I was wondering if anyone had any advice about what to make of my results.
I started seeing a new partner who has genital HSV 1. She rarely gets outbreaks, only once a year, for which she takes valcyclovir. First outbreak was three years ago. I am well aware of asymptomatic shedding, but also the low transmission rates during those times. Anywho, we had sex about three to four times. I used condoms of course everytime. I am also aware that condoms do not eliminate the risk for transmission.
Throughout this time with her I was generally feeling completely normal. May have had some itches here and there, but pretty minor - nothing seemed significantly out of the usual. Cool beans. But after the last time we had sex I started to think more and more about the HSV transmission possibilities and that's when I started Googling all about it after seeing a patient teenager who was having a primary HSV episode and I started worrying about it a lot. The next two days after I had sex with her I then noticing myself having a variety of symptoms - itching, weird tingling, burning, etc - generally coming and going throughout the day and it varied. I also felt rather sick and didn't want to eat dinner. Now granted as well - it was my first day on a different hospital rotation and it was a very busy overwhelming day and I did not get to sleep very much as I had to wake up much much earlier - so I already wasn't feeling great. I frantically kept checking my skin and there was nothing at all resembling a classic herpes outbreak or anything else for that matter. My mind was certainly in a frenzy. I hadn't shaved down there in a while and sometimes I know that has bothered me in the past if its too long and I have had just the usual skin sticking around the region before so I figured maybe it was something to do with that. My skin is generally pretty sensitive and I know the same thing happens on my face sometimes with the hair irritating and drying the skin underneath if it gets too long.
On day 3 post-coitus I went to the doctor and got the antibody bloodtest. He too commented that he could not see anything concerning. Coming back home I trimmed up down there and felt a little better. I did not use a razor, but an electric trimmer with adjustment settings so it was short but not not completely shaved. With a better view I still couldn't see anything that was concerning. But I continued to have just kinda weird feelings down in the perineum area, the occasional twang of sting - which I've had from maybe trimming too short and the hair pokes against your thigh or working out and being sweaty and it's in general a kinda mashed up area - but it just seemed more than usual and poorly timed. I tried wearing looser boxers and shorts when I got home as I usually wear boxer briefs. Anywho, those feelings I was having really would come and go, sometimes change with position, generally worse with sitting. But never as bad as that second day post-coitus. On another day I masterbated but came barely erect (doesn't really happen much, but guess I wasn't in the mood enough) - anywho, that ejaculation was kinda forceful and I think not being erect it sorta pushed out pretty hard so the head of my penis was kinda tingling for the next two days. I think ultimately that symptom is rather unrelated and explained for then. Anywho, flash forward and I got the results back on day 8 post-coitus: HSV 1, 2 IgM positive. HSV 1 IgG positive. HSV 2 IgG negative.
Now I'm well aware of notoriously how unreliable the IgM test is - at distinguishing between 1 & 2 or at even being accurate that HSV is even present at all. I don't even know if the IgM test really was distinguishing between either anyway. Its titer was barely positive as well. The IgM concerns me less since I know it's not very reliable. However, the thing that is strange to me is the HSV 1 IgG positive. I've never had cold sores or anything resembling genital herpes. Granted, 60% of the population would have gotten the same result. I suppose I get buccal mouth ulcers a lot, but I'm pretty certain they're canker sores. In any case, my first sexual intercourse encounter with this girl was a little over two weeks prior to testing. In all likelihood then, I've been exposed to HSV 1 before this girl as the IgG takes anywhere from 3 weeks to 6 months to develop.
It is now day 11 post-coitus. I still think I am experiencing weird herpes-like prodromal symptoms down there with itchiness in the region or "tingling" in my penis generally relived on urination but I do not see any skin findings similar to herpes outbreak. The only skin findings I see are what appear to be very tiny red dots that - as far as I can tell - are all associated with a hair follicle. They have not swollen, are not crusting, do not look like blisters on a erythematous base or blisters for that matter, don't seem to be distributed clumped together or on skin without hair follicles, and are not present on hairless areas (penis shaft, head). Furthermore, they are not constant. For example, if I check a few hours later I'm not likely to notice the same red spot in the same location and there is nothing where it was before.
This doesn't sound like herpes outbreak at all, but given the recent possible exposure, weird blood test results, and the fact that I'm noticing these spots a lot more than before I'm still just very worried about it. I really am scared about it. I know the outbreak typically occurs 2-5 days following exposure, so I guess I made it past that window. The next likely cutoff is 12-14 days, which I guess I am approaching. If I make it to 20 then I guess it's just more and more unlikely that what's going on has to do with herpes. But if that's the case, what is it? A topical folliculitis mixed with contact dermatitis? It's really driving me crazy cause everytime I feel these stings I always think to myself "okay, this is it - the outbreak is going to be starting down there" and then I look and just nothing.
The closest any of the skin findings I mentioned resembled anything like herpes was just earlier today when I felt itchy on my upper inner thigh and scratched the area. When I looked a little later there were a few red spots somewhat clustered in that area and, again, I was convinced "yup, this is it. Here it comes." I sat on a bus for a while feeling it sorta sting or just be uncomfortable. Sure enough, when I got to the bathroom at this restaurant and checked again - there was nothing there.
Am I overthinking this? If I get past day 20 and no visible eruptions or outbreaks, is it just not likely to be herpes then (I understand theoretically a primary episode could occur months and months later, but it's certainly less likely)? What could it be then? I want to stop thinking about it and rest somewhat assured that it's probably just not herpes but it's hard to do when I still feel these stings and what not, feel rushed to look, look and then not really see much of anything, you know? Thoughts?