Worried about herpes

[Worried -999]

4 weeks ago I received unprotected oral sex from a stripper, and also kissed her on the mouth. The encounter lasted probably around 5 minutes total. I did not notice any sores on her mouth at the time. I went to the doctor 3 days later and got tested for herpes. The results said that I had herpes in the past, but not currently, and they did not say which type. I realize that it takes 3-4 months to be truly positive.
About two 12-13 days after the encounter my urethra became red and seemed somewhat swollen, and sort of tingled/burned, my face also became very itchy and tingled. I looked like 3-4 tiny white bumps were on the bottom side of the tip of my penis. This really freaked me out so I set an appointment to see an urologist to get a visual exam. I was not able to see him until about 6 days after the redness, bumps showed up. By this time the redness and bumps had all but gone away. The urologist looked at my penis and said he did not see anything out of the ordinary. This put my mind at ease until yesterday, 12 days since I first noticed the redness, 24 days after the incident. The redness and tiny white bumps seem to have come back, and when I had an erection there was a larger white colored spot that also appeared near the tip of my penis. I went to the bathroom to inspect and it looked like the white spot was still there but I could barely see it since the erection was gone. I am very concerned because I dont want to pass anything on to my girlfriend if I have something.

1. The test at day 3 said I had herpes in the past. Would this have made me immune to getting it in the future?
2. How likely is it that the stripper had HSV-2 and passed it on to my genitals?
3. This is now day 13. The redness and bumps seem to come and go, or at least at times they seem to be more visable, such as when I have an erection. The bumps never crusted or turned red. Does this sound like herpes?

[H. Hunter Handsfield, M.D.]

There is a risk of herpes but statistically unlikely for any single such exposure.  And your symptoms definitely are not typical.  So for you to have genital herpes, two very unlikely scenarios both have to be true--which is statistically very unlikely.  (To get the risk of 2 unlikely outcomes, you multiply them:  if there were a 1% chance you caught herpes and a 1% chance your symptoms were due to that, 0.01 x 0.01 = a 1 in 10,000 chance your have it, a very long shot indeed.)

What I don't understand is why your doc didn't tell you the HSV type on your positive blood test.  If it was positive for HSV-1, then herpes is impossible as a cause of your symptoms, so just knowing that test result likely would end all concern.  Half the population has HSV-1 from childhood (with or without a history of oral herpes), and people are immune to catching the same virus type at any body site.

The direct answers to your questions are:

1) See above.

2) Oral HSV-2 is rare.  There is no realistic chance of catching HSV-2 from oral sex.

3) The sort of bumps you describe do not sound like herpes.  HSV lesions progress from red bump to clear fluid-filled blister to sores to scabs to healing, all over 7-14 days.  Sound to me like you are overly alert to some sort of variation on normal skin bumps and irregularities.  Or maybe a superficial fungal infection.  Or any of a hundred other garden variety skin conditions.

Your urologist may be very good, but dermatologists generally are better choices for diagnosis of uncertain skin conditions, including the genital area.  Consider seeing a derrmatologist if you are convinced that something abnormal is going on.  But herpes is not the likely answer.

Good luck--  HHH, MD

[scaredsenseless111]

But I went through your exact experience and am at day 25.  To answer your questions as I know them:

1.  Did the test differentiate b/n Herpes 1 or 2?  If you had herpes 1 prior to this, you are immune, or highly resistant, to HSV-1 genital.  

2.  Rare.  HSV-2 can be in the mouth, but very uncommon.

3.  No.  You should expect them to be fluid filled, scab over in 2-3 days, and take 2-3 weeks to heal.  Them coming and going does not sound like herpes.

Ready my question and his answer.  It is on the first page.  I am over my herpes scare and now on the HPV scare, although I'm letting it go.  Hopefully the doc will see fit to answer my last questions.  

Good luck

[Worried -999]

I went to the Dermatologist, he was not available for a while so I saw the Physician's assistant. He looked at the bumps and was confused. He said it was possible they were herpes but because they were so small he could not tell. He gave me a prescription for acyclovir and told me to come back in two weeks and see the doctor if nothing has changed. I also called my GP back and asked for specifics of the blood test that was done. They said the results did not say type 1 or 2, only gave me the igg which was 1.40 for HSV 6.

I read somewhere in another thread that you said the initial infection can sometimes exist 3-4 weeks and may not necessarily produce sores the first time. I have had the bumps for over two weeks now. They are skin colored or white, and have darker rings around the outside. They are very small, but there are about 3-4 together. They never scabbed or anything pretty much have not changed for the 2+ weeks they have been there.

1.Would an initial infection produce bumps that stay around for over 2 weeks with out scabbing?
2.Today I noticed my urine was cloudy. Would the acyclovir cause this?
3.Is acyclovir an effective treatment?
4. What do you make of the igg results?

[Worried -999]

Last time I'll post here, but can you please respond to my previous questions?

Going on almost 3 weeks now and the original bumps are still there, as far as I know have not blister, crusted, healed. Looks like some new bumps have appeared. I have poked at them at there does not seem to be any pain, maybe a slight irritation. Could that be because this is a first time infection? Also, been on acyclovir for six days now and that has not changed anything either. I wont post again, what do you make of all this?

[H. Hunter Handsfield, M.D.]

All the evidence is overwhelmingly against hepres. You don't have it.  Follow your providers' advice about the acyclovir, but I see no reason for you to continue taking it.  Return to your own provider(s) if your penile bumps continue to concern you.  Next time you probably should insist on seeing the dermatologist and not the PA.

[valetudo]

its weird to see these forums and see so many people who are convinced/worried they have herpes over such a small statisticaly chance.

especially when it comes to oral sex which is even smaller than the genital to genital risk


a lot of you guys need to chill out and relax a bit.  unless you get overt sores than you really shouldnt be worrying after getting oral sex from somebody who doesnt have a sore/blister on the mouth.

at least in my situation i actually had unprotected sex w/ somebody who is hsv 2 pos and thats why im worried(should find out test results in 2 days)  but even then she was on valtrex, no outbreak at the time and my igg at 5 1/2 weeks was negative(which i would think is at least a bit re-assuring)

so chill out guys, if you had oral sex there is a damn good chance you DONT have it. if you are having non-lesion symptoms than its probably something else

[Worried -999]

6 weeks after this incident I had an HIV test done just for peace of mind, which of course was negative. I was wondering if me taking the acyclovir 1 week prior would have had any impact on the test results. I was thinking about testing once again just to be 100% sure so I can get my mind off this.

[H. Hunter Handsfield, M.D.]

Your negative HIV test (which you really didn't need at all) was valid.  No medication or health condition changes HIV test results, with the uncommon exceptions of potent chemotherapy or life threatening conditions like terminal cancer.  Search the HIV forum for extensive discussion about it.