Aa
std help needed
male 240 pounds. no std's nor had sex with anyone but my wife in the past. Had possible std exposure 13 days ago with a stripper. She performed oral and also did some sort of sputtering or licking with her lips near or in my anal area. There was no protection.
2-3 days after exposure stinging/ burning in penis, burning when pee + urgency to pee. a day later started burning in anal area.
i saw dr on day 5. He gave me 1 suprax 400 and I believe 2 azithromycin totaling 1000.
I took tests that afternoon and then took pills. He took blood work for gonorrhea, Chlamdia, herpes and thats all i know.
day 13. i still have I stinging/ burning in penis and burning in anal area. anal looks red with some small pimples.
dr called me and said Gonor. and Chlam. were negative but herpes test showed initially positive but lab did further testing before final was negative. he has me coming back in 2 days and will do urethrea swab and culture of anal area then retested again in 30 days for herpes.
1 - was the 5 days enough to get accurate results for Gonor. and Chlamd. was a blood test good enough as opposed to a culture. should i no longer be concerned about G and C?
2 - he seemed concerned about the herpes . what is the likely hood it will show after 30 days and what test do i ask him to give me, for culture this week and followup in 30 days.
3 - im seeing him on thursday, can you list specific tests (whats need for gnu's,types of cultures) and other questions i should ask about to make sure i can get a better understanding of what i have and do not have. please also explain cultures/swabs vs what they look for in blood and whats more effective
4- what other stds should i be concerned about? GNU's, Hiv, syhplis etc
5 - i had scheduled urologist for friday. should i still go and let him know what tests my gp took? seeing him would be for the same reason im seeing my gp.
6 -if take more tests will they be accurate as i had antibotics day 5 .will they effect testing.
2-3 days after exposure stinging/ burning in penis, burning when pee + urgency to pee. a day later started burning in anal area.
i saw dr on day 5. He gave me 1 suprax 400 and I believe 2 azithromycin totaling 1000.
I took tests that afternoon and then took pills. He took blood work for gonorrhea, Chlamdia, herpes and thats all i know.
day 13. i still have I stinging/ burning in penis and burning in anal area. anal looks red with some small pimples.
dr called me and said Gonor. and Chlam. were negative but herpes test showed initially positive but lab did further testing before final was negative. he has me coming back in 2 days and will do urethrea swab and culture of anal area then retested again in 30 days for herpes.
1 - was the 5 days enough to get accurate results for Gonor. and Chlamd. was a blood test good enough as opposed to a culture. should i no longer be concerned about G and C?
2 - he seemed concerned about the herpes . what is the likely hood it will show after 30 days and what test do i ask him to give me, for culture this week and followup in 30 days.
3 - im seeing him on thursday, can you list specific tests (whats need for gnu's,types of cultures) and other questions i should ask about to make sure i can get a better understanding of what i have and do not have. please also explain cultures/swabs vs what they look for in blood and whats more effective
4- what other stds should i be concerned about? GNU's, Hiv, syhplis etc
5 - i had scheduled urologist for friday. should i still go and let him know what tests my gp took? seeing him would be for the same reason im seeing my gp.
6 -if take more tests will they be accurate as i had antibotics day 5 .will they effect testing.
MEDICAL PROFESSIONAL
I have nothing to add. The main part of my last response remains appropriate: "None of your symptoms suggests any STD. You don't need any more testing. Continue to visit your GP if your symptoms continue or you remain concerned, then follow his or her advice if s/he believes a specialist might help."
That will end this thread.
That will end this thread.
dr,
i was hoping you would answer this.
is there any bacterial or viral std that can produce the continued burning in both the anal and urethra. its on and off throughout the day and started a few days after the exposure.The reason i ask is it possible to have an ngu or other std that did not respond to the specific antibiotic that i was given and would have needed a different one.
i was hoping you would answer this.
is there any bacterial or viral std that can produce the continued burning in both the anal and urethra. its on and off throughout the day and started a few days after the exposure.The reason i ask is it possible to have an ngu or other std that did not respond to the specific antibiotic that i was given and would have needed a different one.
take you for your kind remarks, i do take them out of your compassion for helping and understand the position you are in in answering so many different questions. I also feel much better after hearing your words.
2 quick questions if you have the time and kindness to reply.
