Herpes Whitlow or Blister?

[jcmoney55]

Dr.

Nearly 3 months ago (about 11 weeks now) I fingered a woman and had sex with her a few times (under 5), each time protected. At the time I did not notice any cuts on my fingers, surely none that were painful or bleeding so significantly that I noticed it.

So of course with my luck I happened to glance at my middle finger, which is the same one I used to finger her on multiple occassions, and I noticed a white blister with a red base (this was about a month after exposure). It was just one blister on the bottom portion of the finger, near the knuckle, and there was no real pain associated with it unless I touched it directly. No fever or any flu-like symptoms. It did have watery-clear fluid in it, however.

I still have a scare, but no more have occurred. I am so confused because an immediate care facility looked at it and simply said "yep" thats whitlow, and put me on valtrex. My family doctor ran tests at about 8-9weeks after exposure. IGG negative (.20 and .08 HSV1/2)  IGM equivocal (I know the IGM is essentially worthless).

I got another test at 3 months and will hopefully get results today. My concerns:
1. If my IGG is negative at this point, can I finally move on? (I have had severe anxiety over this). I have heard of such tests taking 6 months.
2. I cannot convince myself that this blister is anything but herpes because I have never had any such thing before, let alone on the very same finger I used to pleasure the girl. What, if any, other explanations could there be? If it was any other finger I would have just brushed it off.
3. If this is herpes, I got it from her genitals, which makes me concerned I have genital herpes.

I am only 21 years old and am carrying around extreme guilt, anxiety, and I feel disgusted with my actions. Hopefully I don't pay to hefty a price. i am dating someone now and I am not sure if this is something I should tell her when I don't know whats going on yet. The last thing I want to do is spread it to her.

[Edward W Hook, MD]

Gvie up on the IgM.  You acknowledged in your inital post that it is worthless.  That in fact is the case.  YOU DO NOTHAVE HERPES.  End of story.  EWH

[jcmoney55]

Well when I got the tests done I had the blister on my finger, and that is when the original testing was done, and the IGM came back equivocal at that point (a little over a month after possible exposure). If the blister was in fact herpes I am assuming the IGM would have been a conclusive positive since I am assuming my body would have been making antibodies.

[Edward W Hook, MD]

The valacyclovir could, in theory, delay your antibody response. There are no real guidelines as to how often this happens and it is really likely to have little impact in your case since you should have actually had a lesion and that should elicited a normal antibody response. I remain convinced that you do not have herpes and urge you not to be concerned.  EWH

[jcmoney55]

Final question,

   I took Valtex for about a week when the health care facility looked at my finger, I am assuming this would not affect antibody test results since the medication attacks the virus. Is this a fair assesment?

[Edward W Hook, MD]

Some people with definite infection can develop antibody after a prolonged perriod.  In your case, given the low likelyhood that you are infected, there really is little be gained from repeat testing.  This will not "come back tohaunt you".  You do not have herpes.  EWH

[jcmoney55]

Dr.,

   Just called and got my results: IGG negative at 72 days (I was a little wrong in my math before, so its a little over 10 weeks).

  The doctor said they did not do an IGM, which I know is pointless. This result comes at a good time because I had begun to feel sharp and aching pains in my finger/hand/and arm, which I am assuming is psychosematic- I have a very strong imagination after all of this.

  So, is this my final test, or should I go back at 12, or maybe 16 weeks? I have read that some people did not test positive until 6 months. I don't want this to come back to haunt me, especially since I am dating someone and I do not want to spread something. Thanks again for your responses.

[Edward W Hook, MD]

I predict that your repeat test will be negative and when it is, I would say that this is evidence that what you had was not a herpetic whitlow and that you have nothing to worry about from here forward.  Herpetic whitlows are just not that common, particularly in the location you describe.  In addition, the timing you resent is wrong. A herpetic whitlow would have occurred within 10 days of exposure, not a month out.  Finally, you do not even know that you r partner had herpes.  While HSV is common, Chances are that she did not.  as for your specific questions:

1.  If it is negative, forget it. It was not a whitlow.
2.  There are many other dermatological processes which could present as you describe. As to what it might have been,. can't say - it’s gone and trying to guess at this time would be a waste of time.
3.  Let's cross that bridge when you get to it (which you will not)

Let me know what your repeat test shows.  EWH