Possible Herpes Infection Proper Steps From Here

[zach345]

Hello,

I am concerned about a possible herpes infection resulting from oral sex about 6 weeks ago. I have had symptoms alarmingly similar to herpes- a few pimple like lesions on my penis that first appeared 2-3 weeks post-exposure.

I was examined 2 days after I noticed a red spot that appeared to be cut by a dermatologist.The dermatologist concluded it was nothing to worry about

I have recently noticed a pimple-like structure on the head of my penis, which I suspect has actually been there for 3 weeks. It seems like it is starting to heal/scab.

I have also taken many pictures over the last couple weeks and have noticed the back of my penis looked red and irritated with possible tiny ulcers at the 4 week mark. I also had this examined at Planned Parenthood, but nothing there was cause for concern.

Most recently, I went to my primary care doctor to have the pimple-like lesion examined. He opted not to take a swab, since it was not an open ulcer.

However, I was given an igg blood test at the 5.5 week mark, which was negative for both HSV-1 and HSV-2. I plan to test again at the 3 week mark, to account for lags in antibody development.

I feel like the blood test will be sufficient to confirm or deny an HSV-2 infection, but I am not sure what I should think about HSV-1. A positive follow-up test would confirm a recent HSV-1 infection, but I am not sure how to interpret a negative result, since there is a 10-15% false negative rate.

Are there any additional measures I should take right now to secure a more definitive diagnosis? What should somebody do or think in this situation?

Thank you for your help!

[Life360_Dave]

It would be to late for a swab as are most accurate at 48 hours. As Fleetwood suggests there no real concern youve contacted herpes from this. You can pretty much disregard penis head symptoms as rarely occur there.
Testing at 8 weeks would be a good indicator but if she did not have any lip sores at the time your risk would be close to zero.
Shedding with hsv1 is not that often and shedding for hsv2 is next to never.

[zach345]

One outstanding concern I have is whether poor timing could have hindered accurate diagnosis by examination, since I believe I discovered the lesions at a late stage. 

Im wondering if it is most difficult to diagnose when ulcers are healing. I had an area that was red and rough and maybe had ulcers that has cleared up. 

The only remnant I have is a pimple like lesion that has started to heal. 

Is it worth getting a swab at this point? I think I have had this for up to 3 weeks but discovered it late. 

Thanks

[zach345]

One outstanding concern I have is whether poor timing could have hindered accurate diagnosis by examination, since I believe I discovered the lesions at a late stage.

Im wondering if it is most difficult to diagnose when ulcers are healing. I had an area that was red and rough and maybe had ulcers that has cleared up.

The only remnant I have is a pimple like lesion that has started to heal.

Is it worth getting a swab at this point? I think I have had this for up to 3 weeks but discovered it late.

Thanks

[zach345]

Thank you so much for the rapid and helpful reply!

I will definitely look into the Western Blot.

[Fleetwood20]

As you note, HSV2 is accurately detected in testing and was probably never a risk given how rare oral HSV2 plus low transmission rate even if the person has such an infection.

Your timing does seem a bit out. The average time until symptoms is 4 days.

HSV1 is difficult in a handful of cases. Even if the next test is positive then this does not technically discount an established oral infection. I take it neither you or your parents have ever had oral cold sores?

A genital swab is really the best way of identifying genital HSV1 the prevalence of oral infections and testing inaccuracies may leave room for doubt. It does seem though that experts are telling you that what you have is not herpes. This combined with a negative test should be enough to conclude you do not have genital herpes.

If this fails to convince you, then a Westernblot will give you in excess of 99% accuracy in identifying a HSV1 infection. As mentioned above though, this will not prove a genital infection.