1 - i am interested in knowing if the reason you agree with my gp is that both igg and igm are now negative negative at 5 weeks or anotherreason? i was under the understanding that 5 weeks on the igg gave me a 60 or 70% negative and the igm decreases as time goes on, therefore could be gone by 5 weeks. i have read your many responses on those tests and think a response will not just help me but others that read these.( Also the breakout and rash I have early on was a concern to you)
2 - i had asked my gp last time if he felt anxiety could bring on or enhance what i'm feeling. while he said thats always possible his response was knowing my me and my past, he did not think that was the case in this situation. as i mentioned my gp is not really sure what to do now and thats why i asked your advice. with continued urethra and anal burning and soreness daily that started 2 days after this encounter (it's 2 months now), any other leads or suggestions I can bring to my gp would be Helpful.
(maybe one of the normal antibiotics that knocks stuff out that i was given, just didnt d it for my body and a different one needs to be tried?)or something else.
2 quick questions if you have the time and kindness to reply.
1 - i am interested in knowing if the reason you agree with my gp is that both igg and igm are now negative negative at 5 weeks or anotherreason? i was under the understanding that 5 weeks on the igg gave me a 60 or 70% negative and the igm decreases as time goes on, therefore could be gone by 5 weeks. i have read your many responses on those tests and think a response will not just help me but others that read these.( Also the breakout and rash I have early on was a concern to you)
2 - i had asked my gp last time if he felt anxiety could bring on or enhance what i'm feeling. while he said thats always possible his response was knowing my me and my past, he did not think that was the case in this situation. as i mentioned my gp is not really sure what to do now and thats why i asked your advice. with continued urethra and anal burning and soreness daily that started 2 days after this encounter (it's 2 months now), any other leads or suggestions I can bring to my gp would be Helpful.
(maybe one of the normal antibiotics that knocks stuff out that i was given, just didnt d it for my body and a different one needs to be tried?)or something else.
MEDICAL PROFESSIONAL
I agree with your doctor; you can now be sure you didn't catch herpes. You could not have caught any STD of the anal area from the exposure described. None of your symptoms suggests any STD. You don't need any more testing. Continue to visit your GP if your symptoms continue or you remain concerned, then follow his or her advice if s/he believes a specialist might help. I also suggest you ask your GP whether s/he believes some or most of your symptoms might be psychological, as a result of your anxiety about a sexual event that you regret. That's my best guess as to what is going on here. Counseling may be in order; I suggest it out of compassion, not criticism.
In any case, for sure you have no STD, and that's the only topic for this forum. Therefore, I won't have any further comments or advice. Good luck.
In any case, for sure you have no STD, and that's the only topic for this forum. Therefore, I won't have any further comments or advice. Good luck.
dr. H,
thank you for all you have done so far in helping me understand all of this.
i wanted to update and ask for further advice if possible.
i took to hsv igg 1 and 2 and another igm on june 20th, which was 5 weeks past encounter. all 3 tests i was told were negative. the dr said to me its definitely not herpes as the igm would be positive by now. I know from reading your posts that i do not believe is accurate as the you say to discount the igm. should i still do a final igg at 3 months?
it has been almost 3 weeks since that test. i still feel soreness and burning , on and off throughout the day from both my anal area and my penis(urethra). i did see a urologist who is going to do a cystoscope. he says that the burning and soreness in urethra would have nothing to do with the anal area. I find that hard to believe as each started together. he temporarily put me on pyridium which helps the pain in the urethra but i know this is only a temporary solution as it will not cure it.
i did have a nasty rash on my butt for a few weeks that went away that had some red pimply and had some whitish fluid at times. i did show to pics to gp was was unable to test as was no longer there when i saw him at 4 weeks.
1 - if something was obtained anally, like gon, sypl or herpes, would cultures down there be necessary or will blood work show it if i have it.
2 I have started to get extreme fatigue in the last 2 weeks. Is there a possibility that I could have caught hiv asi believe its a major symptom? the girl that performed oral and rimming/spitting in my anal was below me so i'm not sure if she did anything else. should i be tested fro that?
3) is it possible i need to try a different antibiotic as possibly my body was resistant to it.
4 - any other tests i should take for bacteria or viral, hiv, final herpes or others?
5- anything i can ask my gp or urologist. also should i see a gastro dr.
i'm really at a loss as to what to do and have no direction from my gp.
thank you for all you have done so far in helping me understand all of this.
i wanted to update and ask for further advice if possible.
i took to hsv igg 1 and 2 and another igm on june 20th, which was 5 weeks past encounter. all 3 tests i was told were negative. the dr said to me its definitely not herpes as the igm would be positive by now. I know from reading your posts that i do not believe is accurate as the you say to discount the igm. should i still do a final igg at 3 months?
it has been almost 3 weeks since that test. i still feel soreness and burning , on and off throughout the day from both my anal area and my penis(urethra). i did see a urologist who is going to do a cystoscope. he says that the burning and soreness in urethra would have nothing to do with the anal area. I find that hard to believe as each started together. he temporarily put me on pyridium which helps the pain in the urethra but i know this is only a temporary solution as it will not cure it.
i did have a nasty rash on my butt for a few weeks that went away that had some red pimply and had some whitish fluid at times. i did show to pics to gp was was unable to test as was no longer there when i saw him at 4 weeks.
