Herpes 9 months after frottage with escort

[Curious6149]

Hello doctor. I want to thank you for your time in considering my question. I turned to this forum last year and it helped me immensely in a time of great stress and anxiety. I hope my situation is a help to others that may read this.

First, I had an encounter with an escort about 9 months ago. It was an erotic massage and there was some genital to genital contact. There was no inserting sex. Like many folks I soon experienced acute anxiety and starting to experience some genital discomfort. I was tested for gon/clamid and tests were negative. I was told by your experts and forum members that this was a "zero" risk encounter. I have since tried to move on and put that mistake in my past. I never had any blisters so I never worried about herpes. (Although it still was a concern in my head)

Now here it is 9 months later and I am in a very stressful situation. My wife and I just recently found out that the child we are expecting in August has a cystic hygroma. I'm sure you are aware that this is a very bad thing for the baby and based on what we know the baby is not likely to survive. This has obviously brought my stress and anxiety levels to very high levels. About the same time I noticed some small pimples on the shaft of my penis. I then notice a couple very small ones on the head. There are not clearly visible unless you look closely. I soon panicked and thought this was a delayed outbreak from the mistake I made last summer.

Is it even possible or probable that this is a delayed herpes outbreak? I've had no other sexual encounters outside my marriage since then.

Can herpes cause something like a cystic hygroma?

What symptoms do it need to watch for?  I'm aware my anxiety and stress may simply be play tricks on me but the small pimples are there.

Thanks for your help and patients with me on this. I thought this was in my past but maybe not.

[Edward W Hook, MD]

Correct.

This thread is now over. EWH

[Curious6149]

Thank you again doctor. For the record, early on I did panic and get the blood test before I got your advice and I got the results back last week. They were negative for both HSV 1&2. Also, my pimples still look the same. I guess I can be sure it is not HSV but something else unrelated?

[Edward W Hook, MD]

Glad to help. That your lesions have not changed in five days makes HSV most unlikely.  Glad to hear that you have shared this with your wife, now I hope that you will be able to move forward from this. EWH

[Curious6149]

Doctor. I wanted to personally thank you for the fine work you do out here. The anxiety and stress I've experienced over the last week has been more than I've ever had in my life. I can't describe how high my anxiety levels have been fearing for the life of my child and that anxiety made me feel a tremendous amount of guilt over my foolish mistake last year. Your level headed and reasoned responses to my questions have helped keep me sane during this difficult time. I have also learned a lot about HSV testing and the possible pitfalls. I fear the blood test may do more harm than good.

For the record, it's been about 5 or 6 days since I first saw the spots and they haven't changed much at all. If anything many have faded. The remaining ones appear like very very small pimples and half of them are associated with hair follicles. Just for one last assurance, based on what you have told me this is a good sign that it is not HSV. I'm also factoring in the fact that the other doctor told me last year that the event I was worried about was a no risk event for STDs. My suspicion is that it is my nerves and tremendous guilt that I haven't dealt with. My wife is aware of this and she has forgiven me and truly thinks I am punishing myself for my guilt. I am considering talking to my doctor about getting something for the anxiety, it has been incredible!

Anyway, I don't want to waste your time but words can't express how thankful I am that someone like you is out there willing to help with the facts about STDs and also deal with us neurotic patients that are having a hard time dealing with the consequences of our behavior. Thank you sir very much!

[Edward W Hook, MD]

The blood test will not tell you what the lesions are and you cannot assume that the lesions you have noted are herpes- even if you had herpes, these lesions may not be HSV. Further, statisitcally there is a 60% chance you will have HSV-1 and a 20% chance you will have HSV-2 (those are the national figures).  while the blood test can tell you if you have antibodies, they cannot tell you the location of your infection or its duraation. Finally, there is a fairly high chance that you will have a false positive test.  EWH

[Curious6149]

I'm sorry for the confusion doctor. I'm confused. Why would the blood test not offer answers? Sorry for the follow up I'm just confused.

[Edward W Hook, MD]

The blood test for HSV will not answer the questions you are asking. The bumps you have noticed should be tested using a PCR (Preferrred) or culture test from the lesions.  In testing, please do not let the clincian tell you that there must be an ulcer or fluid filled lesion present for testing- that is not the case.  I predict the test will be negative.  EWH

[Curious6149]

Update. I've checked the bumps again today and most have subsided. Just a few small ones now. I suspect it was stress related. I've decided to get tested for HSV 1/2 just for my peace of mind. Is this a good idea? Are there issues with the reliability of these test? Thank you.

[Edward W Hook, MD]

Correct, for your lesions to have not changed in appearance is strong evidence that they are not HSV.  EWH

[Curious6149]

Thank you sir for your reassuring words. This is obviously a very painful time for our family. I'm glad a stupid mistake I made in the past wasn't a contributing cause.

Just to be clear, with a typical outbreak of HSV the legions would change in appearance over a few days? Mine have not although I started to notice them after we got the bad news almost a week ago.

[Edward W Hook, MD]

What you describe sounds very much like normal variation in the genital skin, not herpes.  

I understand that when you hear about something like your child's abnormality that it is completely normal to begin to look for eaplanations.  This however is not related to your exposures with the CSW 9 months ago.  EWH

[Curious6149]

No significant change over the last few days. They are white in appearance and there is no pain. It was just very worrisome and I was panicked that somehow the cystic hygroma could have been my fault. Can stress like this bring on more fordyce spots? Also, is it significant that my wife has had no symptoms of herpes as well?

[Edward W Hook, MD]

Welcome back to our Forum.  Before I comment on my confidence that what you describe is not a herpes outbreak, let me tell you that I am sorry to hear of your unborn child's cystic hygroma.  I know this is a terrible stressor for you.  Despite that however, let me assure you that cystic hygroma's are not a complication of herpes infection.

Now for your bumps.  You do not tell me how long the bumps have been present or whether they have changed during the period you have been aware of them.  What you describe certainly does not sound like HSV and for an initial HSV outbreak to occur 9 months after a low risk encounter of the sort you describe would be most uncommon.  Further, if you have observed them for more than 2-3 days without them changing, then you can be confident that they are not HSV.  There are an enormous number of normal "bumps" and irregularities present on the genitals and my guess is that this is what you are seeing.  If my reassurance is not sufficient, you could see a health care provider for evaluation and PCR or culture testing of the bumps (FYI, even lesions which are not fluid filled or open sores can be tested for HSV simply by swabbing them).  If you do this, I am confident the tests will be negative.

I hope my comments are helpful.  EWH

[Curious6149]

Just as a follow up. In my research I discovered fordyce spots. I feel kind of stupid now. The pictures I've seen of fordyce spots are very similar to what I have. It still would be helpful to have your feedback concerning my questions though. Thanks again. You provide an amazing community benefit here!