hsv ?

[alm38]

Dear Dr, Been on  forum previously.  On 6.13.11I had unprotected oral sex. Thereafter I had symptoms fever, aches, fatigue, sore throat,  sore gums (continuing), sore in mouth ( continuing). I
had STD panel done as follows:  all blood tests negative expect HSV1 = 450, HSV2 <98, Gon, Cham and Syph tests negative..  You said I should see my physician.  I did.  He could not find any signs of STD.  A few weeks later, I developed a small red bump with a very small puss bag on the right lip of my penis.  I was referred to a urologist who could not verify what I saw. He took Gon and Chlam. urine tests. Both negative.  I also developed a clear discharge from my penis. At one point, there was blood in the discharge.  He did a cystoscope.  Negative. Because of enlarged prostate,  he prescribe Cipro. Burning urinary sensation, discharge and red bump with puss continues. The red penile bump occurs during and after erection.  At other times, it doesn't seem to be there. I,. then developed clear discharge from anus with constipation.  Referred to gastro, who put me on cortisone suppositories. He found some skin tags and hemroids.  Went back to uro for penile problem.  He said it takes months to resolve this problem.  He asked me to read book "Headaches In Pelvis."  I have been seeing a counselor who has been helpful.  Uro put me on Elavil 0.8.  Have been on it for several months. Recent  routine blood tests-all
excellent: Liver, Cholesterol and Sugar.  Now have to have a colonoscopy.  I am very concerned about it since I have read on internet that anal symptoms I am having could be caused by herpes.  This has been a long haul for me. I a very concerned about infecting my family ( wife, daughter, son--in-law, granddaughter ( 4 and 5 ).  Primary and uro suggested that I not say anything about std ( herpes) to my wife.  I have not.  But, I now fear that if the
colonoscopy finds herpes that I have a tremendous burden.  Please give me your take on all of this.  admire your .  

[alm38]

Thanks again, Dr. Hook.  Much appreciated
Have a nice day.

[Edward W Hook, MD]

No, this would not explain the wetness either.  I anticipate that the flaturlence and wetness is unrelated to your interaction with the masseuse.  You should discuss it with you doctor. EWH

[alm38]

Good Morning, Dr. Hook -  After reading your last comment about contact location for herpes,  I recall that when the masseuse was giving me oral she also fingered me anally.  Could this explain the problem of anal wetness and discharge as well as flatulence that I am having.  Thanks again for your advice.

[alm38]

Thanks, Dr. Hook for your rapid reply.  I very much appreciate your
reassurance.  It has been tremendously helpful in my understanding of
what is going on.  Hope you have a very nice day !

[Edward W Hook, MD]

This question appears unrelated to your ealier question or problem.  Certainly flatulence is not a sign of HSV (at any location).  Further, when HSV occurs, it does so at the site of contact, thus your oral sex experience wold not lead to rectal problems of any sort.  I suspect your flatulence is related to some other cause.  EWH

[alm38]

Good Morning, Dr. Hook,
I have developed increasing flattulence with clear anal discharge.  I have a wet feeling around the anus. What can this be a symptom of ?  I had a discussion with my PCP.  He said that my HSV-1 positive result could be an old infection or a new infection ( 6/13/11).  He said it is possible for me to have caught HSV-1 from the oral sex I experienced.  Could you comment on this for me?  I plan on scheduling a colonoscopy as soon as
I have a cataract removed on Wednesday.  Look forward to hearing from you.  Many Thanks.

[Edward W Hook, MD]

Glad to help. EWH

[alm38]

Thank you for your very clear and straight-forward advice.  I very much appreciate it.  I hope you have a very nice day.  I'll let you know what happens with the colonoscopy.   ALM

[Edward W Hook, MD]

There is no reason for you to discuss your condern about HSV with your GI doctor.

Your results inidcate that you, like most Americans have antibodies to HSV-1, the virus that casues cold sores and that htere is no antibody evidence of HSV-2 infection.  I see no reason for you to use condoms with your wife.  EWH

[alm38]

One other comment, Dr. Hook.  I have the appointment to discuss the colonoscopy on Monday, June 11 at 4 PM.  Could you possibly get back to me before that time with regard to the question I posed in my previous comment to you.  Thanks so much !

[alm38]

Thanks for your re-assuring advice.  I believe my previous ID info on Medhelp was "alm" or ***@**** knollwood 913.  Should I reveal any suspicion of herpes to my gastro md or just describe symptoms of clear anal discharge, contstipation and hard stools ?  I don't mean to unload my concerns on you but I am very confused by a good deal of all that is going on.  The tests were done by Lab Corp and are HSV 1 IgG Type Specicific Result = positive 4.51 HIGH; hsv 2 tYPE sPECIFIC SULT nEGATIVE <0,91; hiv, GON, cHAM, SYPH = NEGATIVE. Another item is
that my urologist said that it is rational for me to use a condom with my wife. He said this in the context of telling me that it is not rational for me to worry about spreading herpes to my grandchildren but is rational for me to use protection with my wife.  You should also know that I am a 74 yr. old man.Thanks for the time you are spending on this for me.

[Edward W Hook, MD]

In the meantime, I have a number of comments.

I suspect you may not have genital herpes.  Oral sex is not a frequent route of getting herpes and from what you tell me, it sounds as though you have not ha a typical HSV outbreak.

The symptoms you describe really are not suggestive of herpes.  The internet is full of mis-information about herpes an can be quite misleading.  I suspect that your urologist and PCP do not think that you have herpes either; if they did, they would have suggested that you inform your wife.  

I also cannot interpret the herpes antibody tests that you have.  These are not the sort of values we typically see with type specific tests such as the HerpeSelect so I cannot use this information either.

Finally, I can assure you that herpes virus infection would not be detected on a colonoscopy so this should not concern you.  Further, nothing you have described suggests that any of your family members are at risk for acquisition of HSV from you, in large part because I doubt that you have herpes.  If you did, presuming that your wife is your only sexual partner, no one else would be at risk of infection.  HSV is ONLY spread from person to person through direct contact.

I hope these comments are helpful to you.  Please o not worry and I suspect that continuing to discuss these concerns with your counselor is amongst the most important things you could do to address them.  EWH

[Edward W Hook, MD]

Could you please provide your previous sign on anme.  The previous interaction will help me to adress your concerns.  EWH