1 - if something was obtained anally, like gon, sypl or herpes, would cultures down there be necessary or will blood work show it if i have it.
2 I have started to get extreme fatigue in the last 2 weeks. Is there a possibility that I could have caught hiv asi believe its a major symptom? the girl that performed oral and rimming/spitting in my anal was below me so i'm not sure if she did anything else. should i be tested fro that?
3) is it possible i need to try a different antibiotic as possibly my body was resistant to it.
4 - any other tests i should take for bacteria or viral, hiv, final herpes or others?
5- anything i can ask my gp or urologist. also should i see a gastro dr.
i'm really at a loss as to what to do and have no direction from my gp.
MEDICAL PROFESSIONAL
It's not helpful, and perhaps harmful, for you to speculate on "what if" either test gives a particular result and I won't play that game. When the results are available, your own doctor should be the main source for questions and advice. Then return here if anything seems unclear.
thank you for your kind reply. i just took the tests.
the one thing i was asking and hoping you would tell me from above #2 above is if I should be concerned that the new igm might stay be positive as opposed to the original igm which was done at 5 days and was positive then turned negative upon further testing since as it only had 5 days to build antibodies and more time would have given it more antibodies to stay positive or is that reasoning totally wrong. i'm worried as the igg's were negative so early igm detection is worrying me.
thank you and I hope for a quick reply.
the one thing i was asking and hoping you would tell me from above #2 above is if I should be concerned that the new igm might stay be positive as opposed to the original igm which was done at 5 days and was positive then turned negative upon further testing since as it only had 5 days to build antibodies and more time would have given it more antibodies to stay positive or is that reasoning totally wrong. i'm worried as the igg's were negative so early igm detection is worrying me.
thank you and I hope for a quick reply.
MEDICAL PROFESSIONAL
5 days was too soon even for IgM testing. 5 weeks is fine for IgG.
i just wanted to let you know that my doc has me going back for igm and igg tests today and will furnish results next week. i know you wanted to wait to answer any questions until the results came back but would you consider answering the following 2 minor questions especuially number 2 as i will be worring about it al weekend.
1 - you had recommended a 6 week test for igg. since this is at 5 weeks, would i need to take another one next week.
2 - the original igm was done at 5 days and was positive then turned negative upon further testing. was 5 days past possible exposure long enough to get the igm test done with accurate results or could the reason it wasnt fully postive was the igm needs more time than 5 days to get accurate results.
1 - you had recommended a 6 week test for igg. since this is at 5 weeks, would i need to take another one next week.
2 - the original igm was done at 5 days and was positive then turned negative upon further testing. was 5 days past possible exposure long enough to get the igm test done with accurate results or could the reason it wasnt fully postive was the igm needs more time than 5 days to get accurate results.
MEDICAL PROFESSIONAL
Herpes would not usually cause continuned "burning" of the urethra or anal area after this much time.
If you like, consider printing out this thread as a framework for discussion with your doctor, but beyond that I'm not going to speculate about what should or shouldn't be done or about how I would react if he suggests particular tests or treatment. Despite the problems with IgM testing, if it converted from negative to positive it would probably indicate a new HSV infection.
Feel free to let me know the outcome after he has examined you AND any additional test results are available, but I won't have anything more to say until then.
If you like, consider printing out this thread as a framework for discussion with your doctor, but beyond that I'm not going to speculate about what should or shouldn't be done or about how I would react if he suggests particular tests or treatment. Despite the problems with IgM testing, if it converted from negative to positive it would probably indicate a new HSV infection.
Feel free to let me know the outcome after he has examined you AND any additional test results are available, but I won't have anything more to say until then.
doc,
today is day 32 past ob. while im trying to wait 6 weeks and the symptoms has lessened from when they first started(they were real bad), the urethra and anus still constantly burn.
i called my GP(who is infectous disease also) who put me on his calendar for tomorrow. im a little concerned since he is going to want to do an igm test. i understand that they are unreliable but he stressed last time they can see early infection at this time.
1 - should i insist on another igg test if he takes an igm test?
2- is there anything else i should ask him to do ( other antibiotics? other specialists?)
