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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Hello, I Am A 32 Y/o Female, No Children. 5

Hello, I am a 32 y/o female, no children. 5 days ago, I engaged in reciprocal fingering and oral sex with a new partner. We did not have vaginal or anal sex. I had not engaged in sexual activity for over a year, and the stimulation was vigorous enough to be uncomfortable. I still have swelling in my vaginal area, and it has been itching on and off and is very sensitive to the touch. The itching seems to have extended to the anal area, but it is hard to make a clear distinction, and I currently have mild internal hemorrhoids. Two days ago (three days after the encounter), I woke up with a very sore throat, back pain, and fatigue, and developed a slight (99.6) fever and chills during the day, and eventually dizziness and a headache. The vaginal discomfort also worsened that day, and I started to have slight burning with urination. I went to urgent care and described all of these symptoms, and they did a urinalysis and visual exam, finding evidence of a sinus infection and a UTI (white cells upon visual inspection, confirmed by culture results). I was given a 7-day course of Levaquin, and I have now taken 2 doses. Now, 5+ days after the encounter, my sore throat is much better, the back pain is gone, and I feel less fatigued and less dizzy. However, the vaginal swelling seems to have worsened if anything, and urination is still painful and I feel like I'm not fully emptying my bladder. Today I also noticed one small, fairly firm bump on my outer labia (skin-colored, not particularly red or white), which did not hurt until I touched it firmly and now it feels slightly irritated. It does not look like a blister, but it is difficult for me to get enough light on it to tell for sure.

So, I am now concerned about the possiblity of herpes transmission. My partner showed no signs of an outbreak and did not mention having the virus, but I know that he could still be shedding. I had been having back pain prior to the encounter and I am very prone to headaches, and two coworkers have had sinus issues within the past 4 weeks. I am also prone to UTIs and I had shaved my genital area shortly before the sexual encounter, which could explain some of the itchiness as hair continues to grow back. The PA that examined me heard all of my syptoms, found fluid buildup in my ears, and examined my vaginal area visually and saw nothing of concern, but I do not know if the bump appeared before or after that exam. She stated that the combination of a sinus infection and a UTI could cause the symptoms I was having, which I would summarize as flu-like plus pain during urination and the feeling of having to go again repeatedly. I am worried because these symptoms also sound very similar to herpes (presumably transmission of HSV-1 from mouth to genitals), except that the pain during urination is not caused by any visible blisters or sores and I have continued urinary tract discomfort well after I urinate (best relieved by rinsing with warm water), and I would expect more than one bump with herpes (although I know one could be enough).

I'm wondering if this sounds very definitively to be one thing or the other, given all of the caveats of the situation. Any thoughts would be much appreciated.
Mon, 20 Jul 2015
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Hello, I Am A 32 Y/o Female, No Children. 5