herp question

[letssee]

Hi Doctor,

7 weeks ago, i had unprotected oral sex with someone i didn't know (i am gay). (I should mention also that besides oral sex, i am still a virgin). I went to the doctor 4 weeks ago and was diagnosed with HPV.  I had the warts removed and everything was back to normal.

3 or 4 days ago, my scrotum began to itch and i lightly scratched it.  Th next day, when i woke up, it looked like a nail scratch on the left side of my scrotum.  It didnt hurt except when my thigh chafed against it.  

I immediately went to a dermatologist who told me there was a 30% chance that i may have hsv 2.  (Even though the area doesnt have pimple, not full of puss, etc)  Even now, four days later, it just look like a nail scratch trying to heal..  it never exploded or crusted over or hurt or anything.  He took a culture and sent me to have an HSV test done.

The results of the test take up to a week and i have been freaking out.  A few hours ago, i went to a different doctor and had a biokit performed. The biokit was NEGATIVE, but my doctor said that since i JUST had my first outbreak, I MAY not have the antibodies for it.

My questions are:

1) my sexual activity was 7 weeks ago.  I heard herpes usually shows up 7 to 20 days after contact.  What are your thoughts seeing as how i got my symptons 6 weeks later?

2)  I really think it may be chafing or a staph infection (i have previously had impetigo on my face and lychen planus on my hands/feet) and am prone to staph infections.  Also, the sexual contact i did have did NOT involve my scrotum being touched or licked.

3)  can antibodies for herpes show up DURING your first outbreak or after?

4) does this sound at al like herpes if im not in pain, it doesnt itch anymore, it hasnt "scabbed" or "blistered" or "oozed" for about 4 days now?

Thanks

[Terri Warren, RN, Adult Nurse Practitioner]

The problem is, if you take Valtrex, it could slow the development of antibody, so if you want to test again later, which probably isn't necessary, then the medicine could have influenced the test results.  I don't agree with that advice, if you plan to test again in the future.

Terri

[letssee]

hi doctor,

i just spoke with my dermatologist and EVERYTHING came back negative (the biokit, the hsv 1 and 2 blood test, and the culture!)  HOWEVER,  he still wants me to go on valtrex just in case the antibodies havent shown up in my blood yet.

my question is:  i understand the antibodies may not have shown up for the biokit/hsv1 and 2 blood test, BUT shouldnt the culture have come back positive for sure if i had it?  even if it was toooo early in my breakout??  i dont understand why he still wants me to go on the valtrex?

[letssee]

Hi doctor,

I woke up this morning with some slight itching in the area and the rash has seemed to spread to half my testicle.

also my underwear seems to have little "wet" spots it from where the blister was.  Im still waiting for the swab results, but wondering if these symptoms more indicative of the virus.

thanks

[Terri Warren, RN, Adult Nurse Practitioner]

Herpes shows up anywhere from 2-14 days after contact and infection.  It would be very unusual to get first symptoms 6 weeks later, in fact, unheard of. I could easily be fungal or bacterial as you suggest.  Herpes antibody, measured accurately by IgG, show up after first infection - sometimes as early as a couple of weeks, sometimes it takes as long as 4 months.  It doesn't sound much like herpes to me, either by history or presentation, but the swab tests will give you a clearer answer, for sure.

Terri