3 - if he takes igm and it stays positive at this time should i assume i have herpes? please remember my 2 igg tests at 5 days and 21 days have been negative which shows i did not have it before, and my early igm test said positive and then negative on further analysis at day 5.
4- if he gives an antiviral drug to try, should i hold off until after 6 weeks so they dont effect testing?
one last thing, i saw a dermatologist last friday. the rash that i have now did not seem bad to him, but i showed him pictures of prior weeks rash and said , they could be herpes , but could not say for sure since the picture were not clear enough.
i'm sorry if this is confusing but my head is spinning. could u please help me with what to say to the GP from the questions above or anything else u can think of.
today is day 32 past ob. while im trying to wait 6 weeks and the symptoms has lessened from when they first started(they were real bad), the urethra and anus still constantly burn.
i called my GP(who is infectous disease also) who put me on his calendar for tomorrow. im a little concerned since he is going to want to do an igm test. i understand that they are unreliable but he stressed last time they can see early infection at this time.
1 - should i insist on another igg test if he takes an igm test?
2- is there anything else i should ask him to do ( other antibiotics? other specialists?)
3 - if he takes igm and it stays positive at this time should i assume i have herpes? please remember my 2 igg tests at 5 days and 21 days have been negative which shows i did not have it before, and my early igm test said positive and then negative on further analysis at day 5.
4- if he gives an antiviral drug to try, should i hold off until after 6 weeks so they dont effect testing?
one last thing, i saw a dermatologist last friday. the rash that i have now did not seem bad to him, but i showed him pictures of prior weeks rash and said , they could be herpes , but could not say for sure since the picture were not clear enough.
i'm sorry if this is confusing but my head is spinning. could u please help me with what to say to the GP from the questions above or anything else u can think of.
MEDICAL PROFESSIONAL
The numerical value of your HSV-2 result makes no difference as long as it's in the negative range, i.e. under 0.9. The apparent rise in the number is meaningless. (If the identical blood specimen were tested 10 times, it would give 10 different numbers -- especially if the tests were done with different batches of reagents.) Your negative blood test at 21 days is soft evidence against a new HSV infection; about half of newly infected people have positive results by that time.
1) I expect your new culture (whether for herpes or for various bacteria) to be negative.
2) The doxycycline has no effect on HSV, either by culture or blood test.
3,4) With the symptoms clearing up, I would advise sitting tight for now -- especially if they go away entirely. Have another HSV blood test at about 6 weeks (by which time 80-90% of new infections will give positive results); and if that's negative, a final HSV test at 3-4 months.
5) The symptoms, duration, and all other issues are identical for HSV-1 and HSV-2. Your symptoms say nothing about which virus type is the cause (if you have herpes at all).
1) I expect your new culture (whether for herpes or for various bacteria) to be negative.
2) The doxycycline has no effect on HSV, either by culture or blood test.
3,4) With the symptoms clearing up, I would advise sitting tight for now -- especially if they go away entirely. Have another HSV blood test at about 6 weeks (by which time 80-90% of new infections will give positive results); and if that's negative, a final HSV test at 3-4 months.
5) The symptoms, duration, and all other issues are identical for HSV-1 and HSV-2. Your symptoms say nothing about which virus type is the cause (if you have herpes at all).
Dear Doc, please help as I need further guidance.
my first igg test after 5 days were negative as stated above
hsv-1 .28
hsv-2 .09
i took another igg test after 21 days past OB
hsv-1 .28
hvs-2 .37
the culture the doc took were negative as he said too late to get good sample.
1 - i know this test is only 3 weeks from possible OB and that it could take a few more weeks to get fully accurate igg results but since hvs-2 jumped in just additional 2 weeks, from .09 to.37 should i assume the antibodies for hvs-2 are building up and numbers will continue to do so and turn positive?
2 -I have been on antibiotics. would that effect results?
3 - its a total of a 28 days past possible ob. my urethra and anus still burn, but less so. im not sure what to do next. what doctor(s)should i see or what else could it be other than herpes
4 or is my only option just waiting 2 - 3 months to take another igg test (and iss igg the only test i should take)
5 - is the initial primary breakout different for hsv1 vs hvs2?
I cant thank you enough for your help.
my first igg test after 5 days were negative as stated above
hsv-1 .28
hsv-2 .09
i took another igg test after 21 days past OB
hsv-1 .28
hvs-2 .37
the culture the doc took were negative as he said too late to get good sample.
1 - i know this test is only 3 weeks from possible OB and that it could take a few more weeks to get fully accurate igg results but since hvs-2 jumped in just additional 2 weeks, from .09 to.37 should i assume the antibodies for hvs-2 are building up and numbers will continue to do so and turn positive?
