Likelihood that this is HSV?

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8 days after fellatio, and brief unprotected genital penetration with a partner who has a history of HSV-2, I noticed a slight burning inside the tip of the penis.  I found a small (a few mm) slightly elevated area on one side inside the end of the urethra that has evolved:

1. Appeared to be same color as the normal skin on the other side, but was surrounded by a light red margin.  It was adjacent to a reddish, irritated-looking patch that appeared to extend into the urethra.

2. A day in, the spot seemed to become three adjacent smaller spots (< 1mm) arranged in a triangle.  One was more apparent than the other two, which required pretty close inspection to see.  None were blisters, just tiny, roughly circular patches of normal color divided by red margins.

3. Fourth day, two spots had become less prominent, and the margins of one left had become pretty ragged, but "bullseye" appearance of the spot is very pronounced.  

No fluid or discharge. Burning is minor, more of a slight irritation.  Slightly more burning during and just after urination, at worst the pain is still very minor, a 2/10.  It is constant, and not just the result of friction or poking at it.  No signs of anything wrong outside.

No flu-like symptoms.

I also have a mild ache at base and shaft of penis.  Off and on (more off), testicles are tender and sensitive.  How much of this is a result of my anxiety, however, I couldn't say.

Visited a urologist at about day 3, said that it did not look like a standard presentation of herpes.  However, because the lesion was on a mucous membrane he said herpes might not necessarily look like the standard blister, and he took a swab of the area just in case.

No other partners over the last few years.  We've only been together a handful a times over that time, when there has been penetration we've always used a condom, and always washed thoroughly after outer-skin contact.  This latest unprotected penetration was brief, less than 20-30 seconds.  

Thanks!

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Thanks, Terri.  I just had an IgG test to rule the possibility that this was a recurrence of an existing infection, which came back negative (<0.91 on both HSV1 and HSV2).  This was only 2.5 weeks after my latest possible exposure, so I understand that it wouldn't necessarily have anything to say about a new infection.  Still waiting on my culture test, which I fully expect to be negative regardless of my actual condition, since there was no fluid to collect on the swab. So I expect to not know anything for sure until I get another IgG, which I'll do in a few months.

So my last question is this:  given that the IgG was a couple of weeks after potential exposure, and a week after onset of possible symptoms, if I was in fact exposed, could I at least expect that my antibodies would be up in the equivocal range, rather than the negative range?  At this point I'm pretty confident that I have not been exposed (though I'll wait until the culture test to breathe an unqualified sigh of relief), but the more information, the better.  Thanks!

[Terri Warren, RN, Adult Nurse Practitioner]

I think from your description of the skin presentation, the sexual contact involved, and the time of the contact being very brief, this is unlikely to be herpes.  However, I'm wondering if you have ever been tested for herpes in the past?  Eighty percent of those infected with HSV 2 don't know it, so it is possible that you have been infected in the past and didn't know it.  

You will get your swab test back soon, but it isn't always accurate, so if you continue to have concerns, and since your regular partner has HSV 2, I would recommend that at some point you get an antibody test to see what your true status is.

Terri