STDs Expert Forum
want to rule out herpes
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The STD Forum 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.

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want to rule out herpes

I had a sexual encounter with another male. There was genital contact but no penetration.  About 2 weeks after I noticed itching and burning, especially at night. I went to an STD clinic and tested negative for STD's.  The symptoms worsened. I went to my doctor when I got back from traveling.  She did a viral culture on a healing scab. It came back negative, but I was told cultures from healing sores (if it was GH) were not reliable.  I was referred to a dermatologist. He diagnosed me with scabies.
Then marks on my penis came back. They did not have any discharge or blister, so I went back to the health center at the University I attend. I was referred to another dermatologist.  He said they were cysts and gave me steroid cream and antibiotic. The cysts have since faded.  
I had a iGG blood test for HSV1HSV2 after 5.5wks which both came back negative. IGM also neg.  I now have a lesion on the left side of my testicle, in the same place as previous lesion.  It was more like a lump which turned into raw skin that had some discharge (different than the the lesions on the shaft of my penis) It has now scabbed over. He reassured me with the test results in hand that 5 1/2 wks were plenty of time for antibodies to show.
Over the past week, since i have had that lesion on my scrotum-I have had pain on the entire left side of my body. The pain runs up and down my leg into the arch of my foot and up the left side of my back into my neck.  
I recognize I have every indication to believe this is not hsv2, but I remain skeptical. I have read that HSV2 tests should be performed between 10-12 weeks.Should I consider being tested again?  Please advise on retesting, if an individual with scabies and HSV2+ would more easily transmit the HSV virus,and how long/accurate Igg type specific tests results), also would antibiotic treatment hide antibodies to the virus, is it possible/how common HSV infections in the scrotal area, and is it easier for gay males to get HSV.
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As you point out, there is little reason to think or even suspect that this is herpes.  Receiving antibiotics will not hinder development of antibodies to herpes in any way.  while I cannot give you a clear explanation for the pain that you have experienced, I feel comfortable that it is not related to the herpes infection that you are worried about but that there is no evidence of.

As for additional blood testing, it can take as long as 6 months for all persons with HSV to develop antibodies.  At the same time, the vast majority of infections will have positive blood tests by the 5-6 week period when you were tested.  I hope this is helpful.  While you are waiting for the 6 month time for a repeat blood test (which I doubt is needed) if the lesions of concern should reappear, get a culture or even better, a PCR test as quickly as possible after they appear.  If it is HSV, these tests should be positive.  EWH
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H. Hunter Handsfield, M.D.Blank
University of Washington
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