If lesions are not present there is no reason to test. EWH
Thank you, Dr. Hook.
I actually checked my penis this morning, and it really appears that these "cuts" were not cuts at all. My glans is a bit wrinkly when flaccid. When I play around with it and stretch it out, it's not a cut. I may have overreacted.
Given that there are no lesions beyond these "cuts", do you think testing is warranted? I would have to pay out of pocket and I am feeling fine now.
1. When I look at these cuts, they are very fine when I'm flaccid, and if I have an erection, they are actually invisible. It's really difficult for me to tell, but if these were cuts, wouldn't they become more visible with an erection?
If you can see, them, I would get them tested. Trying to determine what they are without testng is a waste of time.
2. You said my risk for HSV-1 was greater than HSV-2, but what would you categorize the risk overall, given the symptoms? How about if these cuts were not lesions at all?
Overall the rsik remains low but testing is warranted.
3. If this isn't HSV, what else would you speculate is causing these problems?
No, I won't speculate. Without the opporunity to inspect the lesions any such guess would not be worth much.
4. Assuming this is genital HSV-1, does this persistent fever fortell that I will have a similar prodrome in the future if I have a recurrent outbreak?
No, in persons who get HSV, typically only the the first episode has fever as part of the symtoms.
EWH
Hi Dr. Hook,
Thank you for your response. I have some follow-ups.
1. When I look at these cuts, they are very fine when I'm flaccid, and if I have an erection, they are actually invisible. It's really difficult for me to tell, but if these were cuts, wouldn't they become more visible with an erection?
2. You said my risk for HSV-1 was greater than HSV-2, but what would you categorize the risk overall, given the symptoms? How about if these cuts were not lesions at all?
3. If this isn't HSV, what else would you speculate is causing these problems?
4. Assuming this is genital HSV-1, does this persistent fever fortell that I will have a similar prodrome in the future if I have a recurrent outbreak?
Welcome to our Forum. I'll be pleased to comment. From your description your risk for HSV is greater for HSV-1, transmitted through receipt of unprotected oral sex than any other form of HSV. Parts of your description are in line with possible HSV infection- typically HSV lesions appear between 4 and 14 days following an exposure and gen be manifest as small, only moderately uncomfortable lesions. With first episodes of HSV, many persons are feverish as well. On the other hand, your lesions may not be lesions at all. The only way to be sure is through testing of the lesions with a culture or better yet a PCR test. I noted on your comments on the community site that you are a bit reticent to test because you would need to go to an urgent care center. I have mixed feelings about this. The sooner you test the more accurate your test results will be and I suspect you would like to have an answer. My advice would be to call urgent care/walk-in clinics in your area (not emergency rooms) and inquire about the availability of PCR tests for HSV to resolve this issue (no matter what you might be told, a blood test would not resolve your questions although it would tell you if you have ever had HSV or any sort in the past). If you cannot arrange for a PCR or culture, you may not know what these are unless they recur in the future.
In answer to your specific questions:
1. How in line with herpes infection are my symptoms? Particularly since this fever/ill feeling persists, but no visible lesions except the small cuts, and tingling/burning gone.
See above. Only testing would provide the answer you need. The "small cuts" should be tested.
2. Could the cuts be herpes lesions?
Yes.
3. Is it possible that I could have picked up multiple HSVs, both 1 and 2, in my face and genital area simultaneously?
Almost unheard of.
4. How likely is it that I have genital HSV at this point?
Only tesitng will provide the answer you need and even that may not provide a perfect answer.
I hope these comments are helpful. EWH