Aa
Symptomatic GHSV1
Hello Dr. HH,
I was in a relationship with 2 women. The 1st one I found out (1mth ½ later) had HSV1&2 confirmed by blood and visible sores. Lucky, with her I never had sexual intercourse, only a lot of kissing and touching her genital area. The 2nd girl is one I wanted to be with all time but just got side tracked. The same night I was kissing the 1st girl; I gave her oral sex and had sexual intercourse with the 2nd girl.
It was about a month after these events when I start getting symptoms unusual to my body; ones I have never had before.
Symptoms:
1. On my left leg, from waist to my knee I have off and on pain with tingling. Sometime after, I would get what looks like a bump with a red base and white fluid in it. Also, these same bumps would come on my buttocks sometimes.
2. Then, I get tingling on my genital, sometime after, my genital feels sore in the same area and I get a spot that looks like a rash a long with a feeling like pins sticking. I have been keeping a log and this happens once a month.
3. I know for sure I get out breaks on my face very often now. I did a HSV test twice 1mth apart, both pos HSV1, neg HSV2.
Questions:
1. It has been 1yr since these events and I still have these same symptoms. Do I have genital HSV1 from oral sex? Will I be with these OBs every mth? From reading the forum, after 2 OB the pattern stays the same.
2. How long does it take antibodies to build-up to counter the HSV virus?
3. Is it possible for HSV1 to travel from the genital to your foot?
4. Why is my symptoms so symptomatic if it was only GHSV1?
I was in a relationship with 2 women. The 1st one I found out (1mth ½ later) had HSV1&2 confirmed by blood and visible sores. Lucky, with her I never had sexual intercourse, only a lot of kissing and touching her genital area. The 2nd girl is one I wanted to be with all time but just got side tracked. The same night I was kissing the 1st girl; I gave her oral sex and had sexual intercourse with the 2nd girl.
It was about a month after these events when I start getting symptoms unusual to my body; ones I have never had before.
Symptoms:
1. On my left leg, from waist to my knee I have off and on pain with tingling. Sometime after, I would get what looks like a bump with a red base and white fluid in it. Also, these same bumps would come on my buttocks sometimes.
2. Then, I get tingling on my genital, sometime after, my genital feels sore in the same area and I get a spot that looks like a rash a long with a feeling like pins sticking. I have been keeping a log and this happens once a month.
3. I know for sure I get out breaks on my face very often now. I did a HSV test twice 1mth apart, both pos HSV1, neg HSV2.
Questions:
1. It has been 1yr since these events and I still have these same symptoms. Do I have genital HSV1 from oral sex? Will I be with these OBs every mth? From reading the forum, after 2 OB the pattern stays the same.
2. How long does it take antibodies to build-up to counter the HSV virus?
3. Is it possible for HSV1 to travel from the genital to your foot?
4. Why is my symptoms so symptomatic if it was only GHSV1?
MEDICAL PROFESSIONAL
There is a rare syndrome called "benign recurrent lymphocytic meningitis", also known as Molleret's meningitis after a French physician of that name. First identified a long time ago, maybe in 1800s (?). Affected people get recurrent meningitis, typically 2-4 times a year. As "benign" implies, it is painful but not dangerous, unlike classical bacterial meningitis. A few years ago, research revealed that most cases, if not all, are due to HSV-2, i.e. recurrent herpes of the brain. Most also have recurrent genital herpes (no surprise), but often without symptoms.
HSV is neurotropic -- i.e. it main target cells are nerves, in addition to skin. No other organs or tissues are selectively involved, so it would not be expected that HSV would infect muscles, liver, lungs, or other internal organs, and to my knowledge no such cases have been reported. If such a thing occurs, it is rare.
