Aa
test data so far
OK, here are the facts to date.
No acyclovir taken, that has not taken place.
-single exposure vaginal and oral hetero sex
-Partner tested positive IgG for HSV 2, negative for HSV 1
-I tested positve for HSV 1 IgG (2.59), neg for HSV 2 IgG on day 16 post exposure
-tested neg. for IgM HSV 1/2 on days 23 and 30 post exposure
-developed perianal rash with no vesicles day 30 post exposure, dr. said rash did not look like herpes, treated with fluconazole due to prolonged ab therapy for another problem, no anal sex was performed during exposure
-tested positive for HSV 1 IgG (2.6), neg for HSV 2 on day 34 post exposure
-no other lesions penile or otherwise to date
I know the "gold standard" is to re-test fo HSV 1 / 2 IgG at 12 -16 weeks.
How would you inerpret my data to this point?
No acyclovir taken, that has not taken place.
-single exposure vaginal and oral hetero sex
-Partner tested positive IgG for HSV 2, negative for HSV 1
-I tested positve for HSV 1 IgG (2.59), neg for HSV 2 IgG on day 16 post exposure
-tested neg. for IgM HSV 1/2 on days 23 and 30 post exposure
-developed perianal rash with no vesicles day 30 post exposure, dr. said rash did not look like herpes, treated with fluconazole due to prolonged ab therapy for another problem, no anal sex was performed during exposure
-tested positive for HSV 1 IgG (2.6), neg for HSV 2 on day 34 post exposure
-no other lesions penile or otherwise to date
I know the "gold standard" is to re-test fo HSV 1 / 2 IgG at 12 -16 weeks.
How would you inerpret my data to this point?
Your killin' me Doc! (figuratively)
MEDICAL PROFESSIONAL
My, what a wise doctor!
Follow up visit for rash with physician today. 50% resolved, no fissures, no vesicles, in short nothing to culture. Rx nystatin / triamcinolone ointment. His advice, like yours, "get over it, move on, test at 3 months if you need to".
You win. I accept. That's why your a Doctor and I'm not. : )
Thanks again!!
Thanks again!!
MEDICAL PROFESSIONAL
Same conclusion. 4+ weeks is much too late for first symptoms of a new HSV infection. Also, for an HSV infection to "take", the virus generally must be massaged into the affected area. That's why initial genital herpes symptoms almost always occur at sites of maximum friction during sex -- penis in men, labia minor and vaginal opening in women. Recurrent outbreaks can occur in a relatively widespread area from upper thighs to lower abdomen, including anus, but that doesn't apply to the initial outbreak.
So please accept the overwhelming evidence that you don't have herpes. You really shouldn't be at all concerned at this point.
So please accept the overwhelming evidence that you don't have herpes. You really shouldn't be at all concerned at this point.
The rash actually APPEARED at day 30 (a week ago) and is 50% better today at day 37 but still present........same conclusions? Going to have the rash re-checked tomorrow by the way.
I understand "long distance diagnosis", and really appreciate and respect your opinions.
Thanks again.
I understand "long distance diagnosis", and really appreciate and respect your opinions.
Thanks again.
MEDICAL PROFESSIONAL
That your rash is "lingering" this long is itself strong evidence against herpes. Although initial herpes oubreaks last longer than recurrent ones, 30+ days is far too long. If it were herpes, you would been asymptomatic by a couple of weeks ago.
Of course no distant online source can guarantee you didn't catch HSV-2. If you did, however, it is asymptomatic and unrelated to your perianal rash. But the odds are very low, and if I were in your situation, I would continue unprotected sex with my wife with no fear about transmitting herpes. Indeed, I would have resumed sex with her before now, probably around 10-14 days after the other exposure.
Of course no distant online source can guarantee you didn't catch HSV-2. If you did, however, it is asymptomatic and unrelated to your perianal rash. But the odds are very low, and if I were in your situation, I would continue unprotected sex with my wife with no fear about transmitting herpes. Indeed, I would have resumed sex with her before now, probably around 10-14 days after the other exposure.
Thanks Dr. Handsfield. Yes, I have been seeing my regular physician for the rash. After 5 days of fluconazole it is 50% better but still lingering, (part of my concern).
And yes, I have fallen into the "testing trap". During this time of high anxiety and uncertainty it provides the illusion that you are working towards a solution.
One more question then I'll let it drop. What about unprotected sex at this point in time, with this information? That is of course with a significant other that has never been exposed.
