STDs Expert Forum
Herpes?
About This Forum:

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.

Font Size:
A
A
A
Background:
Blank
Blank
Blank
This expert forum is not accepting new questions. Please post your question in one of our medical support communities.
Blank Blank

Herpes?

I had unprotected sex Friday night with a friend that I’ve known for years. I didn’t notice anything on him, and I can’t imagine he would sleep with me unprotected if he knew he had herpes… but I guess that is neither here nor there.

I felt uncomfortable and itchy Saturday – Tuesday but that sometimes happens to me after rough/dry sex so I wasn’t worried. I used monistat cream in case of a yeast infection.

Wednesday (yesterday / 5 days after sex) two little bumps appeared on the inside of my outer labia. They are 1 or 2 mm each and close together but not touching. At first I thought they were ingrown hairs. The bumps were maybe a little red and they felt hard. They didn’t really hurt at that time but they did itch. They didn’t look like blisters until I shone a flashlight on them, then it looked like there could be some fluid in them but I couldn't tell.

Thursday (today) – They don’t look at all like blisters anymore, more like just flesh colored bumps that are slightly indented on top (maybe a ruptured blister?!). They do kind of look like tiny canker sores, but I don’t know if that is just me freaking out. Although they don’t feel better (still itchy and now stinging), they look like they might be going away. I have pain in the lymph nodes on that side of my groin today, but no fever.
300980_tn?1194933000
Welcome to the Forum.  My suspicion is that this is not herpes- the bumps that you describe just do not sound like typical HSV lesions, it would be unusual for a first episode of HSV to be present as just two lesions, and typically a HSV lesion would have more discomfort than just itching.  Furthermore, if this is all the same process than began Saturday this too is inconsistent with HSV since HSV lesions do not typically appear until at least 4 days after an exposure.

Having said this,, genital HSV can have atypical appearances and fool even the most experienced clinicians. Thus, the best and most direct way to address this concern is to seek testing of the lesions using culture or, even better PCR testing of the lesions.  FYI (and because some clinicians are unaware of this), culture of PCR CAN be performed on lesions that do not have obvious fluid filled blisters or ulceration- you just rub the abnormal appearing lesion with the swab.  

Finally, just and an FYI, there is no role for a blood test in evaluating these lesions.

I hope these comments are helpful and provide guidance.  I doubt that this is HSV.   If you choose to test, please let us know the results.  Take care. EWH
5 Comments
Blank
Avatar_f_tn
Thank you so much for your answer. I do have a few more questions if you don't mind.

First I just wanted to clarify that the discomfort I was feeling Saturday - Tuesday seemed like it was just irritation from sex. The bumps/sores didn't appear until yesterday (Wednesday, which was 5 days after sex). Also, they do sting constantly along with the itchy feeling, and they kind of look like tiny ulcers now, but again they look like they are already going away. With these clarifications, do these still not sound like typical herpes lesions? Also, since I can't get into any doctor until Tuesday, if I cannot be seen until after these lesions are gone do you think that I should then have a blood test? My ex boyfriend and I have been discussing the possibility of getting back together and I am worried about passing anything to him should we have unprotected sex in the future as we used to.

Again, thank you so much for all your help!
Blank
300980_tn?1194933000
Your clarifications do not make your lesions sound more like herpes.  Again, if you wish to know, the thing to do is test.  

No, the blood test would not be helpful at this time and it wouuld be more likely to provide a falsely positve result than helpful information.  EWH
Blank
Avatar_f_tn
Hi Doctor. Thanks again for all of your help.

I posted a few follow up questions as a new thread but was told to post them as a comment on this thread instead.

I was starting to relax about the possibility of this being HSV2, as I thought this would be too mild for a first outbreak. However, I did test positive for HSV1 antibodies (& neg for HSV2) two years ago. I had no symptoms at the time, but I have a hunch that this infection was genital, as I had a herpes-like outbreak, complete with scabbing sores, once about 5 years ago. I have read that this prior infection can make an initial outbreak of HSV2 much less severe.

Is this true? And with this taken into consideration, would this be more likely to be a primary HSV2 infection? Or could this possibly be that same HVS1 infection showing up again?

I have an appointment with my GYN tomorrow afternoon, but I am kind of at a loss as to what to do, since the sores are already healed and can’t be cultured.
Blank
300980_tn?1194933000
You continue to spend your energy on something that is not a major possibility.  While genital HSV-1 may make the initial manifestations of HSV-2 a little less severe, that does not in any way change my assessment or advice.  The lesions and time course you described were not suggestive of herpes.  Nor are the "bumps" you describe in any way suggestive of a recurrence of HSV-1 (which, if it was not case would have NO relationship to the sexual encounter you described).  

My advice is to put your unwarranted fears of HSV aside unless there is a recurrence and, if there is, to be evaluated while the lesions are present and not be put off by your doctor.  EWH
Blank
Continue discussion Blank
This Forum's Experts
239123_tn?1267651214
H. Hunter Handsfield, M.D.Blank
University of Washington
Seattle, WA
300980_tn?1194933000
Edward W Hook, MDBlank
University of Alabama at Birmingham
,
MedHelp Health Answers
Blank
Weight Tracker
Weight Tracker
Start Tracking Now
RSS Expert Activity
233488_tn?1310696703
Blank
New Cannabis Article from NORTH Mag...
Jul 20 by John C Hagan III, MD, FACS, FAAOBlank
242532_tn?1269553979
Blank
3 Reasons Why You are Still Binge E...
Jul 14 by Roger Gould, M.D.Blank
242532_tn?1269553979
Blank
Emotional Eating: What Your Closet ...
Jul 09 by Roger Gould, M.D.Blank