Not sure if this is herpes

[Duey1083]

Hi,

Late August I broke up with my S.O.  We'd been sexually active mid-July to nearly end of Aug 2012.

Here is my story:

Sept 10: Noticed minor itching and a red rash under foreskin and a minor irritation of the meatus

Sept 12: Went to a walk-in clinic and doctor looked at it for 5 seconds and stated it was herpes because there were "all these little blisters" (I didn't notice any).  She did not do a swab and did not order blood tests, but she prescribed me valicyclovir

Sept 13: Distraught, I saw an STD specialist who said it does NOT look like herpes and confirmed there were no blisters, but they swabbed me for Chlamydia and Gonorrhea and treated me on the spot with 1g of Azithro due to me working away from home.

Sept 18: Saw my family doctor, he looked at it and said it wasn't herpes.  I developed minor rashes in my groin and armpits; skin was sort of flaky in both locations.  The groin irritation lasted until about October 9th.  He prescribed bloodwork (Sept 19) and prescribed antifungal cream for the groin.

Sept 20: Saw the STD specialist again.  Swab came back negative for Chlamydia.  Did a urethral swab and swab of the irritation around the meatus for herpes.

Sept 27: Received a call from the STD clinic stating that all my tests (swabs and blood) had come back negative, even for HSV-1.

Symptoms went away around mid-Oct.  Mid-Nov, my scrotum started having flaky skin and turned red.  No lesions present.  Lotriderm seem to help and was cleared up early Dec.

Dec 5 - Jan 31: The red rash under foreskin has come and gone several times and seems to respond well to lotriderm cream, but reappears days after stopping treatment.

It was an IGG HSV 1/2 combination test (~4 weeks after last sexual contact and 8 weeks after first sexual contact).  Are my negative results reliable?

My symptoms seems too persistent and mild (no pain or sores) to be Herpes, but I'm still freaked out.  What do you think it could be?

[Terri Warren, RN, Adult Nurse Practitioner]

I would like to be the next person to reassure you that herpes is very likely NOT what is causing your symptoms.  A fungal infection sounds most likely to me.  Men you are not circumsized often have difficulty with mild fungal infections under the foreskin and sometimes they get worse, sometimes better.

Have you been using the antifungal medicine for the prescribed amount of time each time?  The recommended amount of time is twice a day for two-three weeks.  

Neither your symptoms nor your sexual history suggest herpes to me.  

I also agree that three doses of antiviral medicine would not impact your antibody test.  However, testing at four weeks could not be considered definitive.

Hope this helps!
Terri

[Terri Warren, RN, Adult Nurse Practitioner]

I'm so glad things are going well for you, good job for sorting this issues out.

Terri

[Duey1083]

Hi Terri!

Just thought I'd give you an update.  

My second IGG HSV 1/2 combo test came back negative at the 5-6 month (24 - 28 weeks) timeframe after possible exposure.  This is also now the second test coming back negative, which means that the mouth sore was not a cold sore from when I was a kid.  I will accept two negative results and the fact that I haven't had a recurrent sore as evidence that I never had HSV type 1.

Thanks for everything!  I will stop worrying about herpes now as the tests (2 blood and 1 swab) all came back negative, my symptoms aren't typical herpes symptoms (i.e. no pain, blisters, weeping ulcers or crusts), and multiple doctors have confirmed visually that my rashes are not caused by herpes.

Thank you for what you do!  God Bless!  

Though I haven't really lived an extremely promiscuous lifestyle, I have learned a lot of hard lessons from this experience and vow to make changes in my life.  I will save sex for marriage as I had once vowed to do.

[Terri Warren, RN, Adult Nurse Practitioner]

If you've only had the one sore, it is less likely that it was caused by HSV 1 but you really can't be certain.  If you already did have oral infection, then you won't get it back yourself genitally.

The test is 91% sensitive for HSV 1 and 97% sensitive for HSV 2, at about 4 months.

Given everything, I don't think you should worry about this.  

Terri

[Duey1083]

Okay, now I'm extremely anxious...I thought my first test would have ruled out the possibility of me bringing herpes into the relationship.  I have trouble buying into the fact that HSV-1 testing is less accurate than type 2.  The two strains share so many characteristics and traits (up to 90% I believe?).  If anything, wouldn't they be confused for each other?

My ex and I had performed oral on each other only about two times.  In the many years since my childhood, I have never had another sore on my mouth.  Based on the negative results I had and the fact I only ever had one sore on my mouth, are the chances that I would have given her anything very slim?  On top of that, what are the chances that I gave her something that then transferred onto my genitals?

I'm freaked, because I had completely forgotten about that sore on my mouth until she asked if I'd ever had a cold sore (after oral sex).  Then after thinking about it for a moment, I answered yes.  At that time, I wouldn't have even known a cold sore could be transferred to genitalia.  NOTE: neither or us had any sores on our mouths.

I'm sure we're both fine, but I really need reassurance.

[Terri Warren, RN, Adult Nurse Practitioner]

The cold won't impact your herpes test.

I'm not clear that you need to be circumsized, that's an individual decision, but some men continue to have issues under the foreskin, in spite of good hygiene.  More evidence is accumulating that not being circumcized is a risk for other STDs, particularly AIDS, but if you have careful sex practices and partner testing, this need not be an issue for you personally.

I would trust the results at 5-6 months, yes.  Remember that the routine test is not as good for HSV 1 as it is for HSV 2.  Hard to know what the thing in the corner of your mouth was for sure.

Terri

Note:  Some of the videos on this website contains information that is not correct about herpes.  I have not approved them and disagree strongly with some of the content.  Please do not take their presence on this website as an endorsement by me.

