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STDs (Expert Forum)
Candida or Herpes??
Answered by
University of Washington
Seattle - WA
This forum is for questions and support regarding STD issues such as: Chlamydia, Crabs (pubic lice scabies), Gonorrhea, Hepatitis (viral), Herpes, HPV, Molluscum Contagiosum, PID, Rectal Infections, Syphilis, Trichomoniasis, Warts, Yeast Infection.All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.
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Candida or Herpes??
by Spandisman, Mar 01, 2006 12:00AM
About three weeks ago I had sex with a female friend of mine and the condom fell off part way through (although we did not notice until the end). About 5 days later I experienced a persistent tingling sensation in the end of my penis and inside my urethra. This developed into a burning sensation, which was aggravated when I urinated. This is still present. I am now terrified that I have contracted genital herpes.
I have not developed any sores, although I did have what appeared to be an enflamed hair follicle for a few days. This was completely painless and settled down to look just like another sebaceous gland. I have had frequent yeast infections on my penis in the past, but they have never come on so suddenly and severely.
I have already been tested for all other STDs and had a swab taken from inside my urethra and tested for HSV (negative), but in the absence of any sores I cannot really rely on that diagnosis. HSV blood tests are not offered anywhere locally (I am in the UK). The girl has also been tested and treated for cervicitis. She has never shown any symptoms, although is prone to getting thrush.
My reasons for suspecting herpes is the tingling sensation, the suddenness of the symptoms and the fact that I started getting cold sores for the first time this year, having performed oral sex on this same girl about a year ago.
I am in a long distance relationship and my girlfriend is coming to visit soon. We do not use barrier protection and I am terrified that I will give her herpes. I do not, however, want to have to confess to cheating on her without good reason (i.e. if this is likely to just be candida again). Any and all advice will be very gratefully received.
I have not developed any sores, although I did have what appeared to be an enflamed hair follicle for a few days. This was completely painless and settled down to look just like another sebaceous gland. I have had frequent yeast infections on my penis in the past, but they have never come on so suddenly and severely.
I have already been tested for all other STDs and had a swab taken from inside my urethra and tested for HSV (negative), but in the absence of any sores I cannot really rely on that diagnosis. HSV blood tests are not offered anywhere locally (I am in the UK). The girl has also been tested and treated for cervicitis. She has never shown any symptoms, although is prone to getting thrush.
My reasons for suspecting herpes is the tingling sensation, the suddenness of the symptoms and the fact that I started getting cold sores for the first time this year, having performed oral sex on this same girl about a year ago.
I am in a long distance relationship and my girlfriend is coming to visit soon. We do not use barrier protection and I am terrified that I will give her herpes. I do not, however, want to have to confess to cheating on her without good reason (i.e. if this is likely to just be candida again). Any and all advice will be very gratefully received.
Doctor's Answer
by H. Hunter Handsfield, M.D., Mar 01, 2006 12:00AM
, Mar 01, 2006 12:00AM
It probably isn't candida; I have never seen a case of yeast infection (thrush) causing such symptoms in men. Conceivably it could be herpes, but it is uncommon for herpes to cause urethritis without typical herpes sores. Further, urethral herpes doesn't just "tingle"; excrutiating pain is the rule. In any case, either of those would have shown up on routine evaluation, ie there would be signs of inflammation in a urethral swab and/or urine. You are wrong about HSV blood tests not being offered in the UK; not every provider or lab perhaps, but testing can be done. If you have not visited a genitourinary medicine (GUM) clinic, that would a logical next step. UK's network of GUM clinics is generally excellent. But in the meantime, it seems unlikely you have any active infection that will harm you or that can be transmitted to a partner.
Good luck-- HHH, MD
Good luck-- HHH, MD
If you are getting cold sores on your lips and that is presumably due to HSV-1, then there is no chance that your genital symptoms are also caused by HSV-1 as you cannot be reinfected in other parts of the body.
I am surprised by the response that candida does not cause burning in the urethra/head of penis. I was under the impression (from many websites on the subject and the GP that diagnosed me with a yeast infection a while back) that they were precisely the sort of symptoms that it caused.
Is it not also true that lots of people infected with HSV display much milder symptoms (like mine), hence leading to a large proportion of infected people being unaware? It seems that the absense of sores and excrutiating pain is not evidence enough to presume HSV is not there.
(I have been to a GUM clinic - that's where I got tested.)
Any further comments? I am not convinced that my girlfriend will be safe having unprotected sex with me.
HHH, MD
You will have to go private though.
Go to any of the Medi Centres that are situated around many parts of central London. They offer the HerpeSelect test done by Quest Diagnostics - a bleeding fee and the test cost a total of £79.
The Doctors Laboratory - You need a referral for this one. But you can get the blood drawn at their office on WImpole Street and they send it straight to their lab up the road. It's not HerpeSelect but it is reliable (around 95% sensitive) and type specific. Again, around £80.
If your doc won't give you a referral try these:
The Regents Park Clinic (again on Wimpole Street). They use the Doctors Laboratory. Around £120.
Also, online service DrThom offers the Doctors Laboratory test, but again will cost around £100.
Most places send their tests to one of these two labs.
I am not sure about out of London though.
Good Luck!
Am curious about cold sores though - some sources say you cant be reinfected in another site if you've already been infected with one type of HSV. If my cold sores are in fact HSV-2, then would that prevent me from getting genital symptoms, or pehaps reduce them? (Performing oral sex on this girl and starting to get cold sores both happened about a year ago.)
While candida seems to have been practically ruled out as a cause here, I have found that the clotrimazole anti-fungal cream that I have used for previous penile yeast infection does help reduce the pain on the end of my penis. (Is this likely to contain a generic "soothing" ingredient?) I have read on another site that a bad yeast infection of the penis