Manual Transmission

[scared576]

I had manual contact of my penis w/saliva from a man who was touching self.  Day 3 - tip of my penis burned and I had sharp shocks & tingling in genitals.  Went on for weeks but resolved after Myconazol for a week.  Day 10 -  tested neg for Chlamydia, Gonorrhea, & HIV.  HSV1 IGG 0.40, HSV2 IGG 0.09, HSV IGM TITER <1:10 (<1:10), HSV IGM “Detected by EIA but negative by confirmatory IFA.  Day 11:  one side of meatus was raised compared to other - as if by a blister under skin.  Visible only w/an erection.   1 drop of a milky fluid exits meatus after I squeezed hard.  Fear it was a herpes blister inside urethra; & 2) saw red, spot about size of pencil eraser on underside of penis - only visible when pulled tight.  Itched.  I poked at it & may have scraped it. Afterwards, it hurt and, scabbed.  Day 20, after 1,200mg Acyclovir for previous 10 days, tested neg for HSV 1 & 2 by IFA.  Day 52, after Acyclovir (usually 800 mg per day) for all but days 1-10 & 45-52, tested negative by Elisa IGG. Have had periodic pain in lower left back, occasional minor pain w/orgasm, and bad hemorrhoids that I fear are anal herpes - never had hemorrhoids like this before - in intensity or persistence.  They went away for 2 weeks when bumped Acyclovir from 800 to 1,200 mg per day but came back when I went off Acyclovir. Strange feelings in thighs and behind left knee that I have never felt before – w/2 small pimples on my inner thighs and 2 small pimples on my scrotum about ¾ of an inch apart & I was in very hot & humid weather at the time. Except for the red patch on my penis from day 11, nothing hurts when touched.  The hemorrhoids burn most of the time but are not sensitive to touch.  I read you can't catch herpes by hand even if the person has just touched self, but isn't that contradicted by auto-inoculation.  I’m at day 90 now, have been off Acyclovir for the past week (31 of 90 days since exposure off Acyclovir) and am trying to stay off it to re-test. Thoughts?

[Terri Warren, RN, Adult Nurse Practitioner]

I don't know how to reassure you about the very very low risk of your encounter and not be "dismissive" of your concerns.  Kind of a find balancing act.  

Let me go back to looking at your antibody numbers and ask you some questions.  Have you ever in your life had a cold sore on your lip?  Has your wife?  This antibody test misses 1 out of 10 HSV 1 infections though it is much better at picking up HSV 2 infection.  Your value is negative, but a higher negative.  I don't think this indicates new infection.

Please go off the herpes medicine completely and retest in 3 months.  If you don't, you can not rely on these test results.  If going off medicine results in an outbreak, you can have that swab tested to get an accurate answer.

Many people who get herpes for the first time have flu symptoms and more lesions.  Many have enlarged lymph nodes.

If you are infected with herpes, taking suppressive therapy will reduce your risk of transmission by half, her taking therapy would not be useful.

Terri

[scared576]

A related discussion, Reliability was started.

[Terri Warren, RN, Adult Nurse Practitioner]

Good, you are thinking correctly so far.  Now stay OFF the meds and be patient while waiting, even though I know this is not easy.

Terri

[scared576]

Thank you for the answers.  I am off the Acyclovir and will attempt to stay off of it.  I've probably been off of it somewhere around 30 of the 90 days since possible exposure.

I've been more positive lately - in the sense of trying to believe in the reasons why it is might not be herpes and other explanations for the symptoms I've had.  

Unlikely means of transmission.
No obvious classic blisters.
No flu-like symptoms.
No enlarged lymph nodes.

But, SOMETHING, definitely is going on.
Thank you.

[Terri Warren, RN, Adult Nurse Practitioner]

Big nodes are very noticeable when touched.  They feel like large peas under the skin.  By the way, you can make them bigger by pushing on them a lot - they don't like that.  

You can stay on suppression, but it will take much longer, maybe months, for you to to get an accurate antibody test result.  I have a patient who was infected in June, was put on suppression, didn't want to come off, and didn't make antibody until April of the following year.  

Generally herpes sores are somewhat tender to the touch, or the might be downright painful to the touch.

Terri

[scared576]

Terri:  How big are normal lymph nodes?  How big constitutes enlarged?  And should any sores I get hurt when touched?  I just have a lot of pain in my genital and anal region, but nothing is sensitive to the touch.  THANK YOU!

[scared576]

Thank you Terri.  No, I have never had a cold sore.  And I have been tested for HSV 1 and 2 before this and always been negative.  I'm sorry about the
"dismissive" comment.  It's just that I read everything on this site about the almost impossibility of manual transmission, but my symptoms are very real.  3 months seems a VERY long time to go off the meds.  It's so hard because I don't want to infect my wife and because whatever it is keeps coming back or never quite goes away.  I saw a doctor today and he didn't think this is herpes, but he's not impressive in his knowledge of it.  I kept catching him in wrong statements based on everything I've learned on your site.

[scared576]

The "electric" shock-like poking sensations that had resolved when I used the Myconazol have returned.

[scared576]

Also, I never had any "flu-like" symptoms - Do you always get that?  Nor have I noticed any enlarged lymph nodes.  But how big are lymph nodes supposed to be anyway?

I know you will be dismissive of my concern, but I have read posts from other doctors online that say you CAN get herpes from a handjob if the person has just touched his/her own genitals and then touches yours.  I hope they are wrong.  But I have never had these kind of symptoms before and they just keep happening and persisting.  How would I tell the difference between hemorrhoids and anal herpes?  Can stress (fear of herpes) cause hemorrhoids?

Thank you.

[scared576]

Also, if I do have HSV 2 (I'm convinced I do), I will go on suppressive therapy.  Since my wife is uninfected (we've had no sex since my exposure), if she goes on suppressive therapy, too, will it help prevent her from being infected?