Mis-diagnosed?

[DesperatelyConcerned]

I was diagnosed with HSV a few weeks ago. I was later cleared of this diagnosis based on a negative test result. I still seam to be having some of the symptoms that prompted me to be seen originally.

I had unprotected sex with a girl I am currently dating 3 weeks ago. My penis tip almost immediately felt a bit irritated and by day 5 I noticed some very light and clear discharge. Almost like pre-ejaculate. This along with early signs of a sinus infection prompted an ER visit. The MD said it was nothing more than a venereal infection and prescribed antibiotics for both infections. This made sense based on my symptoms. I had him test to see what type of VD it was. The next day I woke up with a terrible cold that lasted 3 days. 5 days after my ER visit I went to a different MD to get my test results. They were negative, but this MD wanted to test for HSV. She diagnosed me as HSV + based on a IgM test and prescribed Valtrex for 10 days. The other test she ordered was a herpeselect type-specific. The results read:

HSV 2 IgG, Herpeselect Type-Specific AB: <0.90 (this value was listed under a column header called "In Range").

She made no reference of this test in her diagnosis however. I went to another MD to get tested again 15 days (11 days after ER) after the unprotected sex. This test came back absolutely negative. The results read:

HS I/II AB IgG: 0.16
HS I/II IgM: 0.26  

I have not had any "typical" herpes symptoms and neither has my GF (or at least she says). However, I did have the irratation and light discharge mentioned above. I'm not sure if the symptoms are in my head at this point due to some hightened sensitivity caused by the HSV diagnosis, but I think my penis still feels a little irritated.

-If I don't have herpes, what could be causing the symptoms I'm having? General urethritis?
-Should I get tested for HSV again in a few weeks?
-Should I get treated by a specialist? Urologist?

Thank you Dr.

[Edward W Hook, MD]

Thanks for the clarification.  You have negative tests and have been treated effectively for STDs, had you had gonorrhea or chlamydia.  Your discharge is not an STD and I would urge you not to worry further about it.  It is likely normal.  If you go to enough doctors, you will find someone who will treat you more or do more tests just to "assure" you.  This is not in your best interest.  Take care.  EWH.  

[Edward W Hook, MD]

You do not have herpes.  Any diagnosis based on an IgM blood test result is suspect and should not be believe unless verified by more reliable tests. there are many, many false positive tests with the IgM assay.  Your symptoms are not consistent with herpes, nor are your HerpeSelect blood tests which, unlike the IgM are highly accurate and reliable.

As for the origin of your discharge.  It may be normal or it may be something more.  Can you tell me what antibiotics you received.

i would suggest you go to your local STD clinic.  You need to have a penile swab or urine test to look for white blood cells and to test for gonorrhea and chlamydia.  the best time to get tested is at a time when you have not voided for at least a hour and preferably two hours before the specimen is collected.

Hope this helps  let me know what antibiotics you took.  EWH

[Edward W Hook, MD]

Your question did not disappear, it was deleted becasue it really added nothing to your original question or my answer and that is still the case.  There was very little (like just aobut nothing) to suggest herpes in your original problem.  You need to stop asking "what if questions" and read my original response(s).  Further questions will be delted as well EWH

[DesperatelyConcerned]

I posted this question last night but apparently it disappeared. I have one additional question pertaining to my original post that I would like to ask. You seem quite certain that I don't have herpes based on the symptoms I described. I am by no means questioning your expertise, but I have read other posts on this site that seem to suggest that my symptoms could be caused by HSV (i.e. discharge, flu symptoms, and urethra irritation).

My question is, were the blood test done too soon to yield reliable results? If so, should I retest in a few weeks and refrain from sexual activity until I do?

I am inclined to agree with your initial response in that I don't have HSV. However, I would hate to pass this virus to someone else if by some remote chance I do have it. On the other hand, I do not want to go through the stress and anxiety of getting tested again if it is not necessary.

Thank you Doctor.

[DesperatelyConcerned]

Thank you Dr. Hook!

It's amazing to me that the internet can give me the answers that I'm looking for but by health care provider can't! Thanks again.

[DesperatelyConcerned]

Thank you for fast repsonse Doctor.

I was prescribed one dose of Ciprofloxacin and Azithromycin for 5 days (1/day). I'm not quite sure what the dosage was but I can out find out if it is necessary. The MD in the ER did do penile swab and a urine test for gonorrhea and chlamydia. They were both negative. The other doctor I saw after the ER visit did a urine test as well and that came up negative too. She also prescribed me another 5 days worth of Azithromycin for my lingering sinus infection. My partner was tested for chlamydia and gonorrhea too. Her results came back negative. I've only known her for a little over a month so there is a possiblitly that she is not being truthful about her results.