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Avatar universal

Scared of positive HSV test

I recently posted with Dr Hook and he did address some of my concerns but I am still uncertain and scared.  I think I got some infected saliva on the head of my penis because 1 week after I broke out in inflammation.  There looked to be a subcuntaneous blister just to the immediate left of my urethral opening (more noticeable if you squeezed the head).  The doctors I saw could not make a visual diagnosis of HSV because there were no distinct blisters or lesions.  They did give my acyclovir and took blood for the IgG testing.  It came back 3 days later with HSV1 positive (1.84 or something).  HSV2 was negative.  I took the acyclovir for 2 weeks and it didn't seem to have any effect so I got another doctor to prescribe Valtrex.  There might have been some very slight flaking of skin.  Antibiotic soap really irritated it.  During the first two weeks it was so sensitive I could hardle handle wearing clothes because of the rubbing, I was stuck indoors.  I was also put on almost every antibiotic in case it was bacterial.  It is in the 4th week now and the urethral opening is still red and unhappy.  The redness started on the left and seems to have moved around the opening.  I had the tingling in the calves and flu like symptoms.  It fells like I am passing glass through my rear end when I go to the bathroom.  I had an IgM done about 2 weeks into the symptoms and it came back Not Detected.  It has gotten more bearable in the last few days but I don't know if it's the Valtex, the antibiotics or just time.  A urologist did not find anything inside me.  I have another test in early August.  I know HSV1 in the genitals can be mild compared to HSV2.  Is it possible that I just had an initial outbreak without lesions and blisters?  My PCP just got back from holiday and took a swab.  I fear it might be too late.  Will I have to wait for an outbreak and hope for lesions?
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Avatar universal
I did find this about HSV symptoms from a medical website:

"A great number of cases may present in an atypical way with skin splits, fissures, minor abrasions, erythema, and pain. "

I did have splits in my skins and fissures.

Just for the record I still have redness and inflammation around the urethra.  It is a complete nightmare.
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Avatar universal
I would still like to know what I should expect to look for (or test for) in the next 3-6 months given your experience.
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101028 tn?1419603004
you have new symptoms so you need to follow up on them with your provider.
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Avatar universal
And I've been sweating profusely for days now and I've been really really tired like I want to sleep all day.  Today has been especially bad.
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Avatar universal
I woke up this morning and both my sides are very sore and tender to the touch.  It's not sore in my armpits but just below the armpit (just at, and below, the armpit hair line).  Could this be lymphnodes?  I always thought they were more towards inside the armpit.  I just find it strange that both sides are hurting at the same time today.
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101028 tn?1419603004
your partner will need tested for herpes to know their own status.

grace
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Avatar universal
Thank you for your post Grace.

It's not that I am unhappy with your replies, I am more unhappy with myself.  I really think I made a mistake in describing my symptoms and especially the "welt" as under the skin.  It was more superficial than I think I gave the impression (small cracks that flaked small skin after starting the acycolvir).  I don't know what herpes lesions and blisters look like other than what I see on Internet.  I understand not all cases of herpes result in blisters/lesions.

I did have symptoms of urethritis, hence the referal to the urologist and the cystoscopy.  I don't know what a classic herpes rash is but you could have described my condition as a rash.  There was no irritation at all in the 10 days between exposure and first symptom.  I am not pinching and prodding him.  Trust me, I can hardly look at him now.  I had flu like symptoms and I had the tingling in my legs (prodrome).  This definitely wasn't in my head.  My back end hurts and I understand that herpes can cause lesions back there.  I've never hurt like that before.  The butt pains just started 3-4 days ago.

The clear discharge was before the cystoscopy.  The urologist did a complete scope (I was under GA) and he found nothing.

The dermatologist could not really make a diagnosis this far beyond but she did mention balinitis and gave me a topical cream for it.  I think she just felt bad for me.

Even now into the fourth week the tip/opening is still red and unhappy.  I am only using the cream advised by the dermatologist, and the valtrex.

If that particular girl hadn't been involved and if my test had come back negative I would rest much more assured.

I just want to know what I should expect in the next 3-6 months assuming this is GHSV1.  What value should I expect in the early Aug HSV test?  What do I tell my partner?

I hope my next posting has some good news for a change.
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101028 tn?1419603004
I understand you are not happy with our replies so I will take the time to make a more detailed reply as to why I posted what I did. Continuing to follow up with your providers is the ultimate best course of action.  You do yourself a great disfavor though to continue to focus on herpes as the reason behind your symptoms.  

