Recurrent buttock bumps turning into boils may be due to herpes simplex II infection. Culture from first appearing bumps can diagnose this.
Sometimes herpes simplex II can manifest with acute GI illness with vomiting, diarrhea, and dysuria, followed by pimple on genitalia after an unprotected sex with new partner. This pimple can turned to ulcer with swollen lymph nodes in the area. Tingling in lower back and thighs may be present. Recurrent eruptions in the area usually occurs which strongly indicates herpes simplex infection and if these eruptions are occurring continuously then there may be an underlying immune deficiency.
The patient with very frequent herpes simplex usually needs herpes simplex suppression therapy continuously.
Herpes simplex virus II in some cases can cause facial involvement so the only way for sure to confirm from which virus one is infected (i.e. HSV I or II) is to do HSV IgG test for both viruses.
Herpes simplex virus sometimes can cause esophagitis and esophageal ulceration which can be found on EGD and can be diagnosed with esophageal biopsy showing focal viral cytopathic changes.
After unprotected sex one can take antiviral therapy to avoid any herpes simplex infection, but protection is best.
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