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Need help diagnosing my symptoms
Hi doctors, it all started after a 3-month trip to Colombia, South America, in summer 2009. I had a 2-month relationship with a local woman; we had unprotected sex several times. About 2 weeks into the relationship, I went to a local doctor after developing lip sores and swollen finger. The doctor visually diagnosed me for oral herpes and herpes whitlow, and prescribed acyclovir. He never ordered any lab tests to confirm herpes. The symptoms went away after about 2 weeks. Towards the end of the relationship I discovered she was very promiscuous.
In mid-October, I developed a faint rash on chest, arms, & legs. The rash intensified in late November, when I began to have other symptoms as well - sore muscles, fatigue, sore throat, swollen lymph nodes & more. I tested negative in mid-December for HIV, syphilis, hep B&C, & HSV 1&2. Symptoms went away in late December.
In early April, the symptoms came back. As of today 5/10, I'm still suffering from fatigue, sore muscles and frequent muscle spasms, especially in legs, and now heart palpitations and chest pains around my heart (pain is occasional and dull, like it's under pressure). My skin has also become sensitive to touch and pressure, becoming and staying very red for quite some time, for example, after carrying something heavy on my forearm for a while.
Went to PCP twice, once in January - she did basic blood work, all normal; and again in April, more blood work, including retest for HIV, syphilis, and ANA - all negative/normal. For rash, referred to dermatologist, who said I didn't have anything (rash was mostly faded by appointment date).
1) Herpeselect test in Dec was negative - how? I thought HSV antibodies stayed with you for life. No outbreaks since the first.
2) If not herpes, what else could this be? Parasite? Tropical disease?
3) Is there any test or specialist you recommend I take/see?
I'm at wit's end and any suggestions would be greatly appreciated. Thank you.
In mid-October, I developed a faint rash on chest, arms, & legs. The rash intensified in late November, when I began to have other symptoms as well - sore muscles, fatigue, sore throat, swollen lymph nodes & more. I tested negative in mid-December for HIV, syphilis, hep B&C, & HSV 1&2. Symptoms went away in late December.
In early April, the symptoms came back. As of today 5/10, I'm still suffering from fatigue, sore muscles and frequent muscle spasms, especially in legs, and now heart palpitations and chest pains around my heart (pain is occasional and dull, like it's under pressure). My skin has also become sensitive to touch and pressure, becoming and staying very red for quite some time, for example, after carrying something heavy on my forearm for a while.
Went to PCP twice, once in January - she did basic blood work, all normal; and again in April, more blood work, including retest for HIV, syphilis, and ANA - all negative/normal. For rash, referred to dermatologist, who said I didn't have anything (rash was mostly faded by appointment date).
1) Herpeselect test in Dec was negative - how? I thought HSV antibodies stayed with you for life. No outbreaks since the first.
2) If not herpes, what else could this be? Parasite? Tropical disease?
3) Is there any test or specialist you recommend I take/see?
I'm at wit's end and any suggestions would be greatly appreciated. Thank you.
MEDICAL PROFESSIONAL
No STD causes muscle pain, and few if any other infections do so either. I doubt your partner's symptoms and yours are related.
MEDICAL PROFESSIONAL
Welcome to the STD forum.
It sounds like a good possibility that you caught oral herpes, perhaps with a herpes whitlow of the finger, from your Colombian sex partner. It's too bad the doctor didn't order any lab tests at the time -- but if the doctor was experienced with herpes and seemed confident in the diagnosis, it's a good bet you had it.
However, nothing else you describe sounds like an STD, and you had negative tests for all the common STDs. (I'll come back to the HSV test results below.) Regardless of the apparent oral herpes, your current symptoms are not due to any infection you caught the sexual exposures in Colombia. No STD causes fatigue, sore muscles, muscle spasms, chest pain, palpitations, or the sorts of skin symptoms you describe. (Many of these symptoms sound like anxiety or other emotional origin.)