You've had no obvious herpes  lesions. Herpes lesions will not show up under the skin as you described.  Typically a newly acquired hsv1 genital infection will show up with very classic herpes lesions that are very easy to see or even symptoms of urethritis.  to top it off you were on prednisone at one point. Steroids make herpes 'worse' for most folks so odds are you would've had the "classic" herpes rash, not just a heightened skin sensitivity. You also mention a history of overly sensitive skin in the genital area that becomes irritated easily and will bleed.  

You've had no pain with urination( or any other urethritis symptoms ).   if you had had herpes lesions inside your urethral opening, trust me from personal experience, your description of things would never have included no pain with urination.   What you describe in the opening to the urethra does not sound like herpes either. You've had this symptom looked at by a provider and they too did not feel that it looked like herpes.   Honestly many providers will "throw" herpes antivirals at folks with the belief that no harm no foul, especially if the patient comes in worried about herpes the most.  Many providers hear you had sex and prescribe antibiotics and antivirals to cover all the bases especially if they hear that you were with a sex worker.

indeed a herpes culture at this point was far too late. Even without any herpes antivirals, if this was herpes going on, it would've almost run its course completely and the odds of detecting herpes on a swab would be very low.  you also were on acyclovir and valtrex so even if this was herpes, odds are you would still get a negative lesion culture at this point.  

You definitely have irritation going on. You had a cystoscopy too which can cause external irritation and internal irritation.   You also have been on several antibiotics now which can cause yeast issues too.  You also applied alcohol to your very sensitive genital skin which also just adds insult to injury.  Dr Hook also pointed out that you have irritation going on.  You can only irritate our sensitive genital skin so much  before it often goes into "overdrive" so to speak and breaking that cycle can be difficult.  Hence my recommendation to put the lil guy away and stop pinching and prodding him. You are just adding to the over stimulation of your skin at this point by doing so.  Even topical lidocaine on irritated skin can cause issues including more irritation.  Put lidocaine on even non-irritated skin and it can cause blanching of the skin and then redness especially with repeated use.  You have a history of genital skin that does become very easily irritated under what I assume are fairly normal circumstance to boot.  

You tested + for hsv1 though as Dr Hook pointed out, it could possibly be a false positive.  Really no  benefit from further blood testing for hsv1 because it still only tells us what you have, not where you have it and  being + a week after the encounter also reflects a previous infection with hsv1, not a newly acquired infection.    Only 20-40% of all folks who have hsv1 orally ever get obvious cold sores to know that they are infected. 1/3 of us pick it up before we ever even step foot into kindergarten here in the US.   Even if you had tested a clear negative on your hsv1 test,  the odds that you contracted hsv1 genitally from someone using their saliva for lube before applying a condom are very, very  low as Dr Hook already pointed out to you in his original reply to your post. if this gal had poor oral hygiene, many things could be in her saliva that can cause issues. You've been on antibiotics so the typical bacterial causes would be covered but the yeast issues wouldn't have been yet.  

yes you had leg/calf pain and buttock pain. You've been examining yourself repeatedly, assuming positions to do so that you typically probably do not assume. You've had scopes in the genital area, you've been tightening muscles you usually do not tighten in response to the pain of wearing clothing.  All of this can contribute to these sorts of symptoms.  you also have anal pain which too can radiate out to the legs and downward.  you mention that it hurts so much to have bowel movements - what have your providers said about that?  A good theraputic massage might do you a world of good ( plus any excuse for a massage is a good thing! ). Let them know that you've had pelvic pain issues and need your lower back, legs and buttocks worked on to  help loosen up those muscles for you.  

As far as your urination problems, you've been screened for other std's and treated with antibiotics.  you are also under the care of an urologist.  what was their explanation for these issues?   herpes causing urination issues like this 3+ weeks into things after acyclovir and valtrex would be unlikely.  that typically happens immediately with the original symptoms, not this far into things or with recurrences.  Clear discharge can be due to many things , including irritation from the cystoscopy.  

It is VERY frustrating to have obviously something going on but no one can put a name to it and give you a treatment that works quickly and effectively. Been there, done that myself.  Continue to follow up on this with your providers and do what you can at home to relax the muscles in that area and decrease irritation to the genital area.  

grace







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Avatar universal
Please tell me what classical symptoms I should be looking for?

To be clear, and I think this was lost in translation, the doctors did not see obvious blisters or lesions above the skin.  They did see something under the skin that looked suspicious enough for them to prescribe acyclovir and run IgG tests, which came up positive.

I was unable to urinate last weekend so my urologist prescribed me some meds to take orally to help open the passage and he gave me topical ointment to help with the swelling.  Any mediction I have taken has been at a doctors discretion.  I have done nothing in the way to self medicate.  As well, the topical lidocaine was so I would walk around with clothes on.  Also doctor directed.
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101028 tn?1419603004
you've thrown everything but the kitchen sink at this point at your penis. no wonder it still freakin' is bothering you!!!