2 -I have been on antibiotics. would that effect results?
3 - its a total of a 28 days past possible ob. my urethra and anus still burn, but less so. im not sure what to do next. what doctor(s)should i see or what else could it be other than herpes
4 or is my only option just waiting 2 - 3 months to take another igg test (and iss igg the only test i should take)
5 - is the initial primary breakout different for hsv1 vs hvs2?
I cant thank you enough for your help.
doc,
i posted for u to see what tests were taken but they were only from 5 days after exposure. I assume that was too little time based upon what I have read on these boards.
based on you suggestion i went back to primary who i found out is also an infectous disease doc. last thursday to get cultures .he took a vcm cultures for herpes from the urethra and anus area. i realize that you wanted me to get them within 2 days of outbreak but i did not explain correctly to you that these were at least a week old. he did not think what he saw on anus at this time were herpes sores and while the urthera is extremely sore, the tip looks normal.
i also saw a urologist who gave me doxycline 10mg twice a day.
Its day 21 and inside my penis still hurts as does inside and outside the anus.
1 -i should receive the cultures back later this week or next. i assume if the are negative, there is no assurance of not having herpes but if positive i do. is that correct?
2 - is there anything else it could be that causes the burning in both the anus and penis 2 days or so after exposure and lasts at least 3 weeks beside herpes. i already tested negative for gonorrhea and Chlamdia .
3- when should i get retested? i am now on antibiotics for the next 12 days. will they effect testing if i retest for herpes. if so how long do i have to wait until after finshing them.
4- one issue i have with the doc is that he likes the igm test and said if i retest thats the one he would run again (hsvigm ab titer), which i hear is not accurate. should i also insist on igg herpeselects ab
5- lastly, if this is amherpes outbreak, whats the longest amount of time it normally runs for a first time OB.
thank you again for your time.
i posted for u to see what tests were taken but they were only from 5 days after exposure. I assume that was too little time based upon what I have read on these boards.
based on you suggestion i went back to primary who i found out is also an infectous disease doc. last thursday to get cultures .he took a vcm cultures for herpes from the urethra and anus area. i realize that you wanted me to get them within 2 days of outbreak but i did not explain correctly to you that these were at least a week old. he did not think what he saw on anus at this time were herpes sores and while the urthera is extremely sore, the tip looks normal.
i also saw a urologist who gave me doxycline 10mg twice a day.
Its day 21 and inside my penis still hurts as does inside and outside the anus.
1 -i should receive the cultures back later this week or next. i assume if the are negative, there is no assurance of not having herpes but if positive i do. is that correct?
2 - is there anything else it could be that causes the burning in both the anus and penis 2 days or so after exposure and lasts at least 3 weeks beside herpes. i already tested negative for gonorrhea and Chlamdia .
3- when should i get retested? i am now on antibiotics for the next 12 days. will they effect testing if i retest for herpes. if so how long do i have to wait until after finshing them.
4- one issue i have with the doc is that he likes the igm test and said if i retest thats the one he would run again (hsvigm ab titer), which i hear is not accurate. should i also insist on igg herpeselects ab
5- lastly, if this is amherpes outbreak, whats the longest amount of time it normally runs for a first time OB.
thank you again for your time.
MEDICAL PROFESSIONAL
The HSV IgM antibody tests are pretty much worthless. The bottom line is that your test show no evidence of infection with any STD. If you're interested in more information about HSV IgM tests, see the thread linked below. It's a few years old but still accurate.
http://www.medhelp.org/posts/STDs/Confusiion-over-other-IgM-Herpes-posts/show/248394
http://www.medhelp.org/posts/STDs/Confusiion-over-other-IgM-Herpes-posts/show/248394
i went back to dr today. he took a vcm culture of urethra and perianal area for herpes but wasnt much to see as its starting to feel better.
i'm not sure which is for what but
the results of my testing which was taken at day 5 were:
IN OUT OF REFERENCE
RANGE RANGE
rpr w/ titer + CONF RFX
RPR SCREEN NONREACTIVE NONREACTIVE
HSV1/2 IGG HERPESELECT
HSV 1 IGG HERPESELECT AB 0.28 0.00-0.89 INDEX
INTERPETATION NEGATIVE
HSV 2 IGG HERPESELECT AB 0.09 0.00-0.89 INDEX
THE ABOVE LABS WERE TBR
THE BELOW LAB IS AMD
HSV AB (IGM) W/REFL TITER
DETECTED
HSV IGM AB TITLER <1:10 <1:10
HE MADE IT SOUND LIKE WE HAVE TO WAIT 4 WEEKS AD TAKE THE .
