Possible Herpes Symptoms

Hi Doctor,

I engaged in unprotected oral and protected vaginal sex with an escort 7 weeks ago.
Within four days of the incident i had experienced a fever and more worryingly, a stong burning sensation in my groin/inner thigh area. i went to a std clinic where the doctor examined me and stated that they could not see any lesions. i was given anti fungal cream for the burning.
I also took an igg test 4 weeks after the incident which came back negative for hsv 1 and 2.

The burning has reoccured intermittently in the last few weeks with no visible lesions. i have been examined by a different doctor on three occaisions, when i have gone to get tested or receive my results and they can not see any lesions. i have also examined myself on a daily basis and can not see anything which looks like a herpes lesion.

my question is that is it possible to have the burning sensation without any lesions showing and for it to be herpes? my doctor stated that a burning sensation is followed by lesions otherwise it is not herpes. He also stated that the burning would be restricted to a certain side of my thigh, rather than both thighs and my anus as it presently is. i am worried it is herpes, simply because of my intial symptoms such as fever and a burning sensation so soon after the sexual encounter.

I am also going abroad soon. Does an igg test at 8 weeks or 12 weeks hold any value whatsoever or is it only valid at 16 weeks?

[H. Hunter Handsfield, M.D.]

Welcome to the STD forum.

Whatever is the explanation for your symptoms, it is not herpes.  Your doctor is exactly right:  although some online sounces and brochures list "burning" or "tingling", those symptoms only occur in the presence of actual genital lesions -- in other words, the herpetic blisters/sores may burn or tingle, but such symptoms don't occur on their own.  (Recurrent genital herpes may be preceded by tingling or burning for a couple days before the outbreak starts, but this isn't an issue with initial herpes.) He also is correct about the location of the symptoms.  And the duration also is against it. If it were herpes, it would have cleared up within 3-4 weeks and would not continue to recur, and would not have an off-and-on pattern.  There's just nothing in your description that is in the least bit suspicious for herpes.

As for fever etc, when that occur with initial herpes, it always follows the onset of obvious, painful genital lesions. I have never seen or heard about fever alone (or with burning) as the only manifestation of the first herpes infection.  You probably caught some sort of garden variety virus -- perhaps from your sex partner, or from anyone else in your environment about that time.

Had you been my patient, I woud not have recommended HSV blood tests.  But since you have started down that path, have another one about 3-4 months after the exposure.  An 8 week test also would be reassuring -- about 80% of newly infected people are positive by then.  But it takes 3-4 months to reach 90% assurance.

In the meantime, work with your health care provider if your symptoms continue.  But don't worry about herpes as the cause.  It's very unlikely.

Good luck--  HHH, MD

[ricken]

Thanks Doctor.
I have been using trimovate cream for the burning, is it possible that this has repressed any possible lesions at all? ( i know that sounds slightly paranoid but i just want to cover all bases!)

also, is it possible tht i may not have noticed the lesions at all? after all i have read that most people do not even know they have herpes as the outbreak is so mild that they do not notice it.

[ricken]

Apologies Doctor,

I was hoping that you could also state whether this sounds like genital warts at all? what is the risk of catching genital warts in an encounter such as mine....and how would i go about testing for it/after how much time could i test for it? (My work medical insurance would cover me so i am not worried about the cost as long as it brings me peace of mind).

[H. Hunter Handsfield, M.D.]

The steroid cream you have been using does not suppress herpes; if anything, it would make lesions more obvious, not less.

Warts cause warts -- i.e. visible bumps that look pretty much like the warts you might have had on your hands when you were a kid.  They do not cause any other symptoms of any kind and certainly nothing like you describe here.  There is no test for asymptomatic HPV infection in men, and anyway if you aren't a virgen you can assume you have had genital HPV before and will get it again.  It happens to everybody and is almost never an important health issue for men. Just drop that line of thinking.

You came to this professionally moderated site for expert reassurance.  I gave it.  Accept it and move on.  Absolutely for sure no STD is the cause of the symptoms you describe.

That's all for this thread.