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Avatar universal

not familiar with hsv symptoms

Doctors, last year I received a ** from a girl and at 8 weeks I had a red bump on my foreskin. It lasted about 2-3 days and then was gone. I think the irritation was from more friction than usual during wanking off as it was taking longer to finish and was multiple sessions. There was no itch pain or burning. It was a single bump. I tested at 13 weeks and was negative for hsv 1 and 2 on igg. Of recent I had a condom break with a girl on april 9th and then received an unprotective ** on april 26th from another girl (she claims she never had an outbreak ever and there was no visible bump on her lips) on May 10th I had 2 red bumps on my foreskin (area between shaft and head). Again no pain itches or burn sensation. I could touch them and it didn’t hurt at all. They were very small and not right next 2 each other. 1 went away in 3 days and the other in like 5 days. I also had a fever that week but this was determined to be strep.  I immediately went to the urgent care and had a physician assistant look at them. She didn’t think they were hsv and claimed she saw patients with hsv before. She said all of them said theirs came with pain. She did say she couldn’t swab it though and I know from here you say you can swab anything so maybe she was misinformed of what hsv could look like? I was tested for igg and igm for type 1 and 2. Again I am negative. I took pictures of the bumps. I went to a dermatologist and she thought there was no concern (the pictures weren’t the best quality though so I don’t know if it represented what actually was there) but she thought they looked glandular. Possibly from irritation or yeast infection.  So here are my questions.
6 Responses
239123 tn?1267647614
MEDICAL PROFESSIONAL
Welcome to the forum.  However, please note that the reason for the 2,000 character limit (about 400 words) is to require that the initial question be stated in that limit and not spill over into a follow-up comment window.  The moderators have neither the time nor energy to read long essays, and I have never seen any question on this forum (or the HIV prevention forum) that could not be adequately stated within the limit -- including this one.  The normal response is to delete such questions without reply, and without refund of the posting fee.  But I guess you caught me in a good mood, so I have replied below.

HHH, MD
Avatar universal
1. My test for the condom break was at 4.5 weeks but the ** was only 2 weeks. I will retest at 12 weeks but will that be enough for confirmatory to move on or because I had possible symptoms I need to test at even a later date?
2. I read that the only way of knowing if you have hsv is by swabbing and that blood tests can’t confirm if you have it. I am afraid if I don’t get these red bumps again I can never swab so I fear I missed my chance of knowing if I have it if I test negative at 12 weeks. Or can I take that as conclusive at that date?
3. I know you say igm is pointless but would the test add any confidence if it was negative for both as an early indicator? How many people seroconvert at 2 weeks for igg? What you think my odds are I have either hsv down there?
4. Would hsv1 hurt down there as well and be in multiple groups of bumps? Or is hsv1 going to be more atypical symptoms since it doesn’t like to grow there.
5. Does my strep and the bumps seem to be linked together for initial hsv from the **? I know 13 days is in the range for a break out but my bumps were atypical of herpes being no pain or itch?
6. I think terri warren stated that the initial outbreak would be on the shaft.  Is this true?
7. Since I am negative before these 2 incidents with no antibodies to suppress symptoms can I assume my first outbreak would be really bad?
8. Since these were more atypical symptoms meaning no pain or burning and only lasting from 3-5 days do you suggest retesting?
9. Does hsv have to be in clusters? of more than 1 or 2? common for it to be atypical symptoms?
Avatar universal
Thank you doctor for not deleting and replying but I do not see your comments below on my thread
239123 tn?1267647614
MEDICAL PROFESSIONAL
First, the chance of catching herpes from a single oral sex exposure is extremely low.  The combination of that low risk plus the negative blood test 13 weeks later amounts to 100% certainty you didn't catch HSV from the first exposure.

Second, both the symptoms and the negative exams by knowledgeable doctors -- a dermatologist in particular -- argue strongly against herpes from the second pair of exposure (condom break and another oral event).

To your specific questions:

1) I recommend against further testing. The chance of herpes is too low, and although the available blood tests are good, they aren't perfect.  The chance of a misleading false positive result probably is higher than the chance you caught HSV from the April exposures, so why bother?  But if you insist, just have the test at 12 weeks.  It's time since exposure that matters, not symptoms.

2) Although true that the blood test misses a few infections (around 10% of HSV-1, probably 1-2% for HSV-2), the combination of low risk exposure, lack of typical symptoms, plus negative test results is 100% reliable for all practical purposes.

3) IgM indeed is a poor test.  Don't do it; the results are more often misleading than helpful.

4,5,9) You are obsessing too much about these details. Initial herpes lesions often are widespread, recurrent ones in clusters.  The symptoms of HSV-1 and 2 are not different at all, except in lower recurrence frequency for HSV-1.

6) Initial HSV symptoms occur at the sites where the virus enters the skin, typically at sites of maximum contact/friction during sex.  Thus the head and shaft of the penis, vaginal opening and labia minor, etc.

7) No, this is not a valid assumption.  On average, initial herpes is worse than recurrences, but still many new infections are mild or cause no symptoms at all.

8) I recommend no further testing.  

All things considered, it seems apparent you are somewhat irrationally obsessed with genital herpes.  Nobody wants it, but for the most part genital herpes is a relatively mild, easily managed conditions.  It isn't worth the level of concern you seem to have.  Take common sense precautions (condoms for genital sex with new partners, etc) -- then live a normal life without worry about it.

Regards--  HHH, MD  
239123 tn?1267647614
MEDICAL PROFESSIONAL
Do you expect instantaneous replies?  It takes time to write a thoughtful response.  A little patience would be appreciated.
Avatar universal
Hello dr.
Is it possible for ARS to appear 60 days after expusure?
Thank you
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