Herpes Help

[Milkdud85]

5 years ago I had an igg herpes test done because me and my g/f, at the time, wanted to rule out all possible STDs before having unprotected sex.  Test results came back neg for HSV 1&2 ( this was 5 years ago).  I was 22 at the time and now I am 27.

A couple months ago I had a new partner (unprotected both vaginal and oral) and a week or two after I started to experience what you would say are classic herpes symptoms (tingling scrotum, flu like symptoms, and clustered red bumpy sores in my right groin/thigh).  Went to the doc and had an igg blood test done.  This time results came back neg for HSV 2, but pos for HSV 1.  Did not have the sores/lesions swabbed or cultured bc they were not blistery or fluid filled.  

Over the last few months I have had the following symptoms: lesions will come and go about every 2 weeks (sometimes bilateral) either in right groin/thigh or left (but never on the penis).  My scrotum tingles daily (sporadically not constant) and once in a while in my anus.  This is not psychological either it is definitely happening.  

A few weeks ago I went back to the doc to have blood tests done a second time (4 months after the 1st test) and again HSV 2 came back neg but HSV 1 came back pos.  Could not swab/culture bc again no fluid, just clusters of red puffy bumps.

At this point I am starting to go crazy, I need answers to this but cannot get a definite answer bc my doc hasn’t swabbed bc the lesions aren’t blistery or fluid filled…what should I do?  Is it a possible case of ghsv1?

I would also like to say I know I have HSV 1, it’s a newer infection, but I never have had a cold sore in my life.  I have also been tested for all other STDs.

Is it possible to have the areas where I break out swabbed even if the lesions are small and no fluid involved?

[Edward W Hook, MD]

No, this is OT post hermetic neuralgia.   No change in my assessment or recommendation.  EWH

[Milkdud85]

Hi Dr. Hook.  One last thing and I'll be done with the forum.  Could this tingling that I am feeling on my scrotum and in my groin be post herpatic neuralgia?  Like I said it has been about 6-7 months now where I am feeling this tingling on and off through out the day.  I have had one huge out break back in the summer, and then 2 smaller ones since…so I do not think it is prodrome…and I'm just wondering what I can do to mediate the sensations?  Any advice?

[Edward W Hook, MD]

No, genital herpes is not a cause of infertility, in men or women. EWH

[Milkdud85]

Thanks again Dr. Hook...I am going to call around to see where I can have a PCR test done ... in the meantime I have a random herpes question, it's just something I read and freaked me out a bit...can genital herpes cause infertility in men?

[Edward W Hook, MD]

Both are mis-informed.  There does not need to be a blister present to get a positive test.  


As for the tingling you have experienced, this is most often not a manifestation of HSV but a consequence of increased genital focus which causes people to notice sensations they would normally overlook and ignore.  While tingling may sometimes precede a HSV outbreak by a few hours, when the sensation moves around or last more than a few hours, it is not due to HSV.  EWH

[Milkdud85]

Hi Dr. Hook,  Thank you for your reply.  Where can I have a pcr swab test done... I've been to my doc and planned parenthood, and they each said without a blister with some kind of fluid they cannot do the test.  My sores do look like herpes, but they just are not fluid filled...I just don't know where to go to have the test done and will they even do it if the sores don't look like the "typical" herpes sore?  Also do you have any insight on the tingling I feel on my scrotum...it has never happened prior to that sexual encounter and it is definitely not psychological.  I feel it almost everyday at different points in the day...

[Edward W Hook, MD]

Welcome to the Forum. If your doctor will not do the proper tests for HSV, then you should find someone who will.  Blood tests are NOT recommended for diagnosis of HSV, in part because BOTH the tests for HSV-1 and HSV-2 are not uncommonly falsely positive.  The lesions on your thighs and groin do not sound like HSV but do sound like folliculitis, not HSV.  The next time you have an outbreak, as soon as possible after the lesions appear you should have a HSV PCR test performed on a specimen taken from the lesions with a swab.  

As far as blood tests are concerned, if you wish to determine whether your test for HSV-1 represents a true infection or not, I recommend having a specimen sent to the University of Washington for a HSV Western Blot test. This is the gold standard blood test for HSV infections.  

That you have not had a cold sore in the past does not mean that you have not had HSV-1 in the past.  Most people who have HSV-1 do not know it.  I recommend the PCR test on a swab to find out what is really going on.  Whether or not you get the Western Blot test for HSV antibodies is up to you but I will warn you that even if the Western Blot were positive, it would not mean that the lesions on your leg are HSV.  They certainly do not sound like typical HSV

I hope these comments are helpful. EWH