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Are multiple erosions on glans of penis a sign of STD infection?

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Posted on Sat, 12 Dec 2015
Question: by XXXX, Nov 19, 2015
I was given an oral without protection by a girl. About 8 weeks later I observed a small red dot on my penis glans. It stared growing and became a 3 mm spot within 4 days. I waited to see if it would go away. But it kept growing bigger. So I had to visit the doctor after 10 days and he got me tested for HSV 1 & 2, HIV 1 & 2, VDRL. All the results came negative.
HSV 1 & 2 IgG (ELISA) - 0.07 Ratio
HSV 1 & 2 IgM - 0.23 Ratio

HIV Antibody (Elisa) 0.01

VDRL / Rapid Plasma Reagin (RPR Test), Serum - Non-reactive

Blood Sugar - Normal

B12 - Very Low (So I am taking weekly B12 injections now)

I was told that it could be a bacterial infection and he prescribed the following:

1) Anti bacterial cream called Fourderm. - 3 times in a day
2) ZiFi Turbo Tablets which contain Cefixime and Linezolid - 5 days - Morning & Night
3) Anti Fungal Table - Fluconazole 150 table - daily 1 tablet for 5 days.
4) Zerodol - SP for inflammation.

By third day I could see that the spot on the penis glans is gone. So I stopped taking ZiFi Turbo and continued to use the cream for 2 more days and started using Fluconazole 150 and used for only 1 day and stopped.

But after 5 days again I could see that there are multiple more such small dots coming up.
I was terrified and started using Fluconazole 150 for 4 days along with Fourderm cream. But there is no use.

So I started using ZiFi Turbo and used them for 3 days again along with Zerodol SP. The things got worse. The spots grew bigger and also the old spot that was gone came back. All the multiple dots grew bigger and became a big spot on my penis glans. The foreskin also got infected. It was slightly paining. There was discharge coming from the big, small spots and infected foreskin. The penis glans skin was peeling. I thought this could be a yeast infection and stopped eating sweets and started taking lots of natural yogurt along with regular food. As I was away from my home town all these 10 days, finally I called the doctor and sent him the photos of infection.

I expected him to say that it was yeast infection. But to my shock he said that I may have to start using antiviral drugs for genital herpes and he prescribed the following and said lets see result after 5 days.

1) Acivir 200 mg - 5 tablets every 5 hours
2) Herpex cream - Evening and Night
3) Fourderm - 2 times daily

Back to time of exposure, I was tested after 9 weeks of exposure after I got a symptom. The result showed negative. But the doctor has prescribed antiviral drugs for genital herpes now.

I started using Acivir as per doctors prescription since 1 day. Today I have seen a small bleeding spot on the penis glans. I am worried now. Could this be cancer or herpes or something else?

I am posting the link to the image of the infection - http://www.medhelp.org/user_photos/show/633729?personal_page_id=0000
doctor
Answered by Dr. Kakkar S. (4 hours later)
Brief Answer:
Genital Herpes

Detailed Answer:
Hello. Thank you for writing to us

I have gone through your query and I have also reviewed the image.

I can see multiple erosions on glans of penis, some of which are also coalesing with each other. This does look like genital herpes. The test that you did for Hsv was too early and therefore gave a false negative result, more so because it was IgG test which anyways becomes positive later. IgM becomes positive earlier. Therefore I suggest you to repeat ELISA for HSV type 1 and 2 (both IgG and IgM).

If I was the treating doctor I would suggest you to take an oral antiviral for a week.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kakkar S. (1 hour later)
Dear Doctor,

Thank you for your reply.

Presently I am using the following medication:
1) Acivir 200 mg - 5 tablets every 5 hours
2) Herpex 5% cream - Evening and Night
3) Fourderm - 2 times daily

As you suggested I shall use for 7 days.

But do you recommend anything else?