To your specific questions:
1) There are two possible explanations for your negative HSV blood tests. First, maybe you didn't have herpes. Other viruses could have caused similar symptoms. Second, maybe the blood test just missed it. As you were told by Grace on the herpes community forum, 10-15% of people with HSV-1 infections never develop positive blood tests. As I said, it's too bad that lab tests weren't done when you had the oral sores and possible whitlow. At this point, you may never know for sure whether you had herpes. But if at any time in the future you develop a blister-like or pimple-like sore around the mouth, see a doctor or clinic right away; testing at that time might sort this out. In the meantime, don't worry so much about it. Half the adult population in the US (up to 90% in some countries) have oral herpes. It's usually not a big deal and shouldn't concern you very much.
2) Certain other viruses can cause ulcerations around the mouth. Or conceivably an allergic reaction of some sort. I really can't speculate further.
3) Discuss these possibilities with your primary care provider, including my concern that some of your most bothersome symptoms might have a psychological explanation, like depression, anxiety, etc. I suggest it out of compassion not criticism.
In summary, get rechecked for oral herpes if you get a sore (or multiple sores) around the mouth. In the meantime, don't worry much about it. And definitely don't worry about other STDs. No STD is a possible cause of any of your current symptoms.
I hope this helps. Good luck-- HHH, MD
It sounds like a good possibility that you caught oral herpes, perhaps with a herpes whitlow of the finger, from your Colombian sex partner. It's too bad the doctor didn't order any lab tests at the time -- but if the doctor was experienced with herpes and seemed confident in the diagnosis, it's a good bet you had it.
However, nothing else you describe sounds like an STD, and you had negative tests for all the common STDs. (I'll come back to the HSV test results below.) Regardless of the apparent oral herpes, your current symptoms are not due to any infection you caught the sexual exposures in Colombia. No STD causes fatigue, sore muscles, muscle spasms, chest pain, palpitations, or the sorts of skin symptoms you describe. (Many of these symptoms sound like anxiety or other emotional origin.)
To your specific questions:
1) There are two possible explanations for your negative HSV blood tests. First, maybe you didn't have herpes. Other viruses could have caused similar symptoms. Second, maybe the blood test just missed it. As you were told by Grace on the herpes community forum, 10-15% of people with HSV-1 infections never develop positive blood tests. As I said, it's too bad that lab tests weren't done when you had the oral sores and possible whitlow. At this point, you may never know for sure whether you had herpes. But if at any time in the future you develop a blister-like or pimple-like sore around the mouth, see a doctor or clinic right away; testing at that time might sort this out. In the meantime, don't worry so much about it. Half the adult population in the US (up to 90% in some countries) have oral herpes. It's usually not a big deal and shouldn't concern you very much.
2) Certain other viruses can cause ulcerations around the mouth. Or conceivably an allergic reaction of some sort. I really can't speculate further.
3) Discuss these possibilities with your primary care provider, including my concern that some of your most bothersome symptoms might have a psychological explanation, like depression, anxiety, etc. I suggest it out of compassion not criticism.
In summary, get rechecked for oral herpes if you get a sore (or multiple sores) around the mouth. In the meantime, don't worry much about it. And definitely don't worry about other STDs. No STD is a possible cause of any of your current symptoms.
I hope this helps. Good luck-- HHH, MD
Thank you for your thorough response.
My PCP also suspects that these may be psychologically related, and I was starting to agree myself with you both. However, what prompted my new worrying (and what I didn't have enough space to mention in my initial post) is that my girlfriend told me about 4 days ago that her leg muscles are sore (like she's been running all day, as she describes it), and she still feels it. This is what has me worried that it might be an infectious agent.
I'll be seeing my PCP again this week and will bring up the possibilities you discussed, including possible treatment for anxiety or depression. I just want to definitively rule out an infectious disease so that I'm not a danger to her. Thank you again!
My PCP also suspects that these may be psychologically related, and I was starting to agree myself with you both. However, what prompted my new worrying (and what I didn't have enough space to mention in my initial post) is that my girlfriend told me about 4 days ago that her leg muscles are sore (like she's been running all day, as she describes it), and she still feels it. This is what has me worried that it might be an infectious agent.
I'll be seeing my PCP again this week and will bring up the possibilities you discussed, including possible treatment for anxiety or depression. I just want to definitively rule out an infectious disease so that I'm not a danger to her. Thank you again!
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
