HSV-2 Diagnosis

[cade23]

Dr. - Thanks for taking the time to read and respond. I have had aproximately 3 encounters with an escort over the past 6 months, with the most recent being 3 weeks ago. At all times the intercourse has been protected. This past weekend I noticed a small tiny bump on my penis about halfway up the shaft. The only reason I noticed it was I was examining myself and saw it (I do shave there on occasion). There has been no pain, this was not a blister/lesion type sore and I had no "symptoms" but obviously my mind started racing and the first thing that comes to mind in genital herpes.

In my panic I went yesterday and got a herpes blood test for HSV-2 at the clinic. However, now that I have found this blog and have read in-depth the test seems to be pretty much useless (it was negative), because it was too early. Now I am riddled with anxiety assuming this to be genital herpes.

My question would be, does this pimple type bump on my penis point to genital herpes and how long should I wait until the next test?

Thanks in advance

[cade23]

Thank you for your quick response and your time

[Edward W Hook, MD]

At 2-3 weeks about half of persons with recently acquired herpes will have positive blood tests.  

If the bump was herpes it would typically move from a bump to a blister and then burst over a period of about 24 hours.   EWH

[cade23]

Thank you for the quick response, two quick questions in response to your answers.

The blood test at 3 weeks was useless? Is there any accuracy to it?
If the bump/small pimple were to be HSV how long would it be there and should it turn into a blister at some point and pop and ooze as described?

[Edward W Hook, MD]

Welcome to our Forum.  I'll be pleased to comment and add some perspective.  There is little likelihood that the lesion you note is herpes.  I say this for the following reasons:
1.  The lesion you describe is not suggestive of HSV.
2.  The risk of getting Herpes from any single exposure is low, particularly when condoms are used consistently as is the case for you.
3.  The timing is off.  HSV lesions typically occur within 2 weeks of exposure.

If the lesion is still there and that you have not taken antibiotics, having been noted for only 1 day, you could ask your doctor to do a HSV culture or, better yet, a PCR test.  If the test is negative this is further, strong evidence that  it is not HSV.

As far as blood tests are concerned, if this is HSV, there an over 90% probability that your repeat blood test would be positive at 3 months, not that I recommend it.

My guess is that the lesion you describe is something other than HSV.  If you have an experienced clinician take a look they may be able to provide some guidance.

I hope these comments are helpful to you.  EWH