WHY WOULD the HSV IGM AB SCREEN SHOW DETECTED but the HSV IGM AB TITLER NOT? IS IT the time framethe test was taken? is it likely that i have herpeshave herpes?
i'm not sure which is for what but
the results of my testing which was taken at day 5 were:
IN OUT OF REFERENCE
RANGE RANGE
rpr w/ titer + CONF RFX
RPR SCREEN NONREACTIVE NONREACTIVE
HSV1/2 IGG HERPESELECT
HSV 1 IGG HERPESELECT AB 0.28 0.00-0.89 INDEX
INTERPETATION NEGATIVE
HSV 2 IGG HERPESELECT AB 0.09 0.00-0.89 INDEX
THE ABOVE LABS WERE TBR
THE BELOW LAB IS AMD
HSV AB (IGM) W/REFL TITER
DETECTED
HSV IGM AB TITLER <1:10 <1:10
HE MADE IT SOUND LIKE WE HAVE TO WAIT 4 WEEKS AD TAKE THE .
WHY WOULD the HSV IGM AB SCREEN SHOW DETECTED but the HSV IGM AB TITLER NOT? IS IT the time framethe test was taken? is it likely that i have herpeshave herpes?
MEDICAL PROFESSIONAL
"ITG" doesn't mean anything to me, but "IgG" is a kind of blood test. If so, this information doesn't mean much one way or the other.
I think that should wind up this discussion until you have been reevaluated and/or additional test resuls are available. Until then, it's all speculation. Better to wait until you have a better idea what's going on.
I think that should wind up this discussion until you have been reevaluated and/or additional test resuls are available. Until then, it's all speculation. Better to wait until you have a better idea what's going on.
thank you for your detailed reply.
one thing i wanted to point out. the herpes test he told me was initially positive,but after more detailed anaylsis, which he says they do to after initial test show positive, it changed to negative - Is that normal? i think he called it itg test.
one thing i wanted to point out. the herpes test he told me was initially positive,but after more detailed anaylsis, which he says they do to after initial test show positive, it changed to negative - Is that normal? i think he called it itg test.
MEDICAL PROFESSIONAL
I missed the initial positive herpes report. Sorry.
HSV = herpes simplex virus, the cause of herpes. There are two types, HSV-1 and HSV-2. Although HSV-2 causes most genital herpes and HSV-1 is primarily oral (cold sores), HSV-1 can be transmitted to the genital area by oral sex. Here are some other threads that go into the differences between them:
http://www.medhelp.org/posts/STDs/Recently-diagnosed-with-Genital-Herpes-HSV1/show/969931
http://www.medhelp.org/posts/STDs/HSV-1--devastated/show/1159077
In the US, about half of all people are immune to genital HSV-1 because they previously had oral herpes. If your wife is in that group, there will be no danger of infecting her. If not, she could be susceptible. However, genital to genital HSV-1 transmission appears to be rare.
1) The sooner the better and it would be best if another PCR or culture could be done before Friday. Perhaps the office staff can do it even if the doctor isn't available until then.
2) Treatment would speed healing, i.e. help clear the urethral pain and anal irritation. It will get better on its own, but can take a couple of weeks. But if the symptoms aren't severe, it's up to you.
3) HSV-1 is explained above. Adenovirus is a common cold virus, but can be transmitted to the penis by oral sex. But adeno wouldn't cause the anal problem you describe.
4) You shouldn't worry about other STDs because anything other than herpes would have cleared up with the antibiotics you had. Even if you were exposed to other STDs, they are no longer a problem for you or your wife.
5) Positive PCR proves herpes. But a negative doesn't rule it out. In other words, a negative PCR would not prove you don't have herpes.
6) The doctors who most reliably understand herpes and other STDs are those in STD clinics (or GUM clinics, as they are known in the UK or commonwealth countries). Dermatologists are a good bet. Many family medicine, GPs, and gynecologists are well trained in STDs, but not all of them are. In the US, Planned Parenthood clinics are a good bet for both women and men.
In addition to the threads linked above, I suggest you go to three other websites for comprehensive information about genital herpes: the Centers for Disease Control and Prevention (www.cdc.gov/std); the Westover Heights Clinic of Portland, OR (www.westoverheights.com); and the American Social Health Association (www.ashastd.org).
