss further,
Regards.


Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
Experience: 
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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