What Causes Tiny Red Spots And Tingling Sensation In Penis Post An Intercourse?
Doctor informed that I don't have herpes since the tests were negative and also if my symptom were due to herpes, they wouldn't subside with the medication used.
Now it's 5 weeks after the incident I am feeling tingling sensation on my penis but no sores or bumps. I am scared to death if it's herpes..or is the diagnosis from the doc true? Thoughts please.
If it is not herpes, what could the small bumps be? My blood work included hiv dna pcr, hsv panel, hiv rapid test, vdrl, tpha, hpv, hbsag. All were nonreactive. Only discrepancy is that my esr is higher than normal. Does it mean something?
As of now at 5 weeks 3 days, I have intermittent tingling sensation in the penis glans and 2 tiny red raised spots - flat, shiny, no pus, not ulcer for the past 1 week. What could these symptoms be? Is it suggestive of a herpes outbreak?
I'm going to get tested again at 6 week mark but I am losing sleep over this. Please
Likely candidal/ yeast infection; tests for herpes needs to be repeated
Detailed Answer:
Hello. Thank you for writing to us
I am Dr. Kakkar (MD, Skin and STDs). I have read your question and I have understood your concern.
Genital herpes usually presents with multiple sores/ erosions which are painful Or have a burning sensation. The diagnosis is usually clinically obvious.
Primary episode of genital herpes is very painful and in the absence of treatment takes about 2-3 weeks to heal, however, recurrent herpes resolves in about 7 days without treatment. Although your doctor kept a possibility of herpes but did'nt treat you for herpes and rather treated you for candidal infection with an Oral antifungal i.e fluconazole. Moreover, judging by the fact that your lesions responded within 3 days to oral fluconazole and were bumps rather than sores, it seems to me that the genital lesions were actually due to yeast/ candidal infection rather than herpes.
The genital lesions which you notice now, they are also not suggestive of genital herpes and they too seem to be candidal in nature, since they are raised, red, shiny spots unlike those of genital herpes which are usually ulcers or erosions on genital mucosa.
You may upload an Image for my review at "Reports Section" so that I am able to guide you better.
However, regarding screening for genital herpes, lab tests cannot be cannot be taken as conclusive at 2 weeks as most patients of would anyways not have circulating antibodies to the virus by this time and therefore would be false negative. In order to be absolutely sure you need to repeat the tests. Since, its already been 6 weeks, therefore you may take a screening test now, which would be more acccurate than your previous test.
Regards
Use a topical antibiotic ointment
Detailed Answer:
Thank you. I have reviewed the image
I can see a red inflammed patch on glans but there is no erosion suggestive of herpes.
I suggest you to use a topical antibiotic e.g 2%mupirocin ointment (Bactroban ointment), twice daily. Get tested for herpes at 6 weeks.
Regards
Unlikely to be herpes
Detailed Answer:
Hi.
Lesions of herpes evolve fast. Erosions of herpes usually evolve within a few to 24 hours, after onset of an episode of genital herpes.
Do keep me updated about test results.
Regards
Lab test help resolve doubt in cases with confusion
Detailed Answer:
Hello.
Of course, at times there can be some confusion between candidal balanitis and herpes but the appearance is distinctive in each of these conditions. Rapid response to oral antifungals and a short time to heal are points that I consider in favor of candidal involvement. Herpetic erosions are usually painful Or have a burning sensation and last for at least 5-7 days.
In cases with confusion lab tests can help in resolving the diagnosis. Lets wait for the results in your case.
Regards
Detecting IgG is more reliable
Detailed Answer:
Hi.
Though IgM is the earliest to become positive but an IgM test at 2 weeks is not very reliable as compared to a test done later, say at 6 weeks Or 8 weeks for IgG because some patients may develop IgM positivity only transiently Or not at all.
Regards
Herpes is reliably ruled out
Detailed Answer:
Hi.
This screening test for herpes at 6 weeks reliably rules out genital herpes and strengthens out clinical diagnosis.
As far as redness and tingling is concerned, a trial of antifungal is worth recommended. Therefore I suggest you to use a topical antifungal cream, preferaly with a steroid content to take care of redness and inflammation e.g clotrimazole 1% + beclomethasone 0.025% cream (clotrin-B cream), twice daily for a week. It is a prsecription product and I would advice you to get a legitimate prescription from your doctor for the same.
Clean this area with lukewarm water and avoid using soaps etc.
Regards