Erotic Massage encounter - possible Hsv2 infection

[ralph5]

Good morning Doctor,  two weeks ago I had an erotic body-slide massage with oil. No sex, oral or any genital contact. The lady wore underwear but no top, She sat above me as I laid down and slid across my back followed by a regular massage, I believed this to be a very low risk situation for any STD.

A few days ago I noticed my right bum-cheek was a little numb. Today I noticed a group of pimple like spots had formed there, they are small, painless but some what grouped together. My questions are as follows please Doctor.

1) Is it likely I have aquired HSV2 by this skin to skin contact ?
2) If my bottom where to be the area in which I was exposed to this virus how likely would it be that I infect my girlfriend with regular genital sex in the future ?
3) Can the virus move to my genital area or would it stay in this area ?
4) Could it possible that the virus was passed from her inner-thigh to the areA I describe ?
5) Is there a chance that I am jumping the gun ?

Many thanks for your time Doctor.

[H. Hunter Handsfield, M.D.]

Welcome to the STD forum.  I'll try to help.

People don't get herpes from the sort of exposure you describe.  HSV transmission does not occur In the absence of genital-genital or oral-genital contact.  That said, the symptoms you describe are consistent with a herpes-type infection; in addition to the skin lesions themselves, the numbness before the lesions appear could have been an HSV prodrome.  If it is HSV-2, both the location and the mild nature of the outbreak suggest a recurrent infection, not the result of the first exposure.  (Recurrent genital HSV-2 outbreaks can occur anywhere in the "boxer shorts" area, and the buttock is the most common site other than the penis or anus.)  However, there are other possibilities.  You might have herpes zoster (shingles), which can look identical to HSV.  Or a localized bacterial infection.  Or some other kind of rash.

1) You did not catch a new HSV infection from the contact you describe.

2,3) If this episode was recurrent genital herpes, then it is likely that you also have asymptomatic shedding of HSV-2 on or around the genital area as well.  If so, you could infect a sex partner.  The virus doesn't "move around". But once certain areas are infected, usually they remain that way.  Most people with buttock recurrences of HSV-2 also have genital infections.  

4) Where does inner thigh come in?  That's an unusual site for herpes, but it is possible.

5) You may or may not be jumping the gun; you can tell that better than I can.  But your symptoms sound real to me.

What to do?  If the blister/pimple-like lesions are still present, see a health care provider ASAP, preferably in the next 24 hours.  If the lesions are healing, there isn't as much hurry -- but you probably should have a blood test for HSV-2.  It seems a good bet you have it.

Searching your username, I believe you  are in Australia.  If so, I suggest visit your nearest Sexual Health Centre.  The Australian SHCs make up perhaps the best STD clinic system in the world.

If/when you get a definitive diagnosis, please return to the forum to let us know how things turn out.

Regards--  HHH, MD

[ralph5]

Many thanks for your advise, I am visiting a clinic shortly.

It's unusual I don't recall any first outbreak as I'm quite aware of my body etc if it were to be a recurrent outbreak.

Just to reiterate the symptoms:

Small flat red pimple-like spots (7 or 8 in total)
They're painless and don't look at all like blisters with any fluid.
They look unlikely to break open.
They don't itch or are sore to touch.

I guess this may not change your opinion, I'm not looking forward to a possible positive HSV2 out come.


Best.

[H. Hunter Handsfield, M.D.]

With that more detailed description, I agree this doesn't sound much like herpes after all.  However, it still makes sense for you to get it checked out.

That you didn't have genital symptoms in the past does not rule out genital herpes. Up to 90% of people with HSV-2 shown by positive blood test have no recollection of symptoms that suggest genital herpes.  Some of those were truly infected without symptoms; others had mild symptoms that cleared up quickly and were not considered important at the time and then forgotten.

[ralph5]

Hi Doctor, I've been to the clinic and on inspection the STD Dr. diagnosed the pimple-like spots as "Folliculitis".

A regular HSV test has been taken as a precaution but the Dr at the clinic assured me the pimples were extremely likely to be what she has diagnosed them as.

I'll return to the forum if her visual diagnosis is wrong.

Many thanks for all your time and help !!