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Herpes Community
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Conflicting Advice from GUM Clinic Doctors
by Concern_D, Mar 26, 2008 09:12AM
I had foolish drunken intercourse with a SW (unprotected oral on her, protected oral on me, protected intercourse, although condom slipped off at end - unsure if intact due to drunken state - there was also unprotected masturbation).
Around 10 days later I noticed an unusual 'rash' - many small red spots on glans and under foreskin of penis. No pain, but some itching in general groin area. Over the next two days I noticed that one or two of the spots appeared to have ulcerated and I went to a private GUM clinic the next day. The doctor who examined me (Doctor A) said that the lesions looked quite small, but that the most likely cause was HSV. He then took a PCR swab (from within the urethra - ow! And he says, he also took a swab from the lesions). He gave me Aciclovir, which I took (5 per day for 5 days) and the sores cleared up after a further three days.
Thankfully the test results came back negative. So, I breathed a sigh of relief and assumed it was just a bizarre coincidence. Then, I began to have splitting headaches for almost a week and one morning I woke up with a burning sensation on one side of my groin. Approximately 2 weeks after the initial lesions had gone I then found to my horror that there were new ones on the glans and foreskin. This time they were more scattered and less of them. There was also one right on the opening of the urethra and a slight discharge (just a little ticker than urine and clear). Again, there was no pain but some itching/twinges. These lesions cleared up themselves after a few days and I was unable to go to a clinic at the time due to being away.
On my return I visited the GUM clinic again and saw a different doctor (Doctor B) who looked at photos I had taken of both 'outbreaks' and advised me that it looked herpetic. But after questioning me further he declared that it was 'definitely not herpes' because: (1) it wasn't painful; (2) it re-occurred far too quickly; (3) exposure was very unlikely despite the circumstances; and (4) the PCR swab gave a negative result. However, he was unsure of what else it could be. He then took a blood sample (5.5 weeks after suspected exposure).
The results of ths IgG test for HSV I & II test were also negative. However, when I received the results from the clinic, the doctor (Doctor A this time) informed me that he was very surprised about the negative swab result as he had fully expected it to be herpes. He admitted that he couldn't think of any other conditions that would cause 'eroded lesions on the penis' and was almost certain that it should be HSV. I pointed out that his colleague (Doctor B) felt otherwise and he simply informed me that it can reoccur within two weeks, that it can be painless and that there can be false negative results. He stated that doctors do disagree from time to time.
Fair enough, I thought, but my world collapsed with his every word. He advised that I should wait and see if it reoccurs and to have another swab if so. If it doesn't he suggested that I should have another blood test after 3 months. All sensible advice it seems. But now I feel worse than ever.
I have told my partner that I may have herpes and she is obviously very upset and confused. We had sex once after I noticed the tiny red dots initially (I thought it was simply a rash). But she has not noticed any symptoms. Since then we have used condoms.
This episode has left me confused, anxious, depressed and frustrated. I wonder if you might be able to advise me whether it really is certain that I have HSV as Doctor A suggests, or whether I should stop worrying and that it is a coincidence and some other infection as Doctor B suggests. Obviously I intend to get blood tested again in 6 more weeks but I fear that I will go insane before then. I literally cannot think of anything else at the moment and I have no one to talk to about this. Please help!!
I thank you in advance of any advice and help you may be able to offer and I commend you and your colleagues for taking the time out of your busy days to answer queries such as this.
P.S. I have attached a photo of the initial outbreak for review.
Around 10 days later I noticed an unusual 'rash' - many small red spots on glans and under foreskin of penis. No pain, but some itching in general groin area. Over the next two days I noticed that one or two of the spots appeared to have ulcerated and I went to a private GUM clinic the next day. The doctor who examined me (Doctor A) said that the lesions looked quite small, but that the most likely cause was HSV. He then took a PCR swab (from within the urethra - ow! And he says, he also took a swab from the lesions). He gave me Aciclovir, which I took (5 per day for 5 days) and the sores cleared up after a further three days.
Thankfully the test results came back negative. So, I breathed a sigh of relief and assumed it was just a bizarre coincidence. Then, I began to have splitting headaches for almost a week and one morning I woke up with a burning sensation on one side of my groin. Approximately 2 weeks after the initial lesions had gone I then found to my horror that there were new ones on the glans and foreskin. This time they were more scattered and less of them. There was also one right on the opening of the urethra and a slight discharge (just a little ticker than urine and clear). Again, there was no pain but some itching/twinges. These lesions cleared up themselves after a few days and I was unable to go to a clinic at the time due to being away.