And yes, I have fallen into the "testing trap". During this time of high anxiety and uncertainty it provides the illusion that you are working towards a solution.
One more question then I'll let it drop. What about unprotected sex at this point in time, with this information? That is of course with a significant other that has never been exposed.
MEDICAL PROFESSIONAL
Welcome to the STD forum.
I reviewed your discussion with Terri on the herpes forum. I agree with her judgment and advice: even before the current test results, herpes was a very unlikely explanation for your symptoms. I would also add that the nature of your exposure -- described on the herpes forum but not here -- was one of low risk for herpes, since it was only a single exposure. With an HSV-2 infected partner, the per-exposure transmission risk probably is in the range of 1 in several hundred to a couple thousand. And as Terri said, your peri-anal symptoms didn't suggest herpes, both because of the location (as she told you) and the description of them. And you had an obvious alternative explanation, i.e. the antibiotics that may have triggered a yeast infection.
The additional data provided here further support the conclusion you didn't catch HSV-2. You have been quite over-tested; most likely you are doing it on your own (e.g. through an online lab?). The IgM testing in particular was a waste. Despite the standard advice that it is supposed to detect infection earlier than IgG antibody, it actually doesn't do so. And it gives lots of false positive results -- even if one of thsoe results had been positive, it would have been confusing and upsetting, without helping determine whether you actually were infected. FYI, here is a thread that discussed HSV IgM testing in detail; it's 4 years old but still accuarate: http://www.medhelp.org/posts/STDs/Confusiion-over-other-IgM-Herpes-posts/show/248394
However, the HSV-2 IgG result is reassuring. Around 70-80% of new HSV-2 infections would produce positive results by 5 weeks (34 days).
From a purely medical standpoint, I see no need for any additional testing. In my opinion, you can be completely certain you didn't catch herpes and that you had some other cause of your peri-anal rash/irritation, likely a yeast infection related to antibiotic treatment. (Did you seek professional attention and diagnosis? If your symptoms are continuing, you still should do that.) However, if you remain concerned about herpes, i.e. if you need the additional reassurance of a definitive blood test result, go ahead with your plan for a final IgG HSV-2 antibody test 3-4 months after the exposure. For sure stop wasting money on IgM tests.
I hope this helps. Best wishes-- HHH, MD
I reviewed your discussion with Terri on the herpes forum. I agree with her judgment and advice: even before the current test results, herpes was a very unlikely explanation for your symptoms. I would also add that the nature of your exposure -- described on the herpes forum but not here -- was one of low risk for herpes, since it was only a single exposure. With an HSV-2 infected partner, the per-exposure transmission risk probably is in the range of 1 in several hundred to a couple thousand. And as Terri said, your peri-anal symptoms didn't suggest herpes, both because of the location (as she told you) and the description of them. And you had an obvious alternative explanation, i.e. the antibiotics that may have triggered a yeast infection.
The additional data provided here further support the conclusion you didn't catch HSV-2. You have been quite over-tested; most likely you are doing it on your own (e.g. through an online lab?). The IgM testing in particular was a waste. Despite the standard advice that it is supposed to detect infection earlier than IgG antibody, it actually doesn't do so. And it gives lots of false positive results -- even if one of thsoe results had been positive, it would have been confusing and upsetting, without helping determine whether you actually were infected. FYI, here is a thread that discussed HSV IgM testing in detail; it's 4 years old but still accuarate: http://www.medhelp.org/posts/STDs/Confusiion-over-other-IgM-Herpes-posts/show/248394
However, the HSV-2 IgG result is reassuring. Around 70-80% of new HSV-2 infections would produce positive results by 5 weeks (34 days).
From a purely medical standpoint, I see no need for any additional testing. In my opinion, you can be completely certain you didn't catch herpes and that you had some other cause of your peri-anal rash/irritation, likely a yeast infection related to antibiotic treatment. (Did you seek professional attention and diagnosis? If your symptoms are continuing, you still should do that.) However, if you remain concerned about herpes, i.e. if you need the additional reassurance of a definitive blood test result, go ahead with your plan for a final IgG HSV-2 antibody test 3-4 months after the exposure. For sure stop wasting money on IgM tests.
I hope this helps. Best wishes-- HHH, MD
MEDICAL PROFESSIONAL
I knew that.
I forgot to mention partner was definitely asymptomatic at time of exposure.
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.