Initial HSV infections almost always show up at the site where the virus enters the body (if there are symptoms at all). And the virus generally has to be massaged into the skin or tissues; the outer layers of the skin are an effective barrier to the virus, so simply laying the virus on intact skin doen't result in infection. That's why the first symptoms almost always are at sites of the greatest friction during sex: penis in men, labia minor and vaginal opening in women, or the anus -- and rarely on scrotum, buttocks, pubic area, etc (even though recurrent herpes sometimes involves those sites).
HSV is neurotropic -- i.e. it main target cells are nerves, in addition to skin. No other organs or tissues are selectively involved, so it would not be expected that HSV would infect muscles, liver, lungs, or other internal organs, and to my knowledge no such cases have been reported. If such a thing occurs, it is rare.
Initial HSV infections almost always show up at the site where the virus enters the body (if there are symptoms at all). And the virus generally has to be massaged into the skin or tissues; the outer layers of the skin are an effective barrier to the virus, so simply laying the virus on intact skin doen't result in infection. That's why the first symptoms almost always are at sites of the greatest friction during sex: penis in men, labia minor and vaginal opening in women, or the anus -- and rarely on scrotum, buttocks, pubic area, etc (even though recurrent herpes sometimes involves those sites).
MEDICAL PROFESSIONAL
Thanks for the thanks. Glass half full is exactly the right attitude. The symptoms don't make me worried about any kind of serious underlying health problem.
MEDICAL PROFESSIONAL
Thanks for the additional information. You may view my final comments as one of those "good news, bad news" scenarios. The good news is that almost certainly neither your facial nor genital symptoms are due to herpes. It is possible HSV-1 accounts for some of your facial lesions, but definitely not all of them. You have an HSV-1 infection for sure, as do half of all adults in the US. But most likely it is asymptomatic, not the cause of the sores and other symptoms you describe.
The bad news is that I have no good explanation for your problem. But it isn't hereps or any other infection you caught during the sexual exposures that you mention above.
The reasons these problems aren't herpes have to do with the variable locations you describe, the frequency of the outbreaks, the occurrence in more than one or two locations at different times, tingling (which is not a herpes symptom except just before sores appear), and how quickly the sores heal.
As I advised above, you should see a dermatologist, or return to the ID doc. Get examined at a time when you are having skin lesions. Arrange to have a visit immediately (within a day) if and when a new episode starts, so the sores can be examined when they are fresh and a test for HSV can be obtained from the lesion.
Good luck-- HHH, MD
The bad news is that I have no good explanation for your problem. But it isn't hereps or any other infection you caught during the sexual exposures that you mention above.
The reasons these problems aren't herpes have to do with the variable locations you describe, the frequency of the outbreaks, the occurrence in more than one or two locations at different times, tingling (which is not a herpes symptom except just before sores appear), and how quickly the sores heal.
As I advised above, you should see a dermatologist, or return to the ID doc. Get examined at a time when you are having skin lesions. Arrange to have a visit immediately (within a day) if and when a new episode starts, so the sores can be examined when they are fresh and a test for HSV can be obtained from the lesion.
Good luck-- HHH, MD
MEDICAL PROFESSIONAL
So you had blood tests, not direct tests for the virus itself. (Symptoms no. 3 in your original message suggested virus tests from facial lesions.)
Why have you had so many blood tests? Once positive, the blood test is positive for life. It does not check for the cause of a particular outbreak. Your results mean you are infected with HSV-1, and you caught that infection sometime prior to 5/09. Most likely you have had it since childhood. There is no point in having any more blood tests, just a waste of money.
It is very unusual to have facial HSV-1 outbreaks so frequently. It is possible, but I am inclined to believe that something other than herpes is the cause. Give me more detail about the outbreaks: How to they start and what exactly happens? How many lesions each time? Exactly where are they? How long do they last? Have you seen a herpes expert, such as a dermatologist? You should plan on seeing a doctor (preferably a dermatologist) immediately -- within a day -- the next time you have an outbreak, so that a fresh lesion can be tested for the virus.