On my return I visited the GUM clinic again and saw a different doctor (Doctor B) who looked at photos I had taken of both 'outbreaks' and advised me that it looked herpetic. But after questioning me further he declared that it was 'definitely not herpes' because: (1) it wasn't painful; (2) it re-occurred far too quickly; (3) exposure was very unlikely despite the circumstances; and (4) the PCR swab gave a negative result. However, he was unsure of what else it could be. He then took a blood sample (5.5 weeks after suspected exposure).
The results of ths IgG test for HSV I & II test were also negative. However, when I received the results from the clinic, the doctor (Doctor A this time) informed me that he was very surprised about the negative swab result as he had fully expected it to be herpes. He admitted that he couldn't think of any other conditions that would cause 'eroded lesions on the penis' and was almost certain that it should be HSV. I pointed out that his colleague (Doctor B) felt otherwise and he simply informed me that it can reoccur within two weeks, that it can be painless and that there can be false negative results. He stated that doctors do disagree from time to time.
Fair enough, I thought, but my world collapsed with his every word. He advised that I should wait and see if it reoccurs and to have another swab if so. If it doesn't he suggested that I should have another blood test after 3 months. All sensible advice it seems. But now I feel worse than ever.
I have told my partner that I may have herpes and she is obviously very upset and confused. We had sex once after I noticed the tiny red dots initially (I thought it was simply a rash). But she has not noticed any symptoms. Since then we have used condoms.
This episode has left me confused, anxious, depressed and frustrated. I wonder if you might be able to advise me whether it really is certain that I have HSV as Doctor A suggests, or whether I should stop worrying and that it is a coincidence and some other infection as Doctor B suggests. Obviously I intend to get blood tested again in 6 more weeks but I fear that I will go insane before then. I literally cannot think of anything else at the moment and I have no one to talk to about this. Please help!!
I thank you in advance of any advice and help you may be able to offer and I commend you and your colleagues for taking the time out of your busy days to answer queries such as this.
P.S. I have attached a photo of the initial outbreak for review.
Post Comment
Sounds like you don't have herpes. Get the blood test 12 weeks out and stop worrying so much. Can't you talk to your girlfriend about this?
So you've had 2 doctors who agree that your symptoms appear to be herpetic. Right there is reason enough to assume it's herpes until proven otherwise for the sake of your regular partner. It's totally up to you two if you want to avoid sex completely until your repeat testing has been completed or if you just want to utilize condoms until then. I encourage you to get your regular partner a type specific herpes igg blood test too - you'll need it eventually anyways should your repeat testing be + so you might as well get it done now.
I know it's frustrating but there's nothing you can do until it's time to repeat your igg blood test in a few months. Should you get a return of symptoms then return to the clinic for another lesion culture. Also have they tested you for other std's too?
grace
As to the doctors' opinions, they are totally at odds with each other. I saw 'Doctor B' again today to pick up other STD results. He remains convinced that it isn't HSV. He also stated that the IgG would show up positive after two visible outbreaks.
This seems to conflict with information on this forum and elsewhere on the web. So is it so surprising that I am confused and frustrated?! I would be surprised if I am the only one! And I am a scientist (a biologist) myself, so I understand how viral infections can manifest themselves and the principles of testing ... but I also know about the limitations and the concept of probabilities!
Anyway, he agreed to discuss my symptoms and test results with his colleague. But I have lost confidence in the Clinic if they cannot agree on this matter.
As far as pictures being "worth a thousand words," we don't need 1,000 words worth of snaps of your genitalia floating around here. Trust us on this.
Why is it always the guys who want to post their pics here? Somehow I don't think for these posters it's all about "helping with the diagnosis." If you get my meaning.
I certainly understand your confusion and your frustration with all this. Unfortunately it happens more often than it should. As I said - the wait and see approach sucks but at this point it's the best you can do. Yes indeed about 1/2 of folks who are newly infected will have seroconverted and be testing + on the blood test for herpes but obviously that leaves the other half that takes longer. Just keep following up should you get any return of symptoms.
grace