Herpes?

Hello.  I had a few questions for you.  About 5 days ago I had unprotected vaginal sex with a new partner.  The next day I felt a burning when I urinated and saw a bit of bleeding and assumed this was a yeast infection, since I have had these before.  Also on day after I noticed two unusual small blisters 4-5mm between my thumb and my forefinger.  At first these blisters had no pain and were skin colored.

Since then I have still had some tingling slight itchiness in the vagina, but see no bumps or blisters in that area.  However, I have had other symptoms such as flu like symptoms, body aches, etc.  I also had had some sort of reaction/irritation in my eye.  During this time the blisters on my hand have gotten "hot" and more irritated.  

Now my blisters are deflating, but haven't burst yet.  I would like to get myself checked out, so here are my questions:

1.  When is the best time for me to go and get checked out? (I wanted to go tomorrow)  Is it better for me to wait and see if any blisters develop in the vaginal area? Do I need to get checked out immediately and follow up?

2.  When is the best time to wait to do a check up as a precaution for most other STDs as a follow up visit?  I read somewhere it takes 6 months for HIV antibodies to show.  If I visit then, can I get tested for most other stds then?

3.  There seems to be so many tests for Herpes-when can you take the direct fluorescent antibody test to find out if you have type 1 or 2?  

4.  Finally I have been reading about the differences between type 1 and 2. I know that typically type 1 is oral and type 2 is genital but that you can contract type 1 through intercourse and that sometimes type 1 can be the cause of genital herpes.  This is sort of a random question- If I have type 1, does i how you contract it (i.e. orally or through intercourse) affect what type of herpes you get?  Also will that affect what type- genital or oral you expose a partner to?


Thank you in advance for all you help!

[Edward W Hook, MD]

I cannot comment as to whether you have acquired herpes or not.  I think it is unlikely however.  Your genital symptoms occurred the day after sex and that would be very unusual for herpes.  On the other hand, the blisters on your hand, with the associated achiness do sound as though they could be what we call a herpetic "whitlow" (finger infection).  These are unusual however unless you touched a lesion with your hands.  the best way to get this sorted out is with a culture or, even better yet, a PCR test from the blisters as soon as possible.  

If you get a blood test at this time, it would be too early for you to have developed antibodies if the blisters you describe are your first herpes outbreak but the blood test could tell you if you've had herpes already and did not know it.  This might be a good idea as well, because if you already have antibodies, it makes it more unlikely the blisters on your fingers are herpes.

As for your questions:

1.  See above.  Go tomorrow. get the lesion tested for sure +/- the blood test.
2. For the HIV blood test, in your case with a low probability of infection, any test after 8 weeks would be reliable.  For other STDs (gonorrhea, chlamydia, trich, etc) testing at this time will be accurate.
3.  the fluorescent antibody test is not so great.  The culture /PCR test and blood tests should be able to tell HSV-1 from HSV-2.
4.  These questions have been answered many times on this site.  Take a look.  The short answer is yes, you can get HSV-1 of the genitals and if you did, it would tend to be “milder " than HSV-1 with fewer recurrences and less asymptomatic shedding.

Additional information about herpes can be obtained by accessing excellent informational web sites such as the one run by the American Social Health Association (disclosure, Dr. Handsfield and I are both on the Board of Directors of ASHA).  

Hope this helps. EWH

[koala88]

I forgot to mention that I also had some body aches particularly in my upper legs, and I also have what looks like a canker sore( not sure if it's a cold sore) on the inside of my mouth.  Thanks!

[koala88]

Thank you so much for your direct and clear answers!