You were not at risk for genital herpes from your encounter. Dr Hook told you that and your own providers haven't seen anything resembling herpes either. Odds are that if you had contracted genital herpes, it would've presented with a more "classic" presentation. All your supposed symptoms of herpes that you have yourself convinced means it's herpes are very vague and can even  be related to the multitude of things you've applied to your penis at this point as well as it sounds like you are squeezing the crap out of the poor lil guy on a regular basis!  My recommendation to you is to 1 - stop looking up herpes info on the web. It's obviously adding to your anxiety and you are focusing on the generalized symptoms that you have as meaning that indeed you did get herpes from the encounter you had.  no more pictures, no more reading about herpes.  2 - leave your hands off of your penis! Put him away and don't get him out to look at him except for once a day either before or after you shower. Don't pinch him and poke him when you urinate. Don't put anything on him that isn't told to you to apply by a medical provider of some sort.   3- no more testing.  You don't need it. save your money.

In the future, only give and receive protected oral sex so you don't cause your anxiety to go wild like this. It's just not worth this sort of worry and not worth the expense you've put into it either.  

grace
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Avatar universal
Thanks for the responses Mistake and petal.

As you can imagine, I have read ALL the online articles and most state that oral GHSV1 is the fastest growing type of genital herpes.  I had mouth/oral contact betwen a professional who I assume was a meth addict due to her bad teeth and the head of my penis.  I have since displayed ALL symptoms in the appropriate timeliness except for painful superficial blisters and lesions (except for blister and irritation under skin), including the positive HSV1 result (result of 1.9) after 10 days of exposure.  I had to apply liquid lidocaine to my member just to wear underwear.  I did have some flaking skin after starting the acyclovir but it didn't really seem to be effective until I tried the Valtrex.  My skin has always been very sensitive and I bleed very easily.  I would never make a good boxer.

From herpes.com
"In the absence of prior oral infection, however, HSV-1 spreads easily to the genital area, usually through oral sex. In some countries, such as Japan and parts of Great Britain, genital HSV-1 is as common as genital HSV- 2, or more common."
From CDC
"HSV-1 can cause genital herpes, but it more commonly causes infections of the mouth and lips, so-called “fever blisters.” HSV-1 infection of the genitals can be caused by oral-genital or genital-genital contact with a person who has HSV-1 infection."

I am going to a dermatologist in the morning but I'm afraid the worst is over so she won't have any ideas either.  What can I do from this point on?  You mentioned the WB wasn't worthwhile?  Should I wait for an outbreak?  If I am the 40% who never have another outbreak what in the world do I tell my partner?
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897535 tn?1295206435
One other point to mention: HSV1 and HSV2 present exactly the same genitally. My first outbreak (genital HSV1 confirmed with a swab/culture) was extremely painful. I could barely walk and sleep for a week, and had about 20 lesions on my genitals. I only make this point as you seem to think it's clearly HSV1 based on lackluster symptoms.

As well, it took five long years of very frequent oral sex for my partner to transmit his oral herpes to my genitals. Some discordant couples can go years (or never) without transmission of oral or genital herpes.

We are not doctors on this site, but herpes-educated folks with many of us having herpes ourselves. Feel free to post back with Dr. Hook/Handsfield or Terri Warren if you want expert advice, although I read Dr. Hook's post and it was very straightforward. They are incredibly knowledgeable, with years of experience in the field.
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1174003 tn?1308160819
You are extremely misinformed.  I would invite you to cite such sites that have labeled that as a tranmission and whos qualifications gave that information.  

I can give you well documented sites (including one that Dr. Hook and Dr. Hansfield serve on the Board of Directors).  I can also provide you with several articles from pubmed.gov that will side it is not a common means of HSV-1 transmission and that HSV is ONLY transmited with direct skin-to-skin contact.  I can put any number of sites on the internet that will say what I want them to.  

You are posting to the wrong group of people if you want that end supported.  Prove to us that the infection you got was from saliva. Your PA and even the top HSV experts will visually misdiagnois Herpes 1/3 of the time.  

Petal actually has HSV and I think she would know best how she got GHSV.  

I seriously think you need to consider reading sites that have trained professionals in the field tell you how it is done.

