Member Comments are provided by individuals and reflect their personal opinions only. Under NO circumstances should you act on any advice or opinion posted in this forum. ALWAYS check with your personal physician before taking any action regarding your health! MedHelp International and our partners, sponsors and affiliates have no obligation to monitor any comments posted on this site, or the content and/or accuracy of such exchanges. MedHelp International does not endorse the views of any user.
STDs (Expert Forum)
Systemic symptoms with no sores - what is the likelihood of HSV2?
Answered by
University of Washington
Seattle - WA
Welcome to the STD Forum, which 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.
Systemic symptoms with no sores - what is the likelihood of HSV2?
by lookingforanswersplease, May 14, 2007 12:00AM
I have written to you on this forum before on (April 28th, 2007) with the subject (Fever and aches but no lesions. Should I get a blood test?). I bring this to your attention in case my query sounds familiar and to give you some context (if needed).
As I indicated in my previous posting, I developed a number of symptoms that could potentially have been viewed as indicating a primary HSV2 infection (slight fever, flu-like symptoms, sore legs, difficulty with urination, constipation and so on). I did not, however, develop any of the classic herpes lesions or any unusual discharge. From the onset of my symptoms I was examined internally twice – once by my family doctor and a second time two weeks later by an infectious disease specialist. Neither could see any sores. The specialist made a point to “inspect closely” etc., yet found no irregularities at all.
Your reply and advice were very helpful. Overall, my anxiety has dropped considerably, however, because I can’t do anything else until 3 months have passed (unless of course lesions develop in the meantime), I was hoping you could answer a few specific questions that I have in the meantime:
1. I did not mention in my earlier posting that I also had unusually sensitive skin on my hips and buttocks. It was almost like the skin felt burnt when touched, but not exactly – hard to explain. Would this symptom be related to a potential HSV infection?
2. If my boyfriend and I stay together and neither one of us develop any sores, is it necessary for us to get tested? Aside from peace of mind that may or may not come from testing, is there any medical benefit to knowing that one is infected when one doesn’t have sores? Given that 20-25% are infected with HSV2 generally, I am worried about unnecessarily opening Pandora’s Box, so to speak, and I am considering only getting tested if this relationship dissolves.
3. How likely/unlikely is it to develop systemic symptoms (fever, aches etc.) and for this to not be accompanied by visible sores during a primary infection? Does this happen sometimes, rarely, almost never, 5% of the time, more, or less? Any stats on this, or knowledge from your experience (have you seen this before?), would be greatly appreciated. I'm hoping to reduce my anxiety further if possible, and get a handle on my odds of infection if (a) I choose to not get tested for the above reason, or (b) I cannot find a provider who is willing to test me in the absence of lesions (I have already been told by a provider that it is not policy unless one is pregnant - I did not persist at that time).
Again, I truly appreciate the knowledge you share. This will be my last posting on these concerns. Thank-you very much.
As I indicated in my previous posting, I developed a number of symptoms that could potentially have been viewed as indicating a primary HSV2 infection (slight fever, flu-like symptoms, sore legs, difficulty with urination, constipation and so on). I did not, however, develop any of the classic herpes lesions or any unusual discharge. From the onset of my symptoms I was examined internally twice – once by my family doctor and a second time two weeks later by an infectious disease specialist. Neither could see any sores. The specialist made a point to “inspect closely” etc., yet found no irregularities at all.
Your reply and advice were very helpful. Overall, my anxiety has dropped considerably, however, because I can’t do anything else until 3 months have passed (unless of course lesions develop in the meantime), I was hoping you could answer a few specific questions that I have in the meantime:
1. I did not mention in my earlier posting that I also had unusually sensitive skin on my hips and buttocks. It was almost like the skin felt burnt when touched, but not exactly – hard to explain. Would this symptom be related to a potential HSV infection?
2. If my boyfriend and I stay together and neither one of us develop any sores, is it necessary for us to get tested? Aside from peace of mind that may or may not come from testing, is there any medical benefit to knowing that one is infected when one doesn’t have sores? Given that 20-25% are infected with HSV2 generally, I am worried about unnecessarily opening Pandora’s Box, so to speak, and I am considering only getting tested if this relationship dissolves.
3. How likely/unlikely is it to develop systemic symptoms (fever, aches etc.) and for this to not be accompanied by visible sores during a primary infection? Does this happen sometimes, rarely, almost never, 5% of the time, more, or less? Any stats on this, or knowledge from your experience (have you seen this before?), would be greatly appreciated. I'm hoping to reduce my anxiety further if possible, and get a handle on my odds of infection if (a) I choose to not get tested for the above reason, or (b) I cannot find a provider who is willing to test me in the absence of lesions (I have already been told by a provider that it is not policy unless one is pregnant - I did not persist at that time).
Again, I truly appreciate the knowledge you share. This will be my last posting on these concerns. Thank-you very much.
Doctor's Answer
by H. Hunter Handsfield, M.D., May 14, 2007 12:00AM
, May 14, 2007 12:00AM
It is uncommon for genital herpes to present with only systemic symptoms but no sores; personally, I have never seen a case. The opposite happens, sores without systemic symptoms. In other words, merely from the title you chose for this thread, I would conclude there is no reason to suspect you acquired genital herpes.
1) The additional symptom of 'skin sensitivity' does not alter my opinion. That isn't a herpes symptom.
2) I see no reason for testing. Of course I make no guarantees that you aren't infected, and the only way to know is to have the blood test. But if you were tested and the result were positive, it probably would have nothing to do with the symptoms you describe.
3) See my opening comments. I cannot make an accurate estimate of the frequency with which this happens. Probably less than 5% of the time, but that's only an educated guess.
Putting it all together, I think your priorities are wrong: Most likely it would be best for you to be tested. The overall tone of your comments and questions shows that the possibility of herpes is weighing heavily on your mind. Most likely a test result would be negative, and that would be the best way by far to be relieved of those tensions. Even if positive, it won't be any more stressful than the uncertainty you now are experiencing; in general, fear of bad news is more stressful than the bad news itself. (Same deal with a mammogram in a woman who fears breast cancer.) Be clear: This does not mean I 'really' think you have herpes. I do not, and I do not recommend testing based on any symptoms you describe. I only suggest it because it's probably the best way to deal with your anxieties over the possibility.
Good luck-- HHH, MD
1) The additional symptom of 'skin sensitivity' does not alter my opinion. That isn't a herpes symptom.
2) I see no reason for testing. Of course I make no guarantees that you aren't infected, and the only way to know is to have the blood test. But if you were tested and the result were positive, it probably would have nothing to do with the symptoms you describe.
3) See my opening comments. I cannot make an accurate estimate of the frequency with which this happens. Probably less than 5% of the time, but that's only an educated guess.
Putting it all together, I think your priorities are wrong: Most likely it would be best for you to be tested. The overall tone of your comments and questions shows that the possibility of herpes is weighing heavily on your mind. Most likely a test result would be negative, and that would be the best way by far to be relieved of those tensions. Even if positive, it won't be any more stressful than the uncertainty you now are experiencing; in general, fear of bad news is more stressful than the bad news itself. (Same deal with a mammogram in a woman who fears breast cancer.) Be clear: This does not mean I 'really' think you have herpes. I do not, and I do not recommend testing based on any symptoms you describe. I only suggest it because it's probably the best way to deal with your anxieties over the possibility.
Good luck-- HHH, MD
Related discussions
But I do agree... get the test done so you can stop stressing about it.