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STDs (Expert Forum)
hsv-1 infection?
Answered by
Edward W Hook, MD - HIV Prevention, stds
This forum does not cover AIDS/HIV issues. This forum is for questions and support regarding STD issues such as: Chlamydia, Crabs (pubic lice scabies), Gonorrhea, Hepatitis (viral), Herpes, HPV, Molluscum Contagiosum, PID, Rectal Infections, Syphilis, Trichomonas, Warts, Yeast Infection.
IMPORTANT
This forum is limited to questions about STDs other than HIV/AIDS. For questions about HIV prevention, or if you have general questions about safe sex (e.g., condoms, how to protect yourself from HIV and STDs), please visit the HIV Prevention and Safe Sex Forum
Some of the most common types of questions concern the risk of HIV or STD after a particular sexual exposure, and about symptoms that might or might not be due to HIV. If your question is along these lines, please visit the HIV Prevention and Safe Sex Forum.
This forum is limited to questions about STDs other than HIV/AIDS. For questions about HIV prevention, or if you have general questions about safe sex (e.g., condoms, how to protect yourself from HIV and STDs), please visit the HIV Prevention and Safe Sex Forum
Some of the most common types of questions concern the risk of HIV or STD after a particular sexual exposure, and about symptoms that might or might not be due to HIV. If your question is along these lines, please visit the HIV Prevention and Safe Sex Forum.
hsv-1 infection?
by canthisbepossible, Apr 27, 2008 12:25PM
Seven weeks ago, had brief unprotected oral and vaginal sex (we eventually used a condom). Noticed five or six tiny red/brown spots around the opening of my urethra the next morning. Not bumps and not irritating, just spots. They slowly disappeared over the course of the next week or so.
Noticed sensitivity around the tip of the penis at the two week mark. Went to the doctor’s office to be screened for STDs. Doc assured me it wasn’t herpes. Week four – all results came back negative (HIV, Syphilis, Gonorrhea, Chlamydia), but Doc put me on Doxy for two weeks and Cipro for 1.5 weeks, just to cover all the bases. Continued to have itchy, painful tingling sensations around the groin, mostly isolated around the pubic bone area. Also noticed swollen, painful testicles for a bit, but that went away after a few days.
At about week five (one week into the two week dose of Doxy), noticed redness and sensation/irritation around my buttocks. Went in to the Doc again and told me it was probably a yeast infection caused by the Doxy. Prescribed a cream that I have been applying for a little over a week – it has helped, but hasn’t went away yet.
Tested for herpes at the six week mark. Came back positive for hsv-1 (wasn’t a surprise as I’ve experienced occasional cold sores for years) and negative for hsv-2. The woman I was with also tested negative for everything, including BOTH hsv-1 and hsv-2.
I have not had a herpes “classic breakout,” but have no other explanation for symptoms. Could I have passed hsv-1 to her during oral sex, then passed it back to my genitals shortly after? Remember that she just tested negative for hsv-1. I’ve read that I should have an immunity built up against hsv-1 anywhere else on my body due to the antibodies that I’ve had for years. I did get another cold sore on my lip about two weeks after this encounter, but definitely no signs of it at the time of contact.
Could I have transferred hsv-1 to my genitals?
Noticed sensitivity around the tip of the penis at the two week mark. Went to the doctor’s office to be screened for STDs. Doc assured me it wasn’t herpes. Week four – all results came back negative (HIV, Syphilis, Gonorrhea, Chlamydia), but Doc put me on Doxy for two weeks and Cipro for 1.5 weeks, just to cover all the bases. Continued to have itchy, painful tingling sensations around the groin, mostly isolated around the pubic bone area. Also noticed swollen, painful testicles for a bit, but that went away after a few days.
At about week five (one week into the two week dose of Doxy), noticed redness and sensation/irritation around my buttocks. Went in to the Doc again and told me it was probably a yeast infection caused by the Doxy. Prescribed a cream that I have been applying for a little over a week – it has helped, but hasn’t went away yet.
