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What causes fluid blister on penis shaft?

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Dr. Bharatesh Devendra Basti

Dermatologist

Practicing since :1998

Answered : 1765 Questions

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Posted on Sat, 30 Aug 2014 in Sexually Transmitted Diseases
Question: Hi,

I'm a male and I had unprotected sex with a female recently. 21 days later, 6 small fluid filled 'blisters' appeared on the shaft of my penis well above the hair line, each approximately 1 - 1.5mm in diameter.

I made an appointment with my doctor to see him the next day. Overnight, 4 of the blisters merged into a single large blister approximately 3 - 3.5mm in diameter.

My doctor suspected HSV2 but expressed XXXXXXX that I was in no pain, didn't have a temperature, no discomfort when urinating, in fact no pain what so ever. He ruptured the 'blisters' and took a penile swab of the fluid for a PCR test in addition to ordering a blood test for IgG anti-bodies.

The PCR test returned a positive for HSV2 but I've experienced no pain or discomfort in any form, excepting when I apply medical alcohol to the ruptured 'blisters' and even then, it only stings for a second or two. The blood test returned negative for both HSV1 and HSV2.

Is it plausible that the PCR test returned a 'false positive' ? Everything I've read about herpes blisters state that they are very painful. If not HSV2, what might be the cause of the 'blisters' ?

Thanks, Confused
doctor
Answered by Dr. Bharatesh Devendra Basti 20 minutes later
Brief Answer:
Likely to be HSV

Detailed Answer:
Hi
Thank you for query. I am Dr Bharatesh D Basti answering your query.
The possibilities of Herpes is more with the descriptions given.
PCR is done for the DNA material of HSV.so it will detect any genetic material of HSV.
So here HSV2 so it is likely that you have HSV2 as false positive results are very less with PCR.More so you have unprotected intercourse history,clinical history correlating with HSV and HSV 2 is common in the genital area. Some may not have pain etc
Antibodies to HSV do take some weeks to come so it has come negative as it is in initial phase of disease.
You can get back to me for any clarifications.
Thank you
Dr Bharatesh


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Bharatesh Devendra Basti 4 hours later
Thank you for your reply.

Every article I've read states that genital herpes blisters' are extremely painful, yet I've not experienced any pain what so ever. I've not had a temperature, not felt ill or experienced any headaches, and no pain when urinating. My own doctor showed XXXXXXX when I said 'no' to all of the above and didn't prescribe any medication.

Is it feasible to experience no pain at all when having a genital herpes outbreak in spite of all the material that states otherwise ?

In your opinion, should I revisit my doctor to obtain a prescription for medication, and if so, which anti-viral would you suggest ?

Thanks, Confused
doctor
Answered by Dr. Bharatesh Devendra Basti 2 hours later
Brief Answer:
Herpes can present without pain

Detailed Answer:
Hi
Thank you for follow up query.
Yes there should be pain associated with the vesicles.But there are many cases which have been documented asymptomatic and also many without pain but have vesicles.
PCR is a sensitive test and a very specific test .I would like to treat this as Herpes.
Antiviral medications can be taken like acyclovir (Zovirax), famciclovir (Famvir), and valacyclovir (Valtrex) can be taken after consultation with your doctor.
You can get back to me for any clarifications else please close the discussion and rate.
Thank you
Dr Bharatesh

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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