[Duey1083]

Hi Terri,

Just one more question to the ones I posted above.  When I had my blood drawn on Tuesday for my second test I had a sinus and head cold.  This won't affect my results at all right?

Also, what can I do to reduce anxious moments while waiting for the results?

[Duey1083]

Hi Terri,

Sorry for the double post...not sure I had addressed it to you correctly.

Thank you for the reassurance.  I really don't believe it is herpes either; however, I decided yesterday to go have another blood sample taken so I am patiently (yet nervously) waiting for my test results.  The doctors really didn't see the need, but yielded to my request.

I would also like to say that when I use the lotriderm, it reacts very quickly to reduce the inflammation and sometimes it almost makes the rash disappear in one to two days.  Sometimes I have not been super vigilant about using it for the prescribed period, but last time I treated the rash for the full two weeks and then it reappeared days afterwards.  Now I am going for 3 weeks, and might even extend it to 4 weeks.

I am pretty confident that my results will be negative again.  Do my previous results at least somewhat confirm that I didn't bring any strain of herpes into my last relationship?  

I know how common HSV-1 is and assumed that the sore I had on my mouth when I was younger was a cold sore.  However, it only ever occurred once and when I read up on angular stomatitis, everything seemed to make sense (I didn't notice blistering then either).  I never noticed any hard crust or even weeping from the fissure, there was some dry flaky skin in the adjacent area, it only hurt to eat or laugh or cough.  Then, like I had said before it had come about after me being sick for a week and a half with pneumonia (was on steroid inhalers and antibiotics), so I was probably not taking full advantage of the nutrition in the food I was able to eat.  Also, I have always had chapped lips, so when I was a kid I used to lick my lips constantly, which can be a trigger.

If my results at the 5-6 month period after possible exposure come back negative (I trust they will) but I keep getting these rashes, should I possibly consider a circumcision?  I've heard that there are partial circumcisions, is this true?  The rash on the foreskin usually develops on the portion of the foreskin that hangs below the urethra (on the inner side of the foreskin, not external - so rash is only visible if I retract the foreskin), so moisture definitely could be a factor due to "dribbling" urine or pre-ejaculate.

I am scheduled to see a dermatologist very soon.

Thanks again!
.

[Duey1083]

Hi Terri,

Thank you for the reassurance.  I really don't believe it is herpes either; however, I decided yesterday to go have another blood sample taken so I am patiently (yet nervously) waiting for my test results.  The doctors really didn't see the need, but yielded to my request.

I would also like to say that when I use the lotriderm, it reacts very quickly to reduce the inflammation and sometimes it almost makes the rash disappear in one to two days.  Sometimes I have not been super vigilant about using it for the prescribed period, but last time I treated the rash for the full two weeks and then it reappeared days afterwards.  Now I am going for 3 weeks, and might even extend it to 4 weeks.

I am pretty confident that my results will be negative again.  Do my previous results at least somewhat confirm that I didn't bring any strain of herpes into my last relationship?  

I know how common HSV-1 is and assumed that the sore I had on my mouth when I was younger was a cold sore.  However, it only ever occurred once and when I read up on angular stomatitis, everything seemed to make sense (I didn't notice blistering then either).  I never noticed any hard crust or even weeping from the fissure, there was some dry flaky skin in the adjacent area, it only hurt to eat or laugh or cough.  Then, like I had said before it had come about after me being sick for a week and a half with pneumonia (was on steroid inhalers and antibiotics), so I was probably not taking full advantage of the nutrition in the food I was able to eat.  Also, I have always had chapped lips, so when I was a kid I used to lick my lips constantly, which can be a trigger.

If my results at the 5-6 month period after possible exposure come back negative (I trust they will) but I keep getting these rashes, should I possibly consider a circumcision?  I've heard that there are partial circumcisions, is this true?  The rash on the foreskin usually develops on the portion of the foreskin that hangs below the urethra (on the inner side of the foreskin, not external - so rash is only visible if I retract the foreskin), so moisture definitely could be a factor due to "dribbling" urine or pre-ejaculate.

I am scheduled to see a dermatologist very soon.

Thanks again!

[Duey1083]

Sorry for the multiple posts, but I figured I would give you a little more detail on my sexual history.  I have been given oral sex twice before (unfortunately unprotected); the first time was about 2 years ago and the first time over 6 years ago.

My most recent girlfriend, I do not know her STD status or if she has even been tested before.  But she was the first person I have ever had full intercourse with (most times protected and a couple times unprotected) and she told me that she has been fully sexually active with 3 prior boyfriends.

Another thing to note is that the first doctor had prescribed me valicyclovir and I had taken a day and half worth of doses (3 to be exact) prior to my bloodtest.  I have spoken to four doctors about this and they said it would not affect my herpes blood test results due to the test being for antibodies in my system.

Prior to my last girlfriend I have never had any rashes or anything suspicious.  Is it safe to say that I didn't bring anything into the relationship based on all of my initial tests?

Thanks so much and sorry for the information overload!

[Duey1083]

I should also say that I have seen multiple doctors over my condition and not one of the other doctors has agreed with the first doctor's diagnosis.  Most have said it is fungal, but I'm not sure why it is so recurrent.  5 or 6 times in a little less than 2 months.  Sometimes the rashes will go away in a couple days on their own, other times I need to use the lotriderm.

I have had no blistering or weeping sores or pain.  The other doctors have checked my lymph nodes and there has not been any swelling.

Back when I was about 11 years old I had pneumonia and was on antibiotics and steriod inhalers (I used to have asthma).  After that I had had a sore on the corner of my mouth.  It was a very painful crack.  Reason I bring that up is because I confused it for a cold sore and was surprised by my negative results.  I spoke with several doctors about those symptoms and they have alk said it was likely angular stomatitus.