Fungal Balanitis and Herpes: Symptoms and Diagnosis

Q: Fungal Balanitis and Herpes: Symptoms and Diagnosis

Hello： 1) There should be numerical values and specify which items are being tested; otherwise, it is impossible to make a judgment. <br>2) Personal experiences are not common. <br>3) It hurts when the skin is broken and comes into contact. <br>4) Testing can only determine if th

Diagnosis of fungal balanitis and herpes?

Hello, Doctor.
Recently, I inquired about herpes and fungal balanitis and would like to ask some additional questions.
I noticed that the small blisters were present from the beginning; initially, there was only very red skin.
After applying the first physician's Mycomb cream, I discovered the small rashes (I remember it mentioned to discontinue use if a rash develops).
The blisters are very small, and I am unsure what they are, but they are not located where I have ulcers.
The ulcerated area is on the glans and the corona, and there is no Mycomb cream applied around the meatus.

1.
I tested negative for HSV-1 and HSV-2 last time, and the doctor said those values were absent.
If Dr.
C had administered antiviral medication (around three weeks before the blood test), would it still be detectable, or would there be values indicating a past infection?
2.
Can fungal balanitis cause small blisters?
3.
You mentioned that if the blisters burst, it would be painful.
Is this pain a sensation of discomfort, or does it feel like a stinging sensation when applying medication or coming into contact with water?
4.
I have been under a lot of stress lately.
If I go to the urology department for testing, can herpes be detected through a blood test even if I currently have no symptoms?
5.
Since I recovered in April this year, I sometimes feel a strange cramping sensation in the affected area.
What could this indicate?
6.
It has been about six months since I had any ulcers, but recently I sometimes feel a warm sensation.
Is it possible for herpes to remain dormant for such a long time without an outbreak? I have also been feeling quite low and stressed lately.
7.
Do herpes patients usually seek medical attention upon discovering blisters? I initially did not see a doctor until after I noticed the blisters.
8.
If it is indeed herpes, would it be contagious after six months without any ulcers?
9.
I also mentioned that I developed inflammation and ulcers four months after exposure; could this be related to herpes?
10.
If it is herpes, can I get married? Can I have normal sexual relations and have children? Would it affect the child?
I kindly ask for your assessment regarding the possibility of herpes.
I will go to the hospital for further testing, but currently, there are no symptoms on my penis.
I have been feeling quite depressed and have had a poor appetite for the past three weeks.
Sometimes, I feel a bit of warmth around the corona.
Is it possible for my immune system to be prone to inflammation?
Thank you for your help.

Bai Bai, 20~29 year old female. Ask Date: 2018/10/17

Dr. Du Shixi reply Urology

Hello: 1) There should be numerical values and specify which items are being tested; otherwise, it is impossible to make a judgment.
2) Personal experiences are not common.
3) It hurts when the skin is broken and comes into contact.
4) Testing can only determine if there has been a previous infection.
5) It may be a psychological effect.
6) Herpes can potentially remain dormant for several years without an outbreak.
7) Most people seek medical attention only after the skin is broken and inflammation occurs, unless they are patients with prior experience of recurrence.
8) It is possible, but the chances are significantly lower.
9) It is a possibility.
10) You should consult an obstetrician-gynecologist.

Reply Date: 2018/10/17

More Info

Fungal balanitis and herpes are two distinct conditions that can affect the genital area, and understanding their symptoms and diagnosis is crucial for effective treatment.
Symptoms:
1. Fungal Balanitis: This condition is typically caused by a fungal infection, most commonly Candida species. Symptoms may include:
- Redness and inflammation of the glans (head of the penis) and foreskin.

- Itching or burning sensation.

- White patches or a thick, curd-like discharge.

- Small blisters or pustules may develop in some cases, but these are less common.

2. Herpes Simplex Virus (HSV): Herpes can present with:
- Painful blisters or sores on the genital area, which can break open and form ulcers.

- Itching or burning sensations before the blisters appear.

- Flu-like symptoms during the initial outbreak, including fever and swollen lymph nodes.

- Recurrent outbreaks may occur, but they are often less severe than the initial episode.

Diagnosis:
To differentiate between fungal balanitis and herpes, a healthcare provider will typically perform a thorough examination and may recommend the following diagnostic tests:
1. Visual Examination: An experienced clinician can often diagnose fungal balanitis based on the appearance of the affected area. However, if the diagnosis is uncertain, further testing may be warranted.

2. Culture Tests: A swab of the affected area can be taken to culture for fungi, which can confirm a fungal infection.

3. PCR Testing: For herpes, a polymerase chain reaction (PCR) test can be performed on fluid from a blister or sore to detect the presence of HSV DNA.

4. Blood Tests: Serological tests can determine if there has been a past infection with HSV. However, if antiviral treatment was administered shortly before testing, it might affect the results.

Treatment:
1. Fungal Balanitis: Treatment typically involves antifungal creams or oral medications, depending on the severity of the infection. Maintaining good hygiene and keeping the area dry can also help prevent recurrence.

2. Herpes: Antiviral medications such as acyclovir, valacyclovir, or famciclovir are commonly prescribed to manage outbreaks and reduce the risk of transmission. While herpes is a lifelong infection, antiviral therapy can help control symptoms and reduce the frequency of outbreaks.

Additional Considerations:
- Stress and Immune Response: Stress can weaken the immune system, making individuals more susceptible to infections, including fungal infections and herpes outbreaks. Managing stress through relaxation techniques, exercise, and adequate sleep can be beneficial.

- Long-term Management: If you have a history of herpes, it is essential to discuss with your healthcare provider about long-term management strategies, especially if you are considering marriage or starting a family. Herpes can be transmitted to partners, but with proper management and communication, many individuals with herpes lead healthy, fulfilling lives.

- Consultation with Specialists: If symptoms persist or worsen, it is advisable to consult a urologist or dermatologist who specializes in sexually transmitted infections and skin conditions. They can provide tailored advice and treatment options based on your specific situation.

In conclusion, distinguishing between fungal balanitis and herpes requires careful evaluation of symptoms and appropriate diagnostic testing. If you have concerns about your symptoms or potential infections, seeking medical advice is crucial for accurate diagnosis and effective treatment.

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