Herpes (continued)

[Username100]

I take the Procardia for the Raynauds. In December and two or three times recently I've noticed itching (pruritus) around my chest, arms, etc... But no marks of any kind. Also, for the past four months I've been getting shaking chills daily. It seems that I tend to get these chills more when I'm eating for some reason. I have joint pain in my distal and proximal inter-phalangeal joints of both hands, throbbing/burning muscle pain in the abductor pollicis muscles and abductor pollicis brevis of both hands, pain in the DIP/PIP joints of the foot, Throbbing/burning pain in the dlexor digitorum brevis of both feet. Also, the throbbing/burning pain is greatly increased in my hands and feet and other parts of my body after alcohol consumption. I've also tested positive for non-active EBV (mono). I've been to a Rheumatologist 4 times and had everything tested twice. I've been screened for all STD's three times since then and nothing has ever came up except HSV 2. I was tested for Lyme and that came back negative as well. With the pruritus and pain after alcohol consumption could lymphoma be a possibility? What about Human T-lymphptropic virus, Post-viral fatigue syndrome, Chronic Lyme, viral arthritus, or others? I have an appointment with an infectious diseases specialist and a neurologist next week. Any recommendations on what all this might be?

[Edward W Hook, MD]

The infectious triggeers of the sort of rheumatological problems you mention are hotly debated and tough to prove.  Herpes is not one of the infections commonly suggested as a trigger however.  As I said and as may be most relevant to your situation, suppressive therapy may helpful in eliminating the small chance that HSV could be a contributor.  EWH

[Username100]

I realize HSV 2 is not causing these things to happen, but can the fact that I have a new viral infection trigger these other things?

[Edward W Hook, MD]

There is a word limit for posts on this site.  Any questions which cannot be posed within the constraints of that limit are really too complex to address fully and appropriately over the internet and deserve the full attention of a specialist.  I will briefly try to address some of the concerns you raise but really think that in your situation, having acquired HSV-2 a year ago, having had uncharacteristic pain, and with your rheumatologic problems, you would be far better served by seeking the care of an infectious diseases specialist, rheumatologist or neurologist as you plan to do.  

I suspect that the acquisition of herpes at about the same time you experienced the onset of your arthritic complaints and pain syndrome are coincidental, not cause and effect.  The symptom complex you describe is in no way characteristic of HSV-2 infection, even in usual circumstances and is far more compatible with another systemic disease.  It would be easy to start you on chronic suppressive therapy with antiviral therapy (valacyclovir) to provide further evidence that this is not related to your herpes.  I will predict that such therapy would not change your symptoms.  Since suppressive therapy is so very effective, non-response would be further evidence that what you are experiencing is not related to herpes.  

Good luck.  Please let us know what you consultants say.  EWH