Also provide the same sort of information for your genital outbreaks -- i.e. the exact location, how the lesions start and progress, and how long they last. It is very unlikely that you have both oral and genital herpes due to HSV-1.
CDC does not provide clinical services. However, the DeKalb County health department has an excellent STD clinic, which might be an option if you can't afford a private doctor or don't have medical insurance. (The Fulton Co. STD clinic also might help, but it's a bit of a zoo, very crowded -- it's part of the Grady hosptial complex.)
Let me know the details of your outbreaks, then we'll see where to go from there.
Why have you had so many blood tests? Once positive, the blood test is positive for life. It does not check for the cause of a particular outbreak. Your results mean you are infected with HSV-1, and you caught that infection sometime prior to 5/09. Most likely you have had it since childhood. There is no point in having any more blood tests, just a waste of money.
It is very unusual to have facial HSV-1 outbreaks so frequently. It is possible, but I am inclined to believe that something other than herpes is the cause. Give me more detail about the outbreaks: How to they start and what exactly happens? How many lesions each time? Exactly where are they? How long do they last? Have you seen a herpes expert, such as a dermatologist? You should plan on seeing a doctor (preferably a dermatologist) immediately -- within a day -- the next time you have an outbreak, so that a fresh lesion can be tested for the virus.
Also provide the same sort of information for your genital outbreaks -- i.e. the exact location, how the lesions start and progress, and how long they last. It is very unlikely that you have both oral and genital herpes due to HSV-1.
CDC does not provide clinical services. However, the DeKalb County health department has an excellent STD clinic, which might be an option if you can't afford a private doctor or don't have medical insurance. (The Fulton Co. STD clinic also might help, but it's a bit of a zoo, very crowded -- it's part of the Grady hosptial complex.)
Let me know the details of your outbreaks, then we'll see where to go from there.
MEDICAL PROFESSIONAL
Welcome to the STD forum. I'll try to help.
You describe no symptoms that suggest genital herpes, either HSV-1 or HSV-2. You have obviously been reading information about herpes symptoms. Unfortunatley, many websites etc do not provide the necessary cotext. Herpes lesions can tingle, and tingling can precede an outbreak -- but tingling alone is not a herpes symptom. Recurrent herpes lesions are always in pretty much the same spot, give or take an inch; you are unlikely to have recurrent herpes both of your lift leg and waist plus your buttocks. (Pimples are common on the buttocks, of course -- perhaps that explains those lesions.) Since you have oral herpes due to HSV-1, you actually are protected against ever getting genital herpes due to HSV-1; your immune system makes you resistant to catching a new HSV-1 infection anywhere on the body. I could go on further, but the bottom line is that you give all kinds of evidence against having genital hgerpes.
I do find it interesting, however, that you have such frequent oral herpes. Once or twice a year is the norm. As for genital, recurrent oral herpes is almost always in more or less exactly the same spot. Is that what you have experienced? Can you confirm you have actually had a positive test for HSV-1 (culture or PCR) from a lesion on your lips or face?
To your specific questions:
1) For the reasons above, you can be sure you do not have genital herpes.
2) Within 2-3 months of a new infection, people are protected from further infections with the same virus type.
3) No, the virus does not typically travel in this manner.
4) I cannot say what the cause of your symptoms of the genital area, legs, etc might be -- but for sure not herpes. You'll need to work with your doctor to find other explanations.
Good luck-- HHH, MD
You describe no symptoms that suggest genital herpes, either HSV-1 or HSV-2. You have obviously been reading information about herpes symptoms. Unfortunatley, many websites etc do not provide the necessary cotext. Herpes lesions can tingle, and tingling can precede an outbreak -- but tingling alone is not a herpes symptom. Recurrent herpes lesions are always in pretty much the same spot, give or take an inch; you are unlikely to have recurrent herpes both of your lift leg and waist plus your buttocks. (Pimples are common on the buttocks, of course -- perhaps that explains those lesions.) Since you have oral herpes due to HSV-1, you actually are protected against ever getting genital herpes due to HSV-1; your immune system makes you resistant to catching a new HSV-1 infection anywhere on the body. I could go on further, but the bottom line is that you give all kinds of evidence against having genital hgerpes.
