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Concern about Genital Herpes

I had protected (condom) vaginal sex with a sex worker in TW on 05/14/13. A few days later I developed a slight headache and a itchy/burning/tingling sensation around my right pelvis area 05/18/13 (above my penis and around the pubic hair area). I did not see any sores, blister or ulcers from 05/15 – 05/24/13. However I did see some irritated/red skin on the underside of my penis both side (not the shaft/not sure if this was due to me masturbating without lube). Upon further examination I did see a wound that is leaking liquid on the right underside of my penis but no blood/Not sure if is a sore/ulcer/lesion (I do not see any blister/ulcers/lesion that represent a cold sore). Please advise what is my chance of getting genital herpes (HSV-2)?

PS - I have the cold sore (HSV-1) and I understand that if one has the HSV-1 (cold sore) the symptoms of HSV-2 will be not as severe. Can anyone reflect on this? Thanks.

Also - I have schedule an appointment with my physician next week for further examination. however I am afraid the wounds will heal and only time will tell.
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55646 tn?1263660809
I"m sorry, but we have reached and exceeded the number of responses I give on this board.

Terri
Helpful - 0
Avatar universal
Hi Terri:

Hope everything is well with you. I understand that a herpes test will not be conclusive until the 4 month mark. However, will there be any difference if I test at 7.5 week or 8 week mark? Also, in your experience have you ever encounter someone who has a cut on the underside of their penis? I am asking because I still have that cut and if i spread the skin, a clear liquid will leak out. It has been more than 4 weeks and the hydrocortinsone cream is not helping. I tried some neosporin and is not heling either, so I am some what baffle by it (I wonder if i should leave it alone for a few weeks).  I have schedule a check up with my general physician and urologist next Friday and will post what they diagnose and my result. Thanks.
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55646 tn?1263660809
Cortisone generally makes herpes worse so that is a good sign

Terri
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Avatar universal
Hi Terri:

Thank you for your response. I will call the clinic and set up an appointment if I do require the WB test. Also, I forgot to add, my physician prescribe me hydrocortisone cream 2.5% at the red/irritated area with the liquid coming out and it seem to be improving. Do you think this is genital herpes? I will post my herpes result in two weeks (getting tested again by 8 week mark).
Helpful - 0
55646 tn?1263660809
Yes, of course.  If you go through our clinic, we will set you up with an appointment through Quest labs through a special arrangement that we have with them now.

Terri
Helpful - 0
Avatar universal
Hi Terri:

Thank you for your quick response. Although my swab culture was negative, it was not tested via PCR. I still suffer anxiety and concern because every itch, tingling, pimples, rash I see around the boxer area I believe is herpes.  I will post my IgG result in a couple weeks and by 4 months. May I call you and order a kit  to confirm my HSV2, if I DO need to test via Western Blot? Thanks.
Helpful - 0
55646 tn?1263660809
WHAT??   I don't know what the lab meant by that.  
This has gone on for a long time and your culture was negative, so I"m not too worried about it being herpes.

Terri
Helpful - 0
Avatar universal
Hi Terri:

Unfortunately my physician did not do a PCR test. Labcorb told her it might contaminate the culture (not sure if that is true). However, my culture swab was negative and I am extremely confuse what is on my underside of the penis. It looks more like a cut and it is on the corona rim of the glans yet sometimes there will be liquid around the cut (I have to spread the skin to examine the cut). The area is not red, tender, tingling, burning nor are there any pain associated with it. Can genital herpes last this long and be somehow located on the corona rim of the glans. I read that genital herpes located on corona rim of glans will not have the classic herpes symptom (ie - the blister, the healing, the scabbing/crusting and it will take a very long time to heal) The cut is about 1 - 2mm.  Do you think this might be genital herpes or something else? Thanks.
Helpful - 0
55646 tn?1263660809
What lab does she use?  If she uses Quest labs, she just needs to call and ask for PCR instead of culture for the sample.  They can both be run off the same swab.  Culture may also pick up virus, yes.

Terri
Helpful - 0
Avatar universal
Hi Terri:

I was about to drop off the swab culture when my physician told me she has time to examined me. I show my physician the red/irritated area and a one clear liquid drop came out (there was one small blister/but the liquid did not came out from that blister). My physician got a new swab and culture the liquid and the red/irritated area. I ask my physician about the PCR testing, however she is not familiar with it. If the culture swab is fresh - how likely will it pick up the herpes virus? Thanks.
Helpful - 0
55646 tn?1263660809
Let's just let the swab test be run and see what happens.

Terri
Helpful - 0
Avatar universal
Hi Terri:

Thank you for the quick response. It appears another lesion has appear ( or it seem like is the same one - at the right underside of the glan of my penis) and it seem there to have some liquid again. I swab the area with the liquid (my physician give me a culture swab in case if i have more symptoms) and will drop off to my physician. I wil ask my physician to do a PCR test. The area is still somewhat red and raw and there is no pain, itchiness, tingling or burning sensation. And I do not feel any prodome sensation such as burning, tingling, itchy or pain.

