Do I have herpes and/or some other STD?

[Mysterioso]

I have two bumps on my penis. The bump on my shaft is reddish, with a whitish center. The bump near the tip (foreskin) was similar to the bump on the shaft, but has diminished greatly in size and appearance. It is noticeable with some effort, and is slightly red.

My doctor told me on Friday that my PCR tests indicated elevated levels of HSV-1, and borderline levels for HSV-2. These were based on a blood sample. He thinks I have been exposed to HSV-1, but he is not sure about HSV-2. When I had herpes tests done in 2006 (I'm quite sure the they were not PCR tests), they were negative (they indicated I had no exposure to HSV-1 or HSV-2). In the same conversation on Friday, my doctor indicated the other tests I took for other STDs were all negative.

I met my doctor because a week or two prior to the appointment, I noticed the two bumps on my penis, one on the shaft (A), and the other on the foreskin near the tip (B). At that time, (A) the bump on the shaft was round and whitish. (B) The bump near the tip was reddish, with a whitish center. One morning, maybe a couple days prior to my appointment with my doctor, I noticed that the bump near the tip had “burst” in the morning. There was a mark or residue of some liquid around the bump. The bump itself looked like there was an empty hole in the middle.

Do I herpes? Molluscum? Both? Something else?

What is the chance of a false positive result from my PCR test on the blood sample?

My doctor was not clear about what I had. He gave me Acyclovir and suggested we meet and he take a swab/sample next time I have an active blister/sore. I would prefer not to wait until next time. What type of doctor should I see to get to the bottom of this? A dermatologist? A urologist? Perhaps another specialty?

This is all very depressing. I've told my girlfriend about this, and beyond my own personal issues, want to ensure she does not get this. Your kind support and advice would be highly appreciated regarding all of the above.

[london08]

Hello, basically it is absolutely normal to have HSV-1 appearing on PCR. This is the one that most commonly causes cold sores for instance. HSV-2 typically causes genital herpes but either virus can infect any part of the body. The bump you descirbed does sound like a blister that had burst. Firstly, is this the first time you have noticed these "bumps"? Secondly, how long after it burst did it take to heal? PCR will detect viral DNA but like I said HSV-1 is commone and its presence doesn't indicate a latent infection of nerve endings in and around the groin that would manifest itself as genital herpes. the only way to confirm genital herpes is by a swab test of the sores during a suspected outbreak. A specialist in genito urinary medicine or a dermatologist would be very well placed to make this sort of diagnosis but any doctor really should be able to recognise herpes when they see it. Basically, you are not at a high risk of infecting your partner provided you abstain from sex during an outbreak of blisters. Condom use will further reduce the risk but will not eliminate it since it is not just contact with the penic that can spread herpes and the condom will only cover the penis. Book an appointment with one of the aforementioned specialists and you will get a good idea of your risk levels and make sure you go for a swab test next time you have ant blisters like those described. Take care

[auntiejessi]

Are you sure you had PCR blood tests?  I'd be very surprised if you did, as there are none that are being used commercially.  Perhaps you had an antibody test.  Can you get copies of your test results?  PCR HIV blood tests are common, but not for herpes.

HSV1 is quite common, and while it can be genital, without culturing the spot, you can't be sure that you have it genitally or orally.

I can't say what the chances of a false positive on the type 2 is without knowing for sure what tests you had done.

If you have hsv2, the chances of your gf getting it from you, if all you do is avoid sex during symptoms, is about 8-10% a year.  If you use suppressive antivirals, such as acyclovir, its about 4-5% a year.

You should check out the herpes handbook at www.westoverheights.com for more info on this.

Aj

[auntiejessi]

Oops forgot to ask you how long you've had these spots now.  Based on your description, it does sound more like molluscum than herpes.

Aj

[Mysterioso]

Hi London and Auntie Jessi,

Thank you both for your responses. I will answer your questions below.

London:
(1) Yes, this is the first time I have noticed these "bumps".
(2) One bump has burst maybe a week or two after I first noticed it. The second bump has still not burst, but seems to have gotten slightly larger.

Auntie Jessi:
(1) I am fairly sure I had PCR blood tests, as my doctor mentioned those were the tests he wanted me to have to check for herpes 1 and 2. I will ask for a copy of the report and confirm this, though.
(2) I have two spots, one which burst 1-2 weeks after I noticed it. I can still see it, but it's very small, slightly red/discolored and generally hard to notice. The second one I've had for about 2-3 weeks.

Thanks again to both of you for the information and links.

I look forward to any replies you may have based on the above answers.

[auntiejessi]

Hi there -

I spoke with a friend of mine who is very familiar with all the herpes tests, and she said that if you did get PCR blood tests, she wouldn't rely on those results.  They are not useful for adults, as herpes isn't blood borne.

AJ