1) After seeing your reply I have emotionally become very sad for the mistake I have done. Please tell me what precautions I need to take from now. I am married and I have two kids - Boy: 9 years and Girl: 5 years. We all sleep on the same big bed. I did not have sex with my wife till now after I was exposed. May be I only kissed her couple of times. Would this have transferred infection to her also?

2) I cannot dare to speak about this issue with my family as my wife will definitely react in a negative way and she may even leave home taking our kids with her. I need your suggestions on what I am supposed to do from now.

3) I shall take a re-test after 10 days. But do I need to stop the medication for few days before the test? Or can I get the test after the symptoms are gone?

4) Do you think the HIV report which came negative is fine for a 9 week window period?

5) I am also suffering with B12 deficiency and am presently taking B12 weekly injections.

6) Today I have seen that a small cut on the penis glans when slightly blood is coming. What can I do for that?

7) Do you want me to go through any other test? If yes, when?

Thank you.
doctor
Answered by Dr. Kakkar S. (6 minutes later)
Brief Answer:
Answers to specific queries

Detailed Answer:
Hi.

-Stop using fourderm. It is a topical steroid and would make matters worse. Rather use a topical antibiotic e.g T-Bact cream, twice daily instead of herpex 5% cream. Continue with oral antivirals for a week.
-No, kissing does'nt transfer genital Hsv. Only sexual contact transfers Hsv. Avoid sexual contact with your wife till the erosions resolve completely. There is a more risk of passing on infection in presence of active sores than at other times. You must use a condom everytime you have sex with her. A condom reduces the risk of transmission by about half.
-As far as disclosing this to your wife is concerned I think it would depend on your own understanding of her reaction. Obviously she would be angry.
-Oral sex carries a low risk of Hiv. However, I suggest that you repeat the test at 12 weeks for a conclusive result.
-Use a topical antibacterial i.e T-bact cream, for the cut or break on glans.
-An ELISA for Hsv type 1 and 2 (IgG) at 12 weeks from sexual contact.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kakkar S. (4 hours later)
Dear Doctor,

Thank you for your quick reply.

But you have answered only partially for my questions 1,3 and 5. Please give some more details.
I want to understand how I can improve my immunity by ways other than B12 injections and daily B12 tablets. Is it OK to take the injections weekly now? Also please guide me on my diet to heal from herpse quickly and in a better way. I am from south I XXXXXXX

Thank you.
doctor
Answered by Dr. Kakkar S. (16 hours later)
Brief Answer:
Answers to specific queries

Detailed Answer:
Hi.

Hsv is transmitted only through sexual contact (genital or oral) and not through kissing. Sleeping on the same bed is not a risk for your children or wife. You can transmit the infection to your wife but only through sexual contact. I suggest you to avoid sex during active episodes of genital sores because this is when infectivity is greatest. At other times too, you must always insist on using a condom. A condom reduces the risk of transmission of herpes by half.

Medications won't alter test results for herpes. You can take the test at 12 weeks from sexual contact since it is more likely that an infection would show in tests after this window period of 12 weeks. Earlier than this can give a false negative result.

B12 has no role in Hsv. There are no dietary recommendations for Herpes. Specific treatment of herpes is with oral antiviral i.e acyclovir, valacyclovir or famciclovir.

Immunity can be improved by taking more of fruits and salad, safe drinking water. Avoiding stressful thinking also helps e.g by doing breathing techniques (like kriya), practicing yoga etc.

Regards
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Dr. Kakkar S.

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Practicing since :2002

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Are multiple erosions on glans of penis a sign of STD infection?

Brief Answer: Genital Herpes Detailed Answer: Hello. Thank you for writing to us I have gone through your query and I have also reviewed the image. I can see multiple erosions on glans of penis, some of which are also coalesing with each other. This does look like genital herpes. The test that you did for Hsv was too early and therefore gave a false negative result, more so because it was IgG test which anyways becomes positive later. IgM becomes positive earlier. Therefore I suggest you to repeat ELISA for HSV type 1 and 2 (both IgG and IgM). If I was the treating doctor I would suggest you to take an oral antiviral for a week. Regards