Tested for herpes at the six week mark. Came back positive for hsv-1 (wasn’t a surprise as I’ve experienced occasional cold sores for years) and negative for hsv-2. The woman I was with also tested negative for everything, including BOTH hsv-1 and hsv-2.
I have not had a herpes “classic breakout,” but have no other explanation for symptoms. Could I have passed hsv-1 to her during oral sex, then passed it back to my genitals shortly after? Remember that she just tested negative for hsv-1. I’ve read that I should have an immunity built up against hsv-1 anywhere else on my body due to the antibodies that I’ve had for years. I did get another cold sore on my lip about two weeks after this encounter, but definitely no signs of it at the time of contact.
Could I have transferred hsv-1 to my genitals?
Doctor's Answer
by Edward W Hook, MD, Apr 27, 2008 12:56PM
, Apr 27, 2008 12:56PM
I'm at a loss to explain the increased sensitivity around your penis and subsequently your groin and buttocks. Let's talk first about what it is not:
What you do not have is:
1. A bacterial STD such as nongonococcal urethritis, chlamydia or gonorrhea. Your tests were negative and you were treated for them despite negative tests. No way these are part of the picture.
2. Herpes. First of all, it is implausible that you gave it to her and then quickly she gave it back to you, all over a short period of tests with no lesions for either one of you and negative blood tests on her part. The scenario you have suggested simply does not happen this way. You are correct that your HSV-1 (presumed oral) protects you in large part from getting it elsewhere as well
So, why are experiencing tingling sensations. I cannot say. One of the things that does come to mind is that you could have a fungal infection of some sort. That would explain the redness and in some instances, the associated sensitivity. Another possiblity mihgt be a reaction of some sort to one of the medications you have (nedlessly) taken of late. To be honest however, without the opportunity to examine you, this is just a guess. My suggestions would be to work with your physician to sort this out but also to stop worrying about herpes--that is not what is going on. EWH
What you do not have is:
1. A bacterial STD such as nongonococcal urethritis, chlamydia or gonorrhea. Your tests were negative and you were treated for them despite negative tests. No way these are part of the picture.
2. Herpes. First of all, it is implausible that you gave it to her and then quickly she gave it back to you, all over a short period of tests with no lesions for either one of you and negative blood tests on her part. The scenario you have suggested simply does not happen this way. You are correct that your HSV-1 (presumed oral) protects you in large part from getting it elsewhere as well
So, why are experiencing tingling sensations. I cannot say. One of the things that does come to mind is that you could have a fungal infection of some sort. That would explain the redness and in some instances, the associated sensitivity. Another possiblity mihgt be a reaction of some sort to one of the medications you have (nedlessly) taken of late. To be honest however, without the opportunity to examine you, this is just a guess. My suggestions would be to work with your physician to sort this out but also to stop worrying about herpes--that is not what is going on. EWH
I was referred to a urologist a couple of weeks ago. He quickly examined me and deemed nothing significant was wrong. After examination, he said I might have a slightly swollen prostate and put me on two weeks of Flomax. He mentioned that sometimes a swollen prostate will cause some pain and sensations around the groin and penis. Unfortunately, it hasn't provided any relief with the pain and sensations. I have noticed going to the bathroom at night less (good) and a reduction in semen with ejaculation (not good).
It has been seven weeks now that I've been experiencing irritation/pain/stinging/tingling on the penis and around the groin. Some days are better than others, and it certainly has reduced some since getting off the course of antibiotics a couple of weeks ago, but symptoms have not disappeared.
Tingling/stinging feeling is similar to being pricked by needles. Seems to come and go at random times and places (penis head and shaft, pubic bone area, inner thighs). The pain is mostly limited to the vas deferens area on both sides. Irritation and burning is located on the testicles/scrotum (this also comes and goes - when it is very irritated the scrotum turns very red) and the crease of the buttocks. Sensitivity is located on the penis, mostly the head...this is the worst part, because I can feel it rubbing up against my boxer shorts whenever I move. The closest thing I can compare it to is as if the inside of my boxers were made of sandpaper.
