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Baffled Docs, Baffled Patient - HSV??
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The STD Forum is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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Baffled Docs, Baffled Patient - HSV??

I've posted a few times on the community board but have great respect for your work and wanted your opinion.  Long story short, i had unprotected sex with my girlfriend two times in a week.  After the first time, she complained of pain when urinating.  Did not see any type of lesions.  Her doc diagnosed yeast/UTI.  A few days later she was feeling better (not 100%) and we did it again (no visible lesions).  She went on vacation.  Two weeks later i had a dry small ulcer on the bottom of penis shaft.  No pain, no blisters.  A few red bumps popped up around it that lasted about two months and my entire groin turned bright red.  Derm diagnosed yeast infection and intertrigo.  Red groin went away but bumps remained after diflucan and monistat treatment.  

It's been about 7 months and since this experience I've had pretty constant intense burning on the penis that moves to different sides of the shaft, under the scrotum, on the scrotum etc (worse at night).  Also mild to severe lower back pain and pain in thighs (never had before). Sometimes when i feel burning throbbing on penis, I can feel it in my feet.  Have been unable to have sex due to pain and have missed work.  I have not had any lesions, blisters or any bumps on my penis since the first issue.  My gf (now ex) assured me she didn't have any STD's.  I have had two Herpeselect IGG blood tests taken.   My PCP assures me I do not have Herpes but now 7 months later is concerned about the pain and is suggesting a "final" blood test.  My other two test results are posted below.  Thank you in advance for your thoughts on this.  It is driving me insane.  

2.5 Weeks from Exposure - Sunrise labs Type Specific HSV IGG
HSV1 IGG = .1 Negative
HSV2 IGG = .1 Negative
HSV1/2 IGM = .28 Negative

11 Weeks from Exposure - Enzo Labs Type Specific HSV IGG
HSV1 IGG = .5 Negative
HSV2 IGG = <.2 Negative
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Welcome to the forum.

I have scanned your discussions with Terri on the on the herpes professional forums and with Grace and others on the community forum.  Your continued worry about herpes has no basis in scientific reality.   Your symptoms do not even hint at herpes, which never causes the persistent burning sort of genital discomfort you describe.  Your symptoms are, however, typical for genitally focused anxiety.  Whether or not that's the right explanation, for sure it isn't herpes.  Combining the absence of symptoms that suggst herpes with your negative blood tests -- including repeat testing 11 weeks after the exposure you are concerned about -- you can move on with confidence you do not have genital herpes and are not infected with either HSV-1 or 2.

Best wishes--  HHH, MD
4 Comments
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Avatar_m_tn
Thank you Dr. Handsfield.  I have bad OCD and the pain has been excruciating for 7 months straight.  I don't think there is a worse potential condition for someone with my condition as you scrutinize everything and it's been all consuming.  I am having an MRI next week on my back and pelvis but my dr wanted to "rule out hsv".  Based on your response, i'm wondering if he is doing it to appease me.  The internet is full of people with HSV complaining about constant nerve pain, back aches, pain down the legs, burning and other similar symptoms.  As I've seen you write on a few occasions, people with HSV get back aches too and they aren't necessarily connected.  That makes sense to me but it's also hard to discount so many cases on the web.  I am slightly concerned the test will come up as a false positive even if I don't have it which I know is why you advise against it.  Everything you have posted makes complete sense.  It's hard to live in your own head and look for something that may or may not be there.  The mind is powerful.  I will update with test results.  Thank you.
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Avatar_m_tn
Dr. HHH, I received my 7 month blood test this morning.  Negative for both HSV1 and HSV2.  No numerical values except <.91 for each.  It is clear to me that I am dealing with an excruciating nerve issue which in reality is probably much worse than HSV.  I hope my experience helps others who are in a similar situation of undiagnosed nerve pain in the genitals with lower back pain, thigh pain etc.  I have seen you mention CPPS on a few posts and coincidentally that is what my doctor diagnosed.  I am getting an MRI of the Pelvis and Back and hopefully this sheds some light on my situation.  Thank you again for your patience, expertise, and analysis.  I can assure you that I will never have unprotected sex again unless my partner has had a recent HSV blood test.
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Now you have even more definitive evidence that herpes isn't the explanation for your symptoms.  I'm skeptical the MRI will show anything abnormal, but continue to follow your doctor's advice about diagnosis and treatment.

I think a decision to "never have unprotected sex again unless my partner has had a recent HSV blood test" is unnecessary, impractical, and likely to not be successful as a strategy for a rewarding sex life.  But to each his own.

That will end this thread. I won't have any more comments or advice.
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University of Washington
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