HSV = herpes simplex virus, the cause of herpes. There are two types, HSV-1 and HSV-2. Although HSV-2 causes most genital herpes and HSV-1 is primarily oral (cold sores), HSV-1 can be transmitted to the genital area by oral sex. Here are some other threads that go into the differences between them:
http://www.medhelp.org/posts/STDs/Recently-diagnosed-with-Genital-Herpes-HSV1/show/969931
http://www.medhelp.org/posts/STDs/HSV-1--devastated/show/1159077
In the US, about half of all people are immune to genital HSV-1 because they previously had oral herpes. If your wife is in that group, there will be no danger of infecting her. If not, she could be susceptible. However, genital to genital HSV-1 transmission appears to be rare.
1) The sooner the better and it would be best if another PCR or culture could be done before Friday. Perhaps the office staff can do it even if the doctor isn't available until then.
2) Treatment would speed healing, i.e. help clear the urethral pain and anal irritation. It will get better on its own, but can take a couple of weeks. But if the symptoms aren't severe, it's up to you.
3) HSV-1 is explained above. Adenovirus is a common cold virus, but can be transmitted to the penis by oral sex. But adeno wouldn't cause the anal problem you describe.
4) You shouldn't worry about other STDs because anything other than herpes would have cleared up with the antibiotics you had. Even if you were exposed to other STDs, they are no longer a problem for you or your wife.
5) Positive PCR proves herpes. But a negative doesn't rule it out. In other words, a negative PCR would not prove you don't have herpes.
6) The doctors who most reliably understand herpes and other STDs are those in STD clinics (or GUM clinics, as they are known in the UK or commonwealth countries). Dermatologists are a good bet. Many family medicine, GPs, and gynecologists are well trained in STDs, but not all of them are. In the US, Planned Parenthood clinics are a good bet for both women and men.
In addition to the threads linked above, I suggest you go to three other websites for comprehensive information about genital herpes: the Centers for Disease Control and Prevention (www.cdc.gov/std); the Westover Heights Clinic of Portland, OR (www.westoverheights.com); and the American Social Health Association (www.ashastd.org).
will any of these cause possible infection to my wife deep kissing, me rubbing her vagina with my hand, or me performing oral. I am not planning on the last, but do want to know.
thank you again
thank you again
thank you for your kind reply. my gp did not originally look at my anal area as i did not mention that area to him as i was nervous when i saw him.
i did mention above that he said that he did take a herpes test and the results were weird "herpes test showed initially positive but lab did further testing before final was negative". I will find out on thursday which he did take along with all others he will take. I will bring your list with me.
1 - i have an appointment on thursday for my GP, the first day he is back in the office. Is this too late? i cant get any earlier.
2- why do u say to put me on the anti herpes drugs- what will that do?
3- what is HSV-1, or perhaps adenovirus ? and will i spread it to my wife. I have not told her anything, nor will i have sex with her till i know more.
4 - i see that u said dont worry about other std's, i believe this is based on my activity, but wouldnt herpes have been low risk also as i do not remember any sores. also by reading further, wouldnt i need stronger dose of azithromycin for syphilis?
5 " If the culture or PCR or negative, the next best diagnosis is a blood test that starts out negative and becomes positive in a few weeks. "
if pcr is negative, i assume that means i dont have it, and if its positive i do.,
in the second exampleif it starts out negative and turns positibve, that mean i have it. iare those correct?
6.since i didnt know and many others probably dont either, what doctor is the best to go to for std and specifically to determine herpes (gastro since its on anall area), and if see if i can get into him?
i look forward to your reply.
i will only comment again after thursdays appointment unless you need other info so not to bother you.
i did mention above that he said that he did take a herpes test and the results were weird "herpes test showed initially positive but lab did further testing before final was negative". I will find out on thursday which he did take along with all others he will take. I will bring your list with me.
1 - i have an appointment on thursday for my GP, the first day he is back in the office. Is this too late? i cant get any earlier.
2- why do u say to put me on the anti herpes drugs- what will that do?
3- what is HSV-1, or perhaps adenovirus ? and will i spread it to my wife. I have not told her anything, nor will i have sex with her till i know more.
4 - i see that u said dont worry about other std's, i believe this is based on my activity, but wouldnt herpes have been low risk also as i do not remember any sores. also by reading further, wouldnt i need stronger dose of azithromycin for syphilis?
5 " If the culture or PCR or negative, the next best diagnosis is a blood test that starts out negative and becomes positive in a few weeks. "
if pcr is negative, i assume that means i dont have it, and if its positive i do.,
in the second exampleif it starts out negative and turns positibve, that mean i have it. iare those correct?