My question is can a herpes lesion/sore linger this long (is about 3 weeks)? And does a single herpes lesion/sore always hurt or tender to touch?

Helpful - 0
55646 tn?1263660809
No, one week of herpes meds should not make a difference.

Terri
Helpful - 0
Avatar universal
HI Terri:

Hope everything is well with you. I got my STD (Gon, chlamydia, HIV, syphilis) and Swab culture results. Everything was negative (HSV1 IGG: 5.1 - have cold sores before/HSV2 IGG: 0.08). Unfortunately my physician did not do a PCR swab and is disappointed . I understand that the culture swab is notorious for having a false negative. So far, I do not see any sores, ulcers or lesion on my penis. However, I do see a few scatter pimples (one will be on the left butt cheek and another on the right butt cheek) on my buttocks. It seem each day a new pimple will appear and none of these are itchy, irritating, painful or leaking fluid. I am worried that I have a mild ob of HSV2 on my buttocks since I already have HSV1. I finished my medication (acyclovir - 400 mg for 7 days/3x) and I plan to get tested again at 7.5 weeks, 3 and 4 months.  Also, I finish your book and I understand after 6 weeks - 70% of those infected will test positive and by 16 weeks - almost everyone infected will test positive . Will this impact my HSV2 result since I took one week of acyclovir?  Please advise. Thanks.
Helpful - 0
55646 tn?1263660809
Did she do a PCR swab?
You know, I would suggest using a very minimum of herpes medicine in terms of your antibody test.  Four days should not impact it, however.  In my experience, it takes a little longer for HSV 2 to show up in an antibody test in someone who has HSV 1.  The research agrees, but not a lot longer.

Terri
Helpful - 0
Avatar universal
Hi Terri:

It appears my dermatologist did not do a full STD/HSV2 blood test. I will be doing another full STD/HSV2 blood/urine test tomorrow. However, my physician has prescribe me Acyclovir 400 MG - 3X per day for 7 day (I am on Day 4). Will this affect my HSV2 result or is it still too early? I understand I need to wait 3 - 4 month for the HSV2 antibodies to develop. However, I am not sure if my HSV1 antibodies or the medication (have cold sores) will inhibit the HSV2 to show. Please advise. Thanks.  

I will post my swab and HSV2 result once I have it.
Helpful - 0
55646 tn?1263660809
Let me know how the swab test turns out.  I hope they used a PCR swab instead of culture.

Terri
Helpful - 0
Avatar universal
Hi Terri:

I am fearing the worst  that I do have HSV-2. I was examining my wounds and it appears a large drop of liquid came out yesterday. I went to my physician and she perform a swab test today, however I am fearing my wounds have heal again. I do see a small sore, but both MD (Derm/GP) told me they do not see anything out of the ordinary although they cannot confirm. I will update my swab culture result next week. In the mean time, I have purchase your book (The Good News/Bad News about Herpes) and hopefully it will give me some insight. I am not blaming anyone but myself for this and therefore I need to face the consequences. Thanks.
Helpful - 0
55646 tn?1263660809
OK.  That would be helpful

Terri
Helpful - 0
Avatar universal
Hi Terri:

I was examined by my dermatologist (along with blood and urine) and she told me it does not look like genital herpes because there was no sore/lesion/ucler but cannot be certain (told me it might be irritated skin). My dermatologist prescribe me the following
1. Acyclovir Ointment for the affected area (the right underside of my penis) and 2. Locoid Lipocream. I was some what disappoint a swab test was not done because there was no leakage of fluid and no sores or lesion (assessed by the dermatologist/I was afraid my wounds have heal by that time). Also I am not sure if my mind is playing tricks because the more I think about having genital herpes/examine my penis - the symptoms increase (tingling/burning/itchy). I understand my anxiety might cause this, but this waiting game sucks. I will post my std result next week. Thanks.
Helpful - 0
55646 tn?1263660809
OK

Terri
Helpful - 0
Avatar universal
Dear Terri:

Due to the Memorial Holiday - most of the urgent care is closed. I will try to go to my physician by tomorrow. However I am afraid my wounds will heal by then. I was tested last year in Sept 2012 - my std/HIV/Herpes 2 was all negative. I was aware of HSV-1 since I get cold sores from time to time. The wound has change slightly and no liquid is coming out. I will post an update once I meet with my physician.
Helpful - 0
55646 tn?1263660809
If you have a sore that is leaking fluid, I would encourage you to have it evaluated right away.  Is there an urgent care clinic you could go to to have it swab tested?  I wouldn't wait until next week because testing will not be as accurate if the wound changes.  

Condoms do reduce the risk of acquiring herpes, yes, but they aren't perfect.  A red area is not a concern particularly, by itself, for herpes but a  "wound" is.  
Have you ever been tested for herpes in the past?  Have you ever noticed anything like this in the past?

A single protected act of intercourse presents a very low risk for herpes, but it isn't zero.  If you have a lesion such as the one that you described that has fluid coming from it, you need evaluation for herpes.

Terri
Helpful - 0

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