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Genital or Oral HSV-1

Hello Drs.  I have a question in regards to HSV-1 results I received and exposure to unprotected oral sex.  
Scenario.  In the past I had received unprotected oral sex.  At the beginning of last month I had vaginal sex and it was painful (burned and pressure) at the time of penetration at the head of my penis and intermittently there after.  It never has hurt when urninating and when my urine is not concentrated many times it doesn't hurt after.  There are times that it is either burning or pressure in the tip of my penis on the left side and somewhat in the urethra.  No lesions noted no redness at the opening of the meatus of the penis.   I received a full protocol of antibiotic around 6th of november after labs were drawn.  a week later I noticed some intermittent buring in my groin, scrotum, and perineum (between scrotum and anus) and in the crack area.  with redness.  Also I noticed the appearance of some random purple spots on my scrotum.  I received my tests results on 20th of november.  All negative except HSV-1 >5.0.  Does this symptom sound like genital HSV-1.  spots to date have not changed ruptured crusted or anything.   they appear only slightIy raised wont pop when tried, and are not painful to touch.  I have had in the past some crusting sores to my right ear lobe, and some intermittent sores on the inside of my mouth. does this sound genital or oral  
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239123 tn?1267647614
MEDICAL PROFESSIONAL
I recommend against testing for HSV in this situation.  It is not a possible explanation for your symptoms, so if positive it won't tell what's going on with those, and it will be from some other exposure, not the one you are concerned about.  Therefore, if you go ahead with testing anyway, the timing with respect to that exposure and your symptoms doesn't matter.

Most likely your previous test was the HerpeSelect test, the most common one used by labs in the US.  If you're going to make your own medical decision despite expert advice and go ahead with testing anyway, that's the test you want again.  HerpeSelect is  type-specific IgG antibody test.  Ask that IgM testing not be done, even if the lab offers it routinely.  The IgM HSV antibody tests are uniformly useless and often misleading.

Recurrent genital herpes symptoms are always localized to the area where the outbreak is occurring, which generally is in a patch no larger than a quarter; always is on one side of the genitals or the other, never both sides; always lasts no more than a few days, with no symptom whatsoever between outbreaks; and such outbreaks are never more common than every 4-6 weeks.

You don't have it.  Accept the reassurance and stop trying to talk me, and yourself, into believing that you might.  Time to move on.

That ends this thread.
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Avatar universal
Hello again Dr. H.  

Thanks for your responses earlier.  I finally have my follow up appt.  And I need some questions answered so I can be informed when i go in.   If I want a defenitive answer to HSV-1 and HSV-2 what tests do I need to request be ordered.  from my previous post with the HSV-1 test results of >5.0 does that sound like a herpes select result or IGM or IGG?  How long after exposure would be the opptimum time to wait to have a definative IGG result.   I also have some general questions to just clarify information I have read on the web.   If one has HSV-g  would you have generalized symptoms throughout the boxershort area, or just in the area as to where the blister may occur.  ie if a blister were going to occur on ones penis would or could you have a prodrom symptom of buring throughout the whole area or just on the penis?  after the blister has burst and scabbed over would you continue to have symptoms in the area or just at the site of the sore?  

I am still having some burning in the perineum and anal area and occasional near the head of penis and scrotum, though I havent seen any blisters or sores.   It went away for about a week now has returned.  I had a pimple on my buttock that was hot and itchy for a couple of days, never crusted and never was a group of blisters.   Though I feel i'm not having typical symptoms of herpes, once I saw that result it has stuck in my head so I want to be sure it isn't G herpes.  
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239123 tn?1267647614
MEDICAL PROFESSIONAL
"Purple spots" don't suggest any STD, and neither does intermittent burning on urination -- especially given the antibiotics you have received.  Yeast infections are rare in the urethra, even after antibiotics.

This forum is limited to STD issues, which clearly isn't the problem here.  I have already given you the best advice I can, to see a health care provider to determine just what you have.  I suggest you don't spend any more time or energy trying to get answers online, whether on this forum or elsewhere.  Personal evaluation by a health professional is the only way to go.
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Avatar universal
What do you think would be the cause of the the discolored spots on the scrotum.  I have had a lot of anxiety about this, and the unhelpful nature that my general practitioner left me in only added to the anxiety.   So I appreciate your help.  I have been utilizing some antifungal cream to the area and it relieves some of the discomfort.  I didn't inform you that I had received rocephin, azythromycin and metrondiazole in the second week, which I think might be leading to a fungal/yeast infection to my groin.  But I don't know if that explains the purple spots.  I had read that Rocephin had a tendency to cause yeast infections with higher doses.  I didn't know with that drug in combination if that was enough to disturb the normal flora in the area and let the fungal infection take over.  If so could that explain intermittent burning with urination?    Again thanks for your prompt response and relieving some anxiety about what I've been going through.  
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239123 tn?1267647614
MEDICAL PROFESSIONAL
You describe no symptoms that suggest genital herpes, whether HSV-1 or -2.  Certainly neither herpes nor any other STD can cause pain at the moment of sex and herpes doesn't cause any of the several, rather diffuse sort of genital area symptoms you describe, and certainly a genital HSV infection cannot cause the non-genital skin problems you mention, or sores in the mouth.  Your positive blood test result for HSV-1 probably reflects a distant past infection, most likely acquired in childhood.

You should see a health care provider for assessment of the various genital and non-genital skin problems you describe.  A dermatologist would be ideal.  But in the meantime, I see no realistic reason to believe you have genital herpes or that you acquired HSV-1 from any of the sexual exposures you mention.

I hope th is helps.  Best wishes--  HHH, MD
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