6.since i didnt know and many others probably dont either, what doctor is the best to go to for std and specifically to determine herpes (gastro since its on anall area), and if see if i can get into him?
i look forward to your reply.
i will only comment again after thursdays appointment unless you need other info so not to bother you.
MEDICAL PROFESSIONAL
Welcome to the STD forum. Thank you for your question. I'll try to help. First some general comments, then I'll answer your specific questions.
Like your doctor, I am suspicious you have herpes due to HSV-1, or perhaps adenovirus. Gonorrhea or garden-variety nongonococcal urethritis (NGU) would have responded by now to the antibiotics you received, but viral infections are not affected by antibiotic treatment. Why exactly is your doctor "concerned about herpes"? The pimple-like lesions around the anus certainly seem consistent with herpes. Do you have anything like that, or blisters or other sores, of the penis or in the urethral opening?
I'm concerned that your doctor suspects herpes but apparently didn't test for it yet. I would recommend an immediate swab of your urethra and anal area to check for HSV -- preferably a PCR test, but at least a culture. Waiting several more days risks losing the chance. Although a blood test in a few weeks may sort it out, a PCR or culture is better. In addition, I would recommend you have an HSV blood test now, in addition to another test at about 6 weeks (not 30 days). If the culture or PCR or negative, the next best diagnosis is a blood test that starts out negative and becomes positive in a few weeks.
And I'm also concerned your doctor hasn't yet prescribed anti-herpes treatment. Treatment is only effective when started early, and the standard recommendation is to not wait for a positive test, but to start as soon as the diagnosis is suspected. The anti-HSV drugs are almost entirely without side effects, so no harm comes from treatment if herpes turns out not to be the problem.
Those comments answer questions 2 and 3. To the other questions:
1) Five days is plenty of time for accurate gonorrhea and chlamydia testing. You can be sure you have neither one. (Chlamydia almost never occurs after oral sex anyway.)
3,4,6) At this point I don't recommend any further testing except for HSV as noted above. Based on the tests so far and the treatments you had, you need not worry any longer about NGU, syphilis, or other STDs. If you had them, the antibiotics would have worked and future tests will be negative.
5) I doubt a urologist would add anything at this point. However, if you contact your primary doctor and request immediate HSV testing and a prescription for an anti-herpes drug, as I suggested above, and he isn't interested in doing so, then the urologist might be a good bet.
Please post a follow-up comment and let me know how this all turns out. Whether you return immediately to your current doctor or see the urologist, consider printing out this thread as a framework for discussion.
Good luck-- HHH, MD
Like your doctor, I am suspicious you have herpes due to HSV-1, or perhaps adenovirus. Gonorrhea or garden-variety nongonococcal urethritis (NGU) would have responded by now to the antibiotics you received, but viral infections are not affected by antibiotic treatment. Why exactly is your doctor "concerned about herpes"? The pimple-like lesions around the anus certainly seem consistent with herpes. Do you have anything like that, or blisters or other sores, of the penis or in the urethral opening?
I'm concerned that your doctor suspects herpes but apparently didn't test for it yet. I would recommend an immediate swab of your urethra and anal area to check for HSV -- preferably a PCR test, but at least a culture. Waiting several more days risks losing the chance. Although a blood test in a few weeks may sort it out, a PCR or culture is better. In addition, I would recommend you have an HSV blood test now, in addition to another test at about 6 weeks (not 30 days). If the culture or PCR or negative, the next best diagnosis is a blood test that starts out negative and becomes positive in a few weeks.
And I'm also concerned your doctor hasn't yet prescribed anti-herpes treatment. Treatment is only effective when started early, and the standard recommendation is to not wait for a positive test, but to start as soon as the diagnosis is suspected. The anti-HSV drugs are almost entirely without side effects, so no harm comes from treatment if herpes turns out not to be the problem.
Those comments answer questions 2 and 3. To the other questions:
1) Five days is plenty of time for accurate gonorrhea and chlamydia testing. You can be sure you have neither one. (Chlamydia almost never occurs after oral sex anyway.)
3,4,6) At this point I don't recommend any further testing except for HSV as noted above. Based on the tests so far and the treatments you had, you need not worry any longer about NGU, syphilis, or other STDs. If you had them, the antibiotics would have worked and future tests will be negative.
5) I doubt a urologist would add anything at this point. However, if you contact your primary doctor and request immediate HSV testing and a prescription for an anti-herpes drug, as I suggested above, and he isn't interested in doing so, then the urologist might be a good bet.
Please post a follow-up comment and let me know how this all turns out. Whether you return immediately to your current doctor or see the urologist, consider printing out this thread as a framework for discussion.
Good luck-- HHH, MD
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.