I do find it interesting, however, that you have such frequent oral herpes. Once or twice a year is the norm. As for genital, recurrent oral herpes is almost always in more or less exactly the same spot. Is that what you have experienced? Can you confirm you have actually had a positive test for HSV-1 (culture or PCR) from a lesion on your lips or face?
To your specific questions:
1) For the reasons above, you can be sure you do not have genital herpes.
2) Within 2-3 months of a new infection, people are protected from further infections with the same virus type.
3) No, the virus does not typically travel in this manner.
4) I cannot say what the cause of your symptoms of the genital area, legs, etc might be -- but for sure not herpes. You'll need to work with your doctor to find other explanations.
Good luck-- HHH, MD
MEDICAL PROFESSIONAL
I still believe your symptoms are not due to HSV-1.
We have gone as far as possible for a distant medical advice service. This forum can't help you any further, so that ends this thread. Sorry.
We have gone as far as possible for a distant medical advice service. This forum can't help you any further, so that ends this thread. Sorry.
Ok. I was put on Acyclovir 200mg 5 times per day for 10 days. The symptoms seem to stop.
However, 1wk after the symptoms on my face came back and my genital and buttock same thing.
The Dr. said it is the prodrome signs with no OB and is called an "aborted" outbreak. He said my outbreaks will always happen often with out meds.. Is this true? I thought GHSV1 shouldn't happen this often. Why is it so aggressive?
Thanks,
Ben
However, 1wk after the symptoms on my face came back and my genital and buttock same thing.
The Dr. said it is the prodrome signs with no OB and is called an "aborted" outbreak. He said my outbreaks will always happen often with out meds.. Is this true? I thought GHSV1 shouldn't happen this often. Why is it so aggressive?
Thanks,
Ben
Thank you.
MEDICAL PROFESSIONAL
I remain very skeptical that HSV-1 is cause of your symptoms, and my guess is that your doctors don't actually believe it either. Probably they are recommending anti-herpetic treatment as a therapeutic trial, i.e. to help with diagnosis. If your symptoms do not change with treatment, it will be further evidence against herpes. The drugs are benign, with no significant side effects, so no harm would come from giving it a try. But you should not get your hopes up. I will be very surprised if it makes any difference in your symptoms. You'll know within a week if it's going to have any effect.
Hello Dr. HH,
I just wanted to update you on my condition. I went to back to the Dr. and they said my condition seems to be GHSV1 related because they said “patients can have very mild outbreaks without sores” which makes it hard to do any culture/PCR testing.
As to why they did the tests often, they say it was to validate I didn't really have HSV2 since the reoccurrence happen once a month around the same time.
So they would like to put me on anti-viral meds to help. Just wanted you to know.. Thanks
I just wanted to update you on my condition. I went to back to the Dr. and they said my condition seems to be GHSV1 related because they said “patients can have very mild outbreaks without sores” which makes it hard to do any culture/PCR testing.
As to why they did the tests often, they say it was to validate I didn't really have HSV2 since the reoccurrence happen once a month around the same time.
So they would like to put me on anti-viral meds to help. Just wanted you to know.. Thanks
Very interesting.. Thank you Dr. HH, you are a wealth of knowledge... God bless you..
BTW- Dr. HH I had a curiosity question...not saying this is my case.
This will be my last question. So please don't nail me :) .
Can HSV breakout internally in say muscles or organs like the lungs, liver, etc? If yes, what would cause this?
Thanks..
This will be my last question. So please don't nail me :) .
Can HSV breakout internally in say muscles or organs like the lungs, liver, etc? If yes, what would cause this?
