is this anything to worry about...

Hi,

Three and half weeks ago I had unprotected sex with a girl I know. About 4 days later I noticed a mild burning sensation (and perhaps mild discharge) on urination and the irritation is more apparent in teh morning so I went to my doctor to get tested for Chlamydia. While I was waiting for the test result to come back I told her about my suspicion and that she should get tested. She said she'd had a bad bladder infection in the days following, but she also told me she has HSV-1 although was showing no symptoms and hadn't for over a year.

I went back to my doctor and the Chlamydia results were negative. He did a urethral swab and a mid-stream urine sample and those came back negative too. He said there's a very slim chance of HSV, but given that I have no other symptoms I shouldn't worry about it. He said it wasn't worth testing for as the tests are unreliable when there are no symptoms (blisters/sores). He said that the irritation was likely due to high acid content in my urine due to dehydration from hotter weather, and that any mild discharge is from my prostae and is normal. I'm fine with this and I'm aware that I'm probably somewhat dehydrated most of the time, howvever I still have a couple of nagging questions that didn't occur to me until now:

If this is HSV and using the bathroom is irritating urethral blisters / ulcers should I have expected this to clear up by now? (3 weeks later)

again, if this is HSV and I experience mild burning from time to time but no other symptoms am I at risk of exposing future partners?

There has been no tingling / itching associated with this. I haven't had a fever or joint pain or any of the other symptoms typically associated with HSV. I'm sure I'm worrying too much but I don't want to put anyone else at risk in the future.

Thanks

[Alan Rockoff, MD]

HSV shouldn't last this long or cause these sorts of symptoms.  I think your doctor is right.

Did the girl have HSV-1 on the genitals?  If not--the usual place is the mouth--then you are unlikely to have contracted it unless you had oral sex, in which case the risk would be low without a visible active lesion.

If your fears persist, you can get a type-specific herpes blood test.  I'd wait several weeks, because it takes time to convert to positive.  But again, on clinical grounds your doctor is right to say that the picture doesn't match herpes.

Take care.

Dr. Rockoff

[AJ100]

Did the girl have HSV-1 on the genitals?

Yeah, although she claims to not have had an outbreak in over a year. From what I've read, as this is potentially the first time I've been exposed to HSV I'd expect the sympotoms to be worse than this, or at least coupled with something else. As I said, there's been no pain, tingling, flu, etc, and it has persisted unchanged for 3 weeks now. In the end this could all be my imagination. For the most part we used protection, but I was still really dumb.

Thanks for getting back to me. Given the imformation available on the internet anyone who has a simple cold might as well have herpes, given that there can be some sympotoms / no symptoms / severe symptoms first time / etc. It's all a bit confusing.

[Alan Rockoff, MD]

That's why you should get proper blood tests, just to confirm as best you can that you're in the clear.

Dr. Rockoff