Herpes or injury

[unlucky37]

thank you for this service -

my girlfriend and I were tested when we started dating for everything but herpes (all negative).  We had protected sex one time - then found out she had a previous encounter with herpes 2 - so we both went and got tested.  She had it I did not.  We decided to abstain until we wanted to get more serious but she liked giving oral (tested neg for type 1) and I used fingers only.  She started taking Uciclivir.

Two months after our initial contact she performed oral and the next day used her hands (upward motion - bad).  Right after this I had pain in two areas.  Under the rim on left and the ureathra.  She used some old facial lotion with sunblock for lubrication.  

I tested positive for type 2 about six weeks after this incident (3 months after protected sex).  I did not have any outbreak during this time (still haven't) and then went on Ucicivir.  The pain persists.  I went to a urologist peed in a cup and had a full exam.  Nothing.  He said that I can have pain for awhile in various ways as the herpes takes its course.  I have burning in my left leg - comes and goes - and pain in the Urethra - and a constant pain still around the left 'rim'.  it's been over 2 months now.  I started on Uciclivir when and then after 3 weeks went to Valtrex but the pain is still there in both places.  It sometimes hurts in my left toes, but often feels like a needle under the left 'rim' of the penis. A general aching also around the penis and now below testicles.  

The questions:  Does this all sound like the herpes virus?  Could I have two things going on - as in an injury and the Herpes?  There has not been an outbreak so I don't know where I had contact.  Is there anything else this could be ie prostrate (no troubles peeing and no burning when peeing).  Thanks for your help here Dr.  I'm just so frustrated that I thought I was being safe.  Family Dr. is telling me to take pain pills.

[Edward W Hook, MD]

To be honest, the situation you describe in not at all typical.  I suppose you could have gotten HSV-2 from the single episode of sex you had.  You would not get it from either her hands or oral sex.  

Can you tell me what medication you are each on.  Ucicivir is not an antiviral therapy I recognize.

Also, can you clarify how herpes was diagnosed.  Was it a blood test?  If so, what type?

Finally, with regard to your continuing symptoms or burning in your leg or around the rim of your penis, this too would be very uncharacteristic of herpes.  I think it is likely to be unrelated.  The pain of herpes is episodic and tends to occur in conjunction with the lesions of an outbreak. Both the pain and the lesions tend to not last more than a few days and are not continuous as you seem to be describing.  I think it is likely to be an unrelated process and not due to herpes.  EWH

[unlucky37]

We were both tested with a blood test.  She was neg for 1 and positive for 2.  I was neg for 1 and 2 but recently went positive for 2.  She was put on Acyclovir (sorry-totally mispelled that in my post) when we found out in the first month.  For the 5 or so weeks that I was first 'injured' (this happened after 3 months of dating) there were no signs of any outbreak and was not on any medication.  She has not had any outbreaks that she knows of during all this time, but it is of course possible that she picked up hsv2 in her mouth and I picked it up that way - or from the one time we had sex as turning positive at 3 months is still possible.  I started on Acyclovir and I'm on Valtrex now - currently twice a day - but since it doesn't help my pain, I again wonder if I have just injured myself.  The lotion she was using that day was a heavy facial cream with an exfoliating agent (probably not a good idea).  She was alternating using both hands and moving upwards time after time.  The pain then was immediately after this episode - so I thought it was an injury and didn't go to the doctor until one week had passed - then at 5 weeks.   I have not tried any antibiotics as both times I had the urine test there wasn't anything the doctor found.  My family doctor thinks I should wait it out as the nerves in the penis and in urethra (if herpes) might stay sensitive for several months.  It hurts mostly the day after I am active in any sport or if I'm rubbing on my girlfriend of course.  The sexual activity between us sadly has dropped to near nothing as the situation has been very hard on the relationship.    As far as the burning - I've read from a lot of  posts that there can be a burning in the 'boxer' area which I take to be in and around the genital area.  Is there anything that I'm not thinking of here?  Can I pick it up on another part of my body than I already did (where ever that is)?  Do you think I should take the ibuproben agressively for a little while?  Or some sort of antiboitic?  I'm trying not to take a bunch of drugs at one time obviously -

thanks for you help with this Doctor - I'm really glad that you are on this service.

[Edward W Hook, MD]

Thanks for the clarifications.  Now that you both have HSV-2, you do not need to worry about getting re-infected by each other in different places, it almost never happens.  That would be true whether or not you were taking antiviral therapy and is even less likely since you are.  

The discomfort you describe in your leg and penis is not consistent with herpes and is likely to be caused by something else.  There are people who claim to have neuropathies which are associated with chronic pain but I have to say that neither Dr. Handsfield nor I, nor any of our colleagues have seen this commonly.  In fact, between all that we've asked, despite having taken care of literally thousands of person with herpes, we have cumulatively seen less than 5 or 10 such cases and those, to be honest, are suspect. the pain of herpes is localized, does not persist for long periods and when treated with antiviral therapy goes away.  

Is there any visible abnormality associated with this pain?  

What this is is tough to say.  I agree with your doctor that this is unlikely to be herpes and that watchful waiting may be the best course.  I also agree that a chemical exposure is a reasonable possibility as to what is going on and, i fthat is the case, it should improve with time.   Either way, working through this with your doctor is the approach that I would endorse.   EWH