Fever and aches, but no lesions. Should I get a blood test?

[lookingforanswersplease]

- Sex on Apr 8th, unprotected.  
- Apr 11 started to feel unwell.  Had chills, muscle aches, felt a twinge of discomfort when peeing.
- Apr 12 had flu symptoms.  Small discomfort when peeing, glands in groin slightly swollen.  Thought bladder infection, went to doc that day.  Urine sample was fine.  Temperature of 100.7.  Doc questioned me about possibility of herpes.  Doc did an internal exam - no discharge, no lesions anywhere. Doc took a culture.  
- Apr 13, 14, 15 - felt fine, almost well.
- Apr 16 - 18 - backs of legs all the way down to my feet and buttocks sore, achey.  Still a twinge when peeing.  Difficulty emptying bladder.  Vagina, especially my clitoris, very sensitive and a little achey.  Swollen gland.
- Apr 19, 20 - legs and butt still sore, a little constipated, same urination difficulties.  Called doc for test results.  Urine was fine, culture was fine.  Nurse said I was fine and it was "just one of those things".  I inquired about a herpes blood test - was told not needed
- Apr 21 - 25 - legs still sore, same urination difficulties.  Went to STD clinic for internal exam. Was examined by an "infectious disease specialist".  She said no lesions, very healthy cervix and vagina.  She said no need for blood tests, nothing more I could do - I had gone "above and beyond" already.
- Apr 26 - 28 (today) - almost better, still no lesions.
- Boyfriend has not had any symptoms of any kind ever.

My questions:
1.  Do you think that I have been infected with herpes?
2.  If I had herpes would my symptoms (fever, flu symptoms, swollen glands) coincide with lesions?
3.  Should I get a herpes blood test, either now or in 3 months?  Should my boyfriend? (Very difficult in Canada)
4.  Is it safe to resume sex without condoms with my boyfriend? Future boyfriends?
5.  If I was infected with herpes do you think that this was my primary infection - ie. it came from this current boyfriend?

Thank-you very much doctor for your reply and all the good work you do.

[H. Hunter Handsfield, M.D.]

Your symptoms conceivably could be due to herpes, but unlikely.  They are consistent with any number of other infections, or even some non-infectious conditions.  Symptoms like that can occur with initial HSV infection, but usually along with overt, painful herpes sores.  So on balance, herpes is unlikely.  However, it probably remains a slim possibility.  To be 100% certain, have a type-specific HSV blood test 3 months after onset of symptoms, i.e. in early July.

Your last question sugests the April 8 sex was with your bf, not someone else.  But if I misundersand, if it was someone else, ask that person if he has herpes.

To your direct questions:  1) I don't think so, but impossible to be 100% certain.  2) Usually, yes.  3) See above.  4) If your bf was the only possible source of infection, in the unlikely chance you have herpes, then he is already infected and cannot catch it again.  So I see no reason to use condoms or otherwise alter your sexual practices with him.  But given the frequent inconvenience of finding a provider who will do HSV testing in Canada (what a dumb national policy!), the easiest thing might be to wait until the 3 month mark and go get tested together.  5) Yes.  If this is herpes after all, it almost certainly was your primary infection.

The other thing, of course, is for both you and your bf to be on the lookout for recurrent symptoms.  If either of you develops any kind of genital sore, see a provider right away (within 1-2 days) for examination and culture for HSV.  In the meantime, don't worry:  even if this is herpes, if you caught it from your current bf, it's no longer a signficant health issue as long as the two of you remain together without other partners.

Thanks for the thanks about the forum.  Good luck--  HHH, MD

[lookingforanswersplease]

Thank-you very sincerely for providing me with a clear and reasonably definitive response (to the extent that I'm sure you're able).  It has caused me a great deal of stress and frustration to wade through the ambiguous and vague opinions/information out there on HSV.  The medical opinions that you have provided on this site generally and to me specifically have been the most helpful that I have encountered.  You have greatly increased my knowledge of HSV and reduced my anxiety -- regardless of the outcome of my symptoms.  I hope you know that your work is very much respected and appreciated.  

[HHH,MD]

That clarifies my slight uncertainty about whether you had another partner recently.  It doesn't change my opinion or advice.

HHH, MD

[lookingforanswersplease]

I also wanted to mention that my boyfriend and I have been in a monogomous relationship since January 2007.  We were both STD tested prior to stopping using condoms in March and both were negative for all STDs (we were unaware that herpes testing was not included in the routine testing).  Neither my boyfriend nor I have ever had any soresanywhere or any concerns about STDs in the past.  We've both had few sexual partners and all previous relationships have been monogomous and STD free to our knowledge.