Herpes fears

[kickingself]

Hello Doctors,

7 weeks ago I made a mistake and had unprotected sex with a woman I don't know 3 times over the span of 2 days. The woman repeatedly denied having herpes. I'm inclined to believe her, but she didn't know her numbers from her recent herpes tests that she claimed she had gotten since we slept together, so I'm not sure what to think.

Ten days after, I was tested for hepatitis, gonorrhea, chlamydia and had a baseline done for HIV and HSV 1 and 2. Everything was negative. I hadn't experienced any symptoms and neither has my wife once we started sleeping together again about 3 weeks after the exposure. I was tested 6 weeks after the exposure and everything showed up clear for herpes.

HSV 1 was <.10 and HSV 2 was .48, which is much higher than my baseline test of .24.

Just 3 days ago (7 weeks after exposure), I started having a persistent, general itch in the pubic region (focused 2 inches above my penis). There are a few small red areas that don't seem associated with hair follicles, like little pimples. They're a few inches apart and don't seem to be coming to a head. I'm thinking this is most likely dry skin or actual pimples, but considering the recent past, it's hard to dismiss it so easily.

My questions are:

- Is what I described possibly herpes?
- I know that not everybody experiences an initial outbreak, but when could a secondary outbreak first occur?
- What are the odds that I contracted HSV from 3 sexual events and that both my wife and I are asymptomatic (me for 7 weeks, her for 4) and I tested negative 6 weeks following the exposure?
- Should I seek further testing at 12 weeks or relax? (My doctor doesn't think so, and he seems generally knowledgeable, but he took a minute to make up his mind about this.)

You run a great service here, by the way.

[Terri Warren, RN, Adult Nurse Practitioner]

I would suggest that you go in right away and have a professional look at the bumps.  Please don't wait because the clinical picture will change over time and the person seeing you will not be able to get a complete understanding of what was going on with you previously.  If you can't get an appointment with your regular doctor, I would suggest urgent care.  If they do decide to swab the bumps for herpes, ask if they can do a PCR rather than a culture, far more sensitive.  

The results at 6 weeks are about 70% reliable.  Some people do become positive later, so I guess because you are having these concerning symptoms, it might not be a bad idea to test again.  But more importantly right now, have the bumps evaluated.

Terri

[Terri Warren, RN, Adult Nurse Practitioner]

Good.  I'm glad you went and got reassurance about the bumps.  
As I mentioned before, there is a 70% chance at 6 weeks that your test will remain negative if you decide to test at 16 weeks.  I think given your limited contact with the other person that you are not infected.  But I can't provide you with 100 % certainty.

Terri

[kickingself]

Hey Terri,

Thanks for the feedback. I just got back from my doctor who said she sees herpes every day and that what I have is "definitely not herpes." She said it's most likely a heat rash and to put some cortisone on it. There was no open sore or pus or even head on the spots to pick to create an open sore that she could swab.

So, do you have thoughts on my other questions?

Thanks!

[kickingself]

Mine is actually painless to the touch. Just the whole area is moderately itchy.

[consuelo88]

i am not a doctor but i have had herpes for about a year or more.
i believe i was exposed to it when i stupidly slept with an x of mine although we used a condom he is the only person to have told me he has herpes. (we dated 10 years ago and the exposure was only 2.5 years ago)
i didnt have any signs of anything for several months. i luckily was having an outbreak when i had an appointment with my gyno and she recommended testing. it took SEVERAL months i had no idea.

the herpes does look like a cluster of little pimples. like a red irritated area... mine is itchy as well. always is itchy then hurts like hell if i end up scratching.

i had only slept with him once (since he found out he had herpes) and used a condom!!!! so i dont know that it was him but if not then i could have been exposed at any point in the past 10 years and only first had an outbreak about a year and a half ago...

[kickingself]

I just counted the red spots. There are about a half dozen in a 2.5 inch by 1 inch area in the pubic hair, about 2 inches above the base of the penis. It's too itchy to be pimples.