Hsv2 at second site?

[Theadmiral33]

I have had an herpetic whitlow on my right finger (hsv2) for over 6 years. The hsv2 blood test is >5. I get a mild outbreak every couple of years so it hasn’t been an issue.

I received oral 5 months ago. Extremely briefly as I asked my partner to use a condom. There was no other intercourse. Shortly after, I developed a rash on the head of my penis. A red rash that developed into blisters. And has since remained irritated with small blisters reappearing every couple of weeks. The blisters aren’t painful.

When the blisters appeared, I had 2 swab tests. One at the start and one when the blisters had fluid. The blisters were never that painful. Neither swab test showed positive for either HSV.

I’ve had multiple blood tests which remained positive for hsv2, negative hsv1. The latest blood test was 15 weeks after initial rash.

Question 1: how likely is that this is hsv2 despite the swabs being negative and the fact that I’ve already had hsv2 on my finger.

Question 2: Could this still be hsv1 even though all the tests were negative?


Thanks!

[auntiejessi]

How long after the blisters appeared did you have them swabbed?

It would be really unlikely for this to be hsv2 for a couple of reasons - you already have antibodies for it, and your only risk was oral. Oral hsv2 is rare, and when it does occur, it rarely sheds, rarely recurs, and thus, almost never transmits.

So hsv1 - it could be, but depending on the timing of the swabs, it would be unusual for swabs to miss it. I'd be interested to see what a PCR swab showed - it's more sensitive than a regular swab.

The hsv1 IgG can miss 30% of infections, which is why it still remains a possibility. Given that it was brief and protected, the chances are low, though.

Have they done any other testing? Have you considered trying Valtrex just to see if that helps?

[Theadmiral33]

Thank you.

I had the first swab a couple of days after the blisters appeared which was about a week or so after the irritation appeared. The second swab was a week after that at which point the blisters were larger and had a clear fluid. The blisters themselves are larger than what you would typically expect and more spread out. I don’t know what swab the second dr used but the first one was the pcr dna test?

Over the course of the 5 months I’ve had 3 blood tests and 2 swabs. All HSV1 neg

My dermatologist gave me acyclovir cream to try. Starting that today.

Not sure if it matters but I did get 2nd Covid shot a week before this all started.

I also factually know that the whitlow was the result of my finger being exposed. There wasn’t any genital anything

[auntiejessi]

When you first got whitlow, before you had antibodies, is there anyway you could have transferred the infection to your genitals?

I ask this because there are lots of people who say that after their 2nd dose of the Covid vax, they suddenly get herpes symptoms when they never had it before. They get blood tests that are positive, indicating an established infection. They also seem to have a harder time getting things settled down. This is all anecdotal, and posted on sites like ours and Reddit, etc., but there is enough consistency for me to believe it. People who knew they had herpes were also reporting some pretty bad outbreaks after the 2nd dose - enough that it led to me upping my antiviral dose before and after my own vaccine.

The negative swabs confuse me, though. They sound like they were done when you had fluid, and if it was the PCR swab, I'd expect it to pick it up. They are really sensitive, and can even pick up asymptomatic shedding when there is no blister.

The acyclovir cream will help with symptoms, but won't help new ones appear, if this is hsv2. Is there a reason you aren't taking it orally? Is that your choice or the doctor's?

So the derm thinks this is herpes? What do they say about the neg swabs?

[Theadmiral33]

Actually, 2 urologists, 1 generalist and my derm looked at it. None them thought it presents as herpes. The acyclovir is more of a “try this and then we’ll do a biopsy”  thing.

[auntiejessi]

Why not do a biopsy first? Using acyclovir cream doesn't actually prove anything.

I'm sorry you're going through this.

[Theadmiral33]

I thought I’d share the outcome of the biopsy so you have the info. The biopsy turned out to be genital psoriasis which doesn’t present like traditional psoriasis at all hence all the trial and error. Not entirely sure the viability of treatment but I guess I’ll find out. Big shout out to all of you for what you do. Thank you.

[auntiejessi]

Thanks for the update. I'm glad you got it biopsied, and have some answers. Good luck to you. :)