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Possible Herpes Infection? Please help
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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.

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Possible Herpes Infection? Please help

24 Days ago I had protected intercourse with a random girl. About 36 hours later I begin to experience a burning (like icy hot) in my pubic region and my inner thighs. The burning moves around between my thighs and pubic area. The sensation would come and go throughout the day. After 3 days I went to the doctor for an STD test (negative gonorrhea and chlamydia) The doctor didn't see anything that signaled Herpes. The burning has continued for the next 24 days. I have also been experiencing pains in my lower abdominal, pains in my legs and pain in my lymph nodes. I have been inspecting my penis hourly over the last 24 days for blisters/sores and haven't seen anything. I have been extremely stressed over the possibility of having herpes so yesterday I went back to the doctor. He again inspected me and told me to relax. He told me that since I haven't had any sores and used a condom that this was all anxiety and the likelihood of having Herpes was very small. Today after 24 days of symptoms, a burning rash appeared on the base of my penis. I don't see any sores/blisters. Do you think this is a herpes outbreak? I am 100% positive that I didn't have any STDs before this experience. There for a while, after reading a lot of your posts, I began to think I didn't have herpes since the burning wasn't localized and 24 days without sores/rash/blisters signaled something else. What is the probability that it took 24 days of symptoms to finally break out in rash? Any chance this might be something else?
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239123_tn?1267651214
Welcome to the forum.  Bottom line:  I agree exactly with your doctor.  This is not herpes and it is very typical for genitally focused anxiety in response to a sexual exposure you regret.

The chance of catching HSV from any single random sexual encounter is very low.  And although recurrnent herpes can be associated with a burning sensation, that is only because herpes sores burn; or a burning sensation precedes blisters/sores by a day or two. Ongoing burning is rarely if ever due to herpes, and neither is such widespread burning as you describe (pubic area, inner thighs, etc).  Finally burning without sores is not an initial symptom of the first HSV infection.

As for the new rash, you don't describe it. But if it is not comprised of blisters, superficial pimples, or open sores, it isn't herpes; and 24 hours is too long for onset of initial herpes lesions; 2-5 days is typical and it's rarely more than 10 days.

And so, like your doctor, I am confident you didn't catch herpes.  If the rash persists, return to your doctor for his advice about it -- and believe him.

I hope this helps. Best wishes--  HHH, MD
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Avatar_m_tn
Thanks Dr H for the quick response. The rash I mention above is just a red patch about the size of a quarter on the bottom of my penis near the base. It don't see any obvious blisters forming. It is a little difficult to tell though because I have always had a lot of little pimples on my penis (sebaceous prominence I think is the medical term). The area of the rash really scares me being near the base of the penis where the condom might not of covered. If you have time, I do have a couple more questions that I didn't include in my first post.
1. I have been reading that Herpes sore sometimes only look like tiny paper cuts and not obvious blisters. Is this true?
2. I am starting to believe that the on/off burning and tingling might just be my anxiety and heighten awareness but I am pretty certain my lymph nodes in my groin have been swollen. Could my stress also cause this pain also well?
3. I have been reading about Herpes causing leg pain and twitching? How often is this a symptoms of a primary outbreak?
4. Are there any bacterial infections that cause similar symptoms to to the ones I have described that could last for 3 1/2 weeks?
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239123_tn?1267651214
1) Recurrent herpes might look like that, but rarely if ever the initial infection.

2) Stress, anxiety, depression, etc -- any mental health condition could be responsible.

3) I have never heard of herpes causing muscle twitching in the leg or anywhere else.  You did not learn that from any scientifcally reliable source.

4) No, no bacterial infections either.  Whatever the cause of your symptoms, they are not due to any infection from your recent sexual encounter.

Work with your doctor if you remain concerned.  I won't have any further advice here.
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Avatar_m_tn
UPDATE

I wanted to provide an update regarding my situation. I have learned a great deal of information from this website and found it to be extremely helpful over the past 2 months. I wanted to provide a quick update to help anyone else who might read my post and experience similar symptoms.

Its been 7 1/2 weeks since the exposure. The tingling/burning sensations in my pubic region and most of the other symptoms that I mentioned above ended after 4 weeks. I never developed any sores/blisters/cuts on my penis or in the boxer short area. Occasionally I get some redness at the base of my penis where it connects to the scrotum. It doesn't really itch or burn and seems to come and go so i don't know if its related or not.

I have continued to experience muscle pain/aches in my legs (thighs, knees, calves) and butt. These pains come and go through the day. Sometimes in both legs at the same time. At times I barely notice them and other times they are somewhat painful. I have started running again so some of the pain might just be sore muscles. I also continue to experience tightness in my lower abdominal and stomach cramps. The stomach and leg pain have continued pretty much everyday since the exposure (54 days). I don't know if this is just normal pain that I always felt but never paid attention too or related to Herpes.

At 6 1/2 weeks (45 days) I went back to the doctor and took a type specific Herpes IGG blood test which came back negative for HSV 1 and HSV 2. My doctor told me that based on this result I probably don't have Herpes but I still plan on re-testing at the 12 to 16 weeks for a conclusive test.

Dr. HHH or Hook - Could one of one comment quickly on the accuracy of a blood test at 6 1/2 weeks. I think I have seen in other posts that around 70% to 80% will test positive at that point. Do those numbers sound about right or a little high?

I will post once more in January with the results of my 3 month blood test to let people experiencing similar symptoms know if it ended up being Herpes or not
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239123_tn?1267651214
Once again, your doctor is correct.  70-80% is a bit too low, not high; not far off, but probably closer to 80% or maybe as many as 90% of people with new HSV-2 infections have positive results by 6 weeks.  But in your case, this result is virtually 100% proof.  You had non-herpes symptoms after an exposure unlikely to result in HSV-2 infection.  Since you had probably only 1 chance in a thousand of having HIV before the test, an 80% reliable result drops those odds to 1 in 5,000.  Your final test will also be negative.
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