Thanks..
I really appreciate your help!! I was worried I had another sickness (like cancer) that was triggering HSV.
I will look at the glass as half-full.
Thank you...
I will look at the glass as half-full.
Thank you...
I have seen an ID doctor(when I had insurance) and he said it's just HSV1 based on my blood test..
On my face: 1st Tingling off/on(it feels like bugs on my skin almost). One instance: 2-3 red sores on forehead, white fluid, breaks, heal with scab. These stages happen over a 4-5 day period..
Second Instance: 1st Tingling off/on (it feels like bugs on my skin almost). 3 red sores, one on nose, the other next to nose, and one next to my mustache area, white fluid, breaks, heal with scab. These stages happen over a 4-5 day period.. Also, the tingling happens sometime in the corner of my eyes, but I checked with an eye Dr. and nothing.
=================================================================
Genital: Tingling on mostly 2 spots on the right side of my genital. I am uncircumcised so the rash after tingling comes on my foreskin just below the tip of my penis. This can last for about 2-5 days it varies. Also, it becomes itchy and soreness there. The sore isn't open/blisters with fluid, etc. Lastly, my left groin area hurts with the tingling.
The oddest symptom I feel is like something (during tingling phase) is crawling inside of me below my belly button.. I don't know if this is linked to anything but just giving you all the things I noticed with my body since my encounter last yr.
I am at a brick wall with this Dr. H.. I did a STD panel test and all neg. I will follow your advice..
Please let me know what you think and thanks..
On my face: 1st Tingling off/on(it feels like bugs on my skin almost). One instance: 2-3 red sores on forehead, white fluid, breaks, heal with scab. These stages happen over a 4-5 day period..
Second Instance: 1st Tingling off/on (it feels like bugs on my skin almost). 3 red sores, one on nose, the other next to nose, and one next to my mustache area, white fluid, breaks, heal with scab. These stages happen over a 4-5 day period.. Also, the tingling happens sometime in the corner of my eyes, but I checked with an eye Dr. and nothing.
=================================================================
Genital: Tingling on mostly 2 spots on the right side of my genital. I am uncircumcised so the rash after tingling comes on my foreskin just below the tip of my penis. This can last for about 2-5 days it varies. Also, it becomes itchy and soreness there. The sore isn't open/blisters with fluid, etc. Lastly, my left groin area hurts with the tingling.
The oddest symptom I feel is like something (during tingling phase) is crawling inside of me below my belly button.. I don't know if this is linked to anything but just giving you all the things I noticed with my body since my encounter last yr.
I am at a brick wall with this Dr. H.. I did a STD panel test and all neg. I will follow your advice..
Please let me know what you think and thanks..
Actually, Looking back at my test records. I did 3 tests to verify:
5/09 HSV1 3.88 pos High, HSV2 <0.90, neg -Labcorp
7/09 HSV1 4.34 pos High, HSV2 <0.90, neg -Quest
9/09 HSV1 pos, HSV2 neg -LabCorp (ImmunoBlot)
Yes, I have the OBs on my face on the same spots. It's like clockwork once a month
As for my genital, in the same spot when it happens..
Dr. Handsfield it's driving me nuts. visit 2 Drs. and no luck. I live not to far from the CDC you thing they may have some insight?
Thanks for your help Dr. H..
5/09 HSV1 3.88 pos High, HSV2 <0.90, neg -Labcorp
7/09 HSV1 4.34 pos High, HSV2 <0.90, neg -Quest
9/09 HSV1 pos, HSV2 neg -LabCorp (ImmunoBlot)
Yes, I have the OBs on my face on the same spots. It's like clockwork once a month
As for my genital, in the same spot when it happens..
Dr. Handsfield it's driving me nuts. visit 2 Drs. and no luck. I live not to far from the CDC you thing they may have some insight?
Thanks for your help Dr. H..
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
