Herpes Expert Forum
Please Help! - Herpes or Not???
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Welcome to the Herpes forum. This forum is for questions and support pertaining to herpes simplex virus infections (HSV-1 and 2) and herpes zoster (shingles) and the virus that causes it, varicella zoster virus. Questions about genital herpes are welcome both here and on the STD Forum.

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Please Help! - Herpes or Not???

Hello,

A little over 4 months ago I had protected oral and vaginal sex with a sex-worker of unknown STI-status (although she said she didn't have anything, it's hard to take her word for face value). I did not see any visible sores on her, but I didn't really look hard. The encounter was fairly quick, and I immediately took a shower when finished.

Several days after the encounter, I began to develop one of the worst jock-itch rashes I've ever had between my legs and groin. The skin was very red and tender, burned at times, but no visible blisters or ulcers were present. I immediately freaked out and went to see a clinic doctor. He diagnosed it has a fungal infection, gave me a cream, and told me I had nothing to worry about. The rash slowly improved over time, but flared back up once and while. As I fought the rash with the cream provided, I developed additional symptoms off-and-on. Occasionally I'd get tingling and itching sensations in my groin, I developed a series of red bumps near my butt-cheek (not fluid-filled or painful, just red), and a secondary rash on my lower thighs and behind my testicles which lead to burning and flaking skin, but no cuts, ulcers, etc.

Throughout this process, I have been extremely scared and anxious. I have since seen 1 clinic doctor, 2 GPs, 4 dermatologists, and I have an upcoming appointment with a urologist. Each doctor has said no to herpes. The dermatologists have diagnosed me with jock itch, intertrigo, HPV, and pruritus scroti. All seem to be convinced that if I had herpes I "would know it," even though the CDC and other informational websites say herpes infections can be mild, go unnoticed, and can be confused with other infections. I have also had 5 HerpeSelect tests done - including one after the 4 month mark - and all have come back negative for HSV 1 and HSV 2. This brings me some relief, but I have also read that false negatives can occur, and that some people never develop detectable antibodies.




55646_tn?1263664409
I think the encounter was very low risk since it was a one time event and you used condoms and it was quick and you took a shower right afterwards (though we don't know how much that helps, actually).  The other things speaking against it being herpes are the exams by many doctors and negative testing, which is terrific.  

The diagnosis range is interesting.  All are basically the same except the HPV one.  What did they do about that?  

In my personal experience, the person who has swab test positive herpes and a negative antibody test are very few and far between - I've had 9 in 31 years of practice.  

You could acquire a western blot, but I would recommend that you do it ONLY if it can once and for all settle that you don't have herpes.  

You will never be 100% sure you don't have herpes since there are a very  few people who don't test positive by antibody test and since you continue to be sure you are one of those, you most certainly won't achieve certainty.  I do believe that you are having kind of obsessive thoughts about this, from your description of your path to many medical providers and your frequent testing.  

For me, your symptoms sound nothing like herpes

Terri
5 Comments
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Avatar_m_tn
My close family members are convinced that this has developed into a psychological/behavioral problem, and I have since started seeing a psychiatrist. Still, my rash persists, and I am convinced there is something wrong with me. I have even developed an additional series of red bumps, not far from where the first ones appeared, near my butt check. I am going to attempt to have them biopsied this week.

My questions are:
1. Given my situation, what are the odds of having HSV 1 or HSV 2?
2. What is the likelihood of not being able to produced herpes antibodies, hence revealing false negatives on all my blood tests?
3. Would acquiring a Western Blot blood test help in determining my status?
4. How can I be 100% sure I don't have herpes?

Thank you so much for your time. I look forward to hearing back from you.
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Avatar_m_tn
Hello,

Thank you so much for your response.

HPV was found via biopsy during my many visits to the dermatologist. The doctor assured me that it had nothing to do with herpes, and that it's very common. I have yet to see an additional wart.

I have not actually had a blister that could be swabbed, only red bumps that are red and hard and a bit tender at worst. Sorry if I wasn't clear about that. I am just worried that I have atypical symptoms and atypical blood results (sound silly as I type it, but I've been having a really hard time with this crisis).

I agree that my actions are obsessive. In fact, the therapist I am currently seeing has diagnosed me with OCD, and I am being treated for that. Still, I am going to continue my blood tests until I reach the 6 month mark, which I am told is the most accurate result that can be reasonably achieved. Is this true? If so, I will obtain a Western Blot at that point, only for peace of mind.
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Avatar_m_tn
Also, how often do herpes present themselves as something other than the traditional painful cluster of fluid-filled blisters that break and scab? Is there something else people worried about being infected should look for?
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55646_tn?1263664409
Herpes can certainly present in atypical ways other than a blister or scab, yes.  Breaks in the genital skin without provocation are something that should be evaluated by a clinician

If a western blot at 6 months will help you put this aside, do it.  However, I do worry that no lab test is going to be stronger than your OCD about this issue.  Please continue your therapy.

Terri
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Terri Warren, RN, Adult Nurse Pr...Blank
Westover Heights Clinic
Portland, OR
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