Regarding the symptoms around the anus/buttocks, regular use of the antifungal cream has reduced redness and irritation, but it also has not completely gone away. Still feeling some sensitivity back there and itching around the anus (again this has slowly gotten better). Symptoms in that area have been present for 3.5 weeks. I've been applying anti-fungal cream there for about 3 weeks (with a couple of day break in the middle). If it is a fungal infection, how long will this take to fully resolve? The area around the anus was particularly red, itchy and sore, and of course, I was worried about herpes. PA looked it over and said he didn't see any typical herpes lesions. No swab or culture was taken.
FYI, my HSV tests were as follows...
HSV-1 IgG 4.83 positive
HSV-2 IgG 0.06 negative
Again, my HSV-1 result was not a surprise as I've had cold sores before.
My questions for you...
1.) I know it's near impossible to diagnose online, but do you have any idea what may be causing this?
2.) Where do I go from here? The doctor I've been seeing doesn't seem to have an answer, he prescribed more antifungal cream. The doctor was very nice, but I am seriously considering going to get a second opinion.
3.) Your previous response helped me relax a lot...but still a little concerned about herpes, but mostly because I have no answers. Am I okay to rule that out? Have you or Dr. Handsfield ever heard of a herpes case like this?
4.) Is there any chance this will just go away on its own? Could I be making this worse in my head? The symptoms are very real, but obviously I've been very aware of every little bump/redness/sensation the last couple of months.
I'd like to thank you for taking the time to provide insight and advice to me and others on this site. It's very helpful to get an expert opinion on things, especially when you don't understand what's happening and have no answers. I'm 27 years old and have never had any serious health problems before, so this is both scary and frustrating. Again, I truly appreciate your time and help.
2. A second opinion is reasonable Perhaps with a dermatologist.
3. This is not herpes Your tests confirm that you have HSV-1 but you know that.
4. Yes, there are things that we cannot explain which sometimes just have to run their course and go away. It sounds as though you may be, slowly, getting better. I hope that is the case. If it does resolve on it's own, to be honest, knowing it is not an STD, I would accept that and not worry further.
Sorry I can't clarify things more. EWH
Thinking a fungal infection may be causing the irritation and redness around the anus, the doctor prescribed two doses of diflucan, proctofoam, and hydrocortisone suppositories. This was a week and a half ago and symptoms have not disappeared, only gotten a little better.
He asked if I ever had a herpes outbreak, which I haven't. He said that if I did, these problems I've had could possibly be postherpetic neuralgia. If I had an outbreak in my urethra and therefore didn't see it, he said it could be causing the problems and that I would have to live with it my entire life. He also said there would be no way to tell at this point.
Went to see a dermatologist, but he had no further insight. Just said to pick up Gold Bond Medicated Powder.
Visited an internist this week. She was concerned about a back issue (I was in an accident about 4 years ago) and a nerve pinching, causing the pain and discomfort in the groin/buttocks. After an MRI, found that the back has nothing to do with this. She suggested I visit another internist (she admittedly wasn't too well versed in STDs). In the meantime, prescribed me some pain medication and 10 days of Valtrex. Said that if symptoms subside with Valtrex, I can be pretty sure I've acquired a genital HSV-1 infection. If symptoms don't improve she suggested I also see a neurologist and/or an infectious disease doctor.
It's been a little more than two months of discomfort now. I'm willing to continue searching for answers and relief, as this has dramatically affected my quality of life and I am worried about what the future will be like if these symptoms don't go away. I had been able to accept that this is not herpes related, but then the doctor suggested postherpetic neuralgia. He also admittedly is just shooting for answers in the dark.
Pain/tingling/burning/sensitivity continues throughout upper buttocks/tailbone and groin area. I've also recently noticed pain and discomfort developing in my upper inner thighs and legs.
1. From what I've read, postherpetic neuralgia is mostly related to shingles and persons of older age. As an STD expert, is this even possible genitally? Does my story sound like postherpetic neuralgia? And if so, do I really have to live this way for the rest of my life or is there something I can do?
2. Will the Valtrex I'm on really tell me anything over the course of the next week? I was under the impression that Valtrex is used to suppress outbreaks and reduce transmission of the herpes