Herpes Diagnosis

[joe1888]

I recently had a risky episode of unprotected insertive vaginal sex.

I took an STD lab test 3 days after the episode and was confirmed to have gonorrhea (a cotton swab test analysis using a microscope). I immediately took 2g of azithromycin.

Not feeling better and feeling tingly on the penis for a few days, I went to an STD doctor, he told me that the lab test is not accurate and that I have non-specific urethritis.
He gave me a two tablets which doesn't seem to be working and I have had chronic diarrhea.
Therefore I then took doxycycline (100mg) for a week which made me feel a little better better and the tingly sensation is gone.

Then on the third week, I noticed a small cluster of small reddish bumps with some red lessions around the bumps at the inner uncircumcised skin at my penis head. And If I recalled correctly, they are perhaps already present a few weeks ago, I just did not take them into much concern.

I went to the same STD doctor and asked him weather or not it is herpes, then he said, yes it is herpes (by physical examination). And I asked him if I should test positive for the HSV antibody test during this time, he said yes.

So on day 24th post exposure, I did both IgG and IgM tests for both HSV-1 and HSV-2, the result came back negative.

I went to the doctor and asked him about the negative result, he told me I am still in the window period and asked me to test again in another month.

I already took acyclovir daily for 5 days with 400 mg dosage at 5 times daily but the cluster of small bumps still have not burst and the redness did not go away.
Other than the initial tingly feeling in the first weeks of exposure, I did not experience any significant pain on my genital.

Would it be possible that I may have an acute HIV infection that caused the bumps did not burst for this long?
Up to now (4 weeks post exposure), have not had any fever. Highest temp recorded so far is 37.5C for an hour.
When do the bumps usually burst and become open sore?

[joe1888]

Thank you for the answer Doctor,
Truly appreciate your input.

The test that was taken was a standard herpes antibody test IgG and IgM.
Which is taken right after I took a single dose of Acyclovir.

The reason I asked if this is herpes is because I have been taking Acyclovir for more than 5 days now, and what is suspected to be small herpes bumps on my genital still have not seemed to burst. And I have never experienced any kind of pain from the infected site.

I wonder if you can tell me if genital herpes outbreak will always hurt?

And when would herpes bumps usually burst considering that I took Acyclovir daily?

[Edward W Hook, MD]

Welcome to our Forum.  I see that you have been asking some of these questions on the International Forum as well.  You will get similar answers from me.  Diagnosis of any STD on the basis of examination without testing is potentially unreliable.  We urge you to get tested for the problems you are concerned about and then to believe the test results you have.  If you have herpes and you were tested with a swab test from a lesion before you started taking acyclovir, it would seem that the result should be positive.  If it is not, there is a good reason to wonder if your really do have herpes.   as your doctor told you, it can take as long as 3 months for the blood tests for HSV to become positive.  

As far as HIV is concerned, the sorts of bumps that you describe is not suggestive at all of HIV.  Your risk of HIV from the exposure you describe is low.  A standard HIV antibody test will detect about 90% of infections acquired 4 weeks earlier and would be strong evidence that you did not get HIV from the exposure you describe.  EWH