Start with the Herpes Handbook found at West Over Heights Clinic site.  That is run by Terri Warrn NP who has been working with HSV for quite some time.  

http://www.westoverheights.com/genital_herpes/handbook.html

You will want to start here for Transmission:

http://www.westoverheights.com/genital_herpes/handbook/view_the_chapters/transmission.html

And also ASHA website has an FAQ entry for this question:

http://www.ashastd.org/herpes/herpes_learn_questions.cfm#3

You can review more info on their site at:

http://www.ashastd.org/herpes/herpes_overview.cfm

ASHA Site is one where Dr. Hook and Dr. Hansfield are on the Board of Directors.  I would invite you to review their member profiles for their creditials here on the site.  You have met Dr. Hook.  Getting the correct information from people in the field is very key and important.  
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Avatar universal
Actually, saliva is a common means of HSV1 transmission.  That is well documented on most herpes websites.  That misconception leads to many infections, including mine.
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897535 tn?1295206435
Saliva is not what transmits herpes. It's a skin condition, transmitted by skin to skin contact along with heat/friction.

As mistakeguy said, Dr. Hook knows what he's talking about. Follow up with your doctor if you still have symptoms.
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Avatar universal
The problem is that I can't find pictures of mild herpes outbreak on the Internet.  They always have the worst case outbreaks.  This does not help me.  Please keep in mind that my original condition was enough to warrant my first PA to prescribe acyclovir and to recommend testing.
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Avatar universal
I am thankful for all of your input but I am more confused than ever.  I had saliva from a high risk partner touch my genitals before a condom was put on and since then I have experienced ALL the herpes symptoms except for obvious blisters and lesions.  I tested positive for HSV1 and I have never had a cold sore in my life and I've spent most of it in tanning salons and on beaches.  I still don't know what test result would indicate a true positive.  How can you tell me I don't have herpes?  It got so bad that I couldn't urinate  and I had clear discharge but the urologist didn't find anything.  Unfortunately, I couldn't list all my symptoms for the doctor before the thread was closed.

Please help me through my fears.  I really am in need of some compassion.  I am going to see a dermatologist but please don't tell me that I don't have herpes if there is a chance I do.  True, I don't have his vast experience and knowledge but I'm the one with the experience of having this nightmare on the end of my member and I know this isn't something benign.

Petal - As someone who has genital herpes what can you tell me to assuage my fears?
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897535 tn?1295206435
As Dr. Hook said, this isn't herpes related. Best to follow-up with your dermatologist to find out the real cause. As to your anal symptoms, clearly hemorrhoids can cause such symptoms - again easily diagnosed by an exam by your doctor.

Using topical antibiotics can be extremely irritating and shouldn't be used on the genitals. Even soap should be mild. The fact that you're handling and irritating it so much doesn't surprise me that it's irritated.

I have genital HSV1, and I agree with Dr. Hook. None of this sounds like herpes. It all sounds anxiety driven.
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1174003 tn?1308160819
I read your entire thread with Dr. Hook.  The man has more experince and expertise in dealing with STD's then you will find on most sites.  The Dr. is an expert for a reason he has a long list of credintials.  I wouldn't even second GUESS the doctors on MH at all.  I have used not only Dr. Hook in the past myself but also Various other experts here.  

You getting HSV in the area you describe and the testing you had is way to soon for an accurate result from the encounter you had.  Western Blot won't tell you what site your HSV is located at.  Work with a dermatolgoist and have them investigate your penis issues.  

Furthermore there is nothing we can add to the doctors posting.

Regarding resources it is a volunteer forum.  I didn't read all of the mess between the two of you but one of the things to remember is that top answers does not mean you are giving information just means you post a lot to questions.  I have several posts on both Herpes and Sexual Health.  

My point to the above is we answer questions some of us get their answers selected as the best one and others don't.  Some of us have knowledge and others don't.  But no one here on this forum with any kind of knowledge is going to second guess Dr. Hook, Dr. Hansfield, or Nurse Warren.  None of us that are regulars will ever doubt any advice they give a poster.  We will support posters in their fears and work with them but the advice you were given was perfect.

Something to consider here is that you are new to this stuff.  Dr. Hook has been studying this and other STD's for a number of years.  He has seen the stuff in practice and in a lab.  You have not.  You don't have the knowledge that expert has over the years of time he has delt with patients and books for a number of years.  

Us telling you to move on is providing you the help you need.  Either move on or don't but you won't find us giving you any different advice then the expert you paid for. Take their advice our advice and move on.  You don't have herpes.  You have aneixty from an encounter you regret.  
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Avatar universal
As an example, I don't know if I should get a Western Blot to be certain of the GHSV1 infection.  I don't know anything about the WB.  I am new to all of this and I am very worried.
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Avatar universal
The doctor did address some of my worries but not all.  I came here looking for advice or feedback from real people who have actually experienced this condition or something similar.  I hope that makes sense.  I am in no way second guessing the physician.
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Avatar universal
u asked a doctor no one will answer better so i stick to his answer
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