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Herpes??
Dear Doctor(s)
I engaged in unprotected vaginal sex. Around 36 hours later, I developed burning/discomfort in the head of my penis. At about 44 hours, I developed a single whitish sore on my inner foreskin (im uncircumcised). The sore never hurt, never pussed, or broke open, although I did develop a large build-up of whitish cheesy like material around the head of my penis when the foreskin was retracted. The sore healed in about 5-6 days, and white cheesy material passed in a matter of week. I went to and got the sore cultured the day it appeared, and culture results came back negative for hsv2. What is the likelihood that it is a false negative result? And what kind of follow-up should I do?
Thanks.
I engaged in unprotected vaginal sex. Around 36 hours later, I developed burning/discomfort in the head of my penis. At about 44 hours, I developed a single whitish sore on my inner foreskin (im uncircumcised). The sore never hurt, never pussed, or broke open, although I did develop a large build-up of whitish cheesy like material around the head of my penis when the foreskin was retracted. The sore healed in about 5-6 days, and white cheesy material passed in a matter of week. I went to and got the sore cultured the day it appeared, and culture results came back negative for hsv2. What is the likelihood that it is a false negative result? And what kind of follow-up should I do?
Thanks.
MEDICAL PROFESSIONAL
I have no more thoughts or advice.
Thank you Doctor for your invaluable advice.
I should also add that the day the sore appeared, I was in the shower, and had previously left my foreskin pulled back behind my head for over 24 hours. While in the shower, I had pulled vigorously on the foreskin to bring it back around the head, and felt a sharp pain in the same place the sore appeared but didn't think anything of it. That night, I developed the symptoms and the next morning is when the sore appeared. Logic tells me that it may have been just swelling of a very sensitive part? What do you think?
I am scheduled to speak to a dermatologist and get a blood test on Thursday, btw.
I should also add that the day the sore appeared, I was in the shower, and had previously left my foreskin pulled back behind my head for over 24 hours. While in the shower, I had pulled vigorously on the foreskin to bring it back around the head, and felt a sharp pain in the same place the sore appeared but didn't think anything of it. That night, I developed the symptoms and the next morning is when the sore appeared. Logic tells me that it may have been just swelling of a very sensitive part? What do you think?
I am scheduled to speak to a dermatologist and get a blood test on Thursday, btw.
MEDICAL PROFESSIONAL
As I said, most likely you don't have herpes at all. But the direct answer to your question is yes, genital herpes can remain "dormant" without symptoms for years, then pop up with an outbreak.
However, "triggers" have nothing to do with it. Contrary to popular beliefs and some nonscientific websites, there are no well documented triggers for genital herpes outbreaks. Certainly caffeine, menstruation, and vigorous sex do not trigger outbreaks. And although flu and other infections trigger oral herpes outbreaks (hence the names fever blister, cold sore), they have not been clearly documented to do so for genital herpes. This doesn't mean there are no triggers. But none have been clearly documented, and the commonly assumed ones, such as the ones you mention (and stress, for that matter), don't seem to have any significant role.
However, "triggers" have nothing to do with it. Contrary to popular beliefs and some nonscientific websites, there are no well documented triggers for genital herpes outbreaks. Certainly caffeine, menstruation, and vigorous sex do not trigger outbreaks. And although flu and other infections trigger oral herpes outbreaks (hence the names fever blister, cold sore), they have not been clearly documented to do so for genital herpes. This doesn't mean there are no triggers. But none have been clearly documented, and the commonly assumed ones, such as the ones you mention (and stress, for that matter), don't seem to have any significant role.
My apologies Doctor, an unintentional oversight on my part, as I was in rush to post the question.
The last potential exposure I could have had, in thinking, was over four and a half years ago. Since that time, and up to about a month ago, I was in a long term monogamous relationship. Neither me nor my partner had ever any reason to be concerned. I've looked at potential triggers, such as caffeine, menstruation, vigorous sexual activity. My partner and I, over the years, have had "rough sex" a couple of times a day many, many times. We both consume lots of caffeine (in coffee and soft drinks). I've been sick with the flu plenty of times. And in four years, have never developed sores. Neither has she. Is it possible that it would remain dormant for so long with so many potential triggers in both of us?
The last potential exposure I could have had, in thinking, was over four and a half years ago. Since that time, and up to about a month ago, I was in a long term monogamous relationship. Neither me nor my partner had ever any reason to be concerned. I've looked at potential triggers, such as caffeine, menstruation, vigorous sexual activity. My partner and I, over the years, have had "rough sex" a couple of times a day many, many times. We both consume lots of caffeine (in coffee and soft drinks). I've been sick with the flu plenty of times. And in four years, have never developed sores. Neither has she. Is it possible that it would remain dormant for so long with so many potential triggers in both of us?
MEDICAL PROFESSIONAL
That's pretty basic information that you could have provided in the initial question. It means you didn't catch herpes from her. That makes herpes even more unlikely for you -- but if you have it, it proves you didn't catch it from her.
She was tested twice, once here, and once in the UK, with what I believe was a IGG blood test, and her results were negative.
MEDICAL PROFESSIONAL
Makes no difference in my opinion or advice, except that it supports the notion that if you have herpes, it likely is something you had well before the new sexual exposure you described.
I forgot to mention that you can speak with your partner, and conceivably she could be tested to see if she is infected. If not, of course there was no risk of herpes.
I forgot to mention that you can speak with your partner, and conceivably she could be tested to see if she is infected. If not, of course there was no risk of herpes.
MEDICAL PROFESSIONAL
From your description, your penile lesions doesn't sound much like herpes, and the negative cutlure test is evidence against it. So is the rapid onset; herpes rarely causes any symptoms before 2-3 days and generally doesn't cause open sores until a few days have gone by. On the other hand, herpes is the most common overall cause of genital ulceration, and cultures can miss the diagnosis. If you have herpes, probably you had it before the sexual encounter a couple days earlier, i.e. you are experiencing a recurrent outbreak of a previously asymptomatic infection.
As to follow-up, you should follow the advice of the provider who examined you and did the HSV culture. You could have a blood test for HSV-1 and HSV-2. But if positive, it won't necessarily mean herpes explains your genital lesion.
All in all, I am inclined to doubt herpes. But that's about all I can say.
Best wishes-- HHH, MD
As to follow-up, you should follow the advice of the provider who examined you and did the HSV culture. You could have a blood test for HSV-1 and HSV-2. But if positive, it won't necessarily mean herpes explains your genital lesion.
All in all, I am inclined to doubt herpes. But that's about all I can say.
Best wishes-- HHH, MD
I should also add that during that 5-6 day period, I had no fever, no "constitutional" symptoms, other than pain in my groin (in the area where the leg meets the pelvis), and slight pains in my left upper thigh.
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.
