what to do

[dumas]

hi i have a few questions. about 2 months ago i had a threesome with a girl that i know and her friend who i just met. while we were having sex i used a condom on the girl i just met but not on my friend. i performed oral sex on both, they both performed oral on me. a day and a half later i noticed the head of my penis had red spots that were not blisters and didnt hurt and on my pubic hair region had some red spots that eventually got puss and looked like pimples. i went to the doc, she looked at me and said that it doesnt look like herpes. my penis head didnt hurt, itch, or cause any discomfort nor did my pubic hair region. she gave me a gono and chlamidia test, both neg. she also gave me a herpes blood test came back pos. she said that the red spots on my pubic region could have been caused by the friction during sex, I trimmed my hair very low during that time, and that the girl might have had a yeast infection at the time,posible cause of the red spots on my penis head. after both symptoms cleared up about 1 to 2 weeks later i have had nothing show up on my penis head or the hair region.  earlier this week i though i felt a slight burning on my left side were the thigh meets the scrotum. and later notice 2 small blisters, during my first episode 2 months back there was nothing there,i freaked and popped them. they did not hurt or cause any discomfort and are now healing. As far as the test goes it was not type specific but i can remember having 1 or 2 cold sore when i was younger. I was doing fine for the last month and a half but these two new blister made me worry again what should i do
My questions are
1)IF i have hsv 2 from one of the girls why dont i get symptoms on my mouth if i performed oral on both of them.
2)DO herpes blister ALWAYS hurt or GENERALLY hurt because the last two on my groin i dont even feel them
3)should i go back and get tested again and if so what is the best test available. ( i asked for a culter the first time i went to the doc, she said there is nothing for her to culture, no open sores just red spots)
4)the doc said that i may have been exposed to herpes but not contracted it during that time, can you explain that to me
5) do you think that my constant worry might make my head "play tricks on me" and make me feel things that are really not there.

Thank you doc,

[H. Hunter Handsfield, M.D.]

New herpes symptoms cannot show up in less than 2 days after exposure; usually it's 3-5 days.  So the red spots you describe were not new herpes, and probably not related at all to the sexual events you describe.  In other words, if those spots were herpes, it was a recurrent infection.  Further, it takes several weeks for a herpes blood test to become positive.

But I'm not at all certain the red spots were herpes at all.  Genital herpes usually involves the genitals, not the pubic area.  In hairy areas, red bumps that develop pus and "look like pimples" usually are folliculitis or other bacterial infection.

However, you don't provide enough information about the herpes blood test.  If it was a truly type-specific test, such as the HerpeSelect test (and especially if it wasn't an IgM test), and if it was positive for HSV-2, then clearly you have genital herpes--whether or not that explains the red spots.  But then you go on to mention "these two new blister[s]".  What's that about?  Where?  Blister-like lesions do indeed suggest herpes.

To your questions:

1) You did not catch herpes from either of the women you describe.

2) Herpes lesions often are painless.  Herpes in men usually does not occur in the groin; mostly on the penis.

3) See my comments about which blood test was done.  If it was the right kind of test and was positive for HSV-2, there is no reason for further testing.  Check with your doc about the details of the test.

4) You either misunderstood your doc, or she doesn't understand herpes testing.  There is no such thing as being exposed but not infected.  If the test is positive, you have it.

5) I cannot judge which of your symptoms might be physcial versus psychological.

I hope this helps.  Best wishes--  HHH, MD

[dumas]

thanks doc for the reply.
these 2 blisters occured where the leg and groing meet right on the fold of the skin. and i believe the test was not type specific

[H. Hunter Handsfield, M.D.]

Then you need a type-specific test.  The non-type-specific ones are useless.  In particular, they do not distinguish between HSV-1, which most people have anyway, and HSV-2, the usual cause of genital herpes.

Genital herpes lesions do not commonly occur in the groin.

HHH, MD