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Treatment for abdominal pain and enlarged gland on groin after protected sex?

DOCTOR OF THE MONTH - Jan 2014
Jan 2014
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Answered by

Dermatologist
Practicing since : 2002
Answered : 6921 Questions
Question
Dear Doctor, I have recently visited a doctor in Indonesia regarding a sensitive and unpleasant issues. I have developed a spot that grow bigger – it got sore and red around. During my first visit to doctor the dermatologist said it is infection and prescribed Bactodermin cream – I first though it possible as I have been visiting a swimming pool as well as hot XXXXXXX Nevertheless after 4 days another spot developed bellowed the initial one (this is all bellow my belly button). This second spot was at first little itchy but only little bit. So on my second visit do dermatologist she said that it is viral infection and more likely herpes – she said that test here takes long time and is very expensive – which is true so I have been taking Acyclovir 400mg three times a day plus Mefinal 500mg three times a day too. Plus I have been applying Acyclovir 5% several times a day. These medicines as I have realised are generic (thus not sure if they work – but it is what the dermatologist prescireb to me). I have had sex three times with a girl here approximately week before this started to happen. I have used a condom. Nevertheless, my first intention was to ask you whether this really is a herpes as I was hoping that it might not be – but now I have seen the detailed picture I am less positive. Please would you confirm or suggest what to do next. I have completed the course of the medication hat is 5 days and so I dont know what to do next. As you can see for your self it is still there. It is not painful – it does itch only very little – perhaps when I put the cream on. I have a slightly enlarged gland on the left groin and some occasional abdominal pain. I do not have a pain while urinating nor have I this anywhere else around or on the genitals. Thank you for taking time to have a look at this – I am distressed and I though it be wise to get a second opinion. Best XXXXXXX
Posted Sat, 8 Mar 2014 in Skin Hair and Nails
 
 
Answered by Dr. Kakkar S. 19 minutes later
Brief Answer: Herpes Genitalis &Secondary Bacterial infection Detailed Answer: Hi. Thanks for posting your concern at HCM After going through the history and looking at the picture, I would keep a possibility of Herpes Genitalis with Secondary bacterial infection. If I was your treating doctor I would have prescribed you an oral antibacterial (penicillin group e.g Amoxycillin in combination with clavulanic acid, thrice daily for a week) along with an oral Antiviral e.g Famciclovir 500mg thrice daily for a week. Topical antibacterial ointment. e.g 2% mupirocin twice daily for a week is also recommended. I would advice that you also get a lab test for herpes for confirmation of clinical diagnosis. HSV Elisa (IgG and IgM). IgM usually becomes positive within a week of infection and stays positive for 2-4 weeks whereas IgG is detectable after 4 weeks of infection. take care regards
Above answer was peer-reviewed by
 
Follow-up: Treatment for abdominal pain and enlarged gland on groin after protected sex? 12 minutes later
Dear Doctor, thank you for your swift reply...i understand that the list of medication that you have included in your reply is not a direct recomendation but if say i would like to give it a go is it ok after the week of previous medications. I am not allergic to any medication as far as i know. Thanks
 
 
Answered by Dr. Kakkar S. 17 minutes later
Brief Answer: Herpes Genitalis &Secondary Bacterial infection Detailed Answer: Hi. I could see 2 lesions which are erosions/sores with seropurulent base and surrounding redness/inflammation and is thus definitely infected with bacteria. Therefore I would have definitely recommended an oral antibacterial for the bacterial infection that would have got superimposed on the sores of Herpes. Since bacterial infection delays healing of Herpetic erosions so that also explains why the erosions are still persisting after 5 days of Acyclovir, which in any case is recommended for 7 days and not 5 days, if it is primary infection/first episode of herpes. In recurrent herpes genitalis the dose of acyclivir is 400mg thrice daily for 5 days. Though I have recommended a different antiviral (famciclovir for 7 days since you did'nt seem to respond to acyclovir) but you can also continue with the same antiviral, Acyclovir for 2-3 more days as well. take care regards
Above answer was peer-reviewed by
 
Follow-up: Treatment for abdominal pain and enlarged gland on groin after protected sex? 8 minutes later
Ok Thanks...my last question - all these is it twice or three times daily - you wrote thrice daily - so i presume that means twice but not sure. thanks and all the best
 
 
Answered by Dr. Kakkar S. 3 minutes later
Brief Answer: Herpes Genitalis &Secondary Bacterial infection Detailed Answer: Hi. Three times daily (OR every 8 hourly). regards
Above answer was peer-reviewed by
 
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