Complicated potential Herpes situation

[thirdstrike]

Hello!

I have a bit of a complicated situation that I will try to relate in as straight forward manner as possible. In October of 2012, I had protected sex, and received unprotected oral sex from a girl. 5-6 days later I started having tingling, pins and needles sensations, and then small bumps appeared on my glans, largely painless, but some appeared to have a little fluid in them. I would treat them with a little bit of peroxide and neosporin, and they would heal in a few days (I am uncircumcised). I suspected herpes, and at 3 months took an IGG test. Negative. The symptoms persisted, and took more tests as 6 and 9 months, I think. Still negative. Every doctor I showed them to thought they were folliculitis, as after the initial penile bumps they almost exclusively appeared on my buttocks and thighs. Eventually, around 9 months and a few weeks, I got a Western Blot, which showed a result of negative for HSV2, but positive for HSV1. I took this as good news, and moved on. In time, the symptoms subsided, with an occasional bump, here and there.

Last April (2014), I finally had another sexual encounter with a girl; very brief unprotected oral from her, and protect sex (again, very brief, it had been a long time!) And, within a week, the exact same symptoms, in the same spots, same hot feeling in my legs under the skin, tingling, same small, largely painless bumps, no open ulcers, or weeping or crusting. But persistent. I assumed that I had gotten HSV2 this time, confronted her, she got mad and denied, stopped talking to me. Again, took several IGG tests (which oddly never showed the HSV1 that my WB test did), Finally, this past November, at the 6 and a half month mark, got another Western Blot. Again, positive for HSV1, not HSV2. By then the symptoms where few and far between, not a problem for me. I took the good news, and moved on.

On week ago this evening, I met up with a girl that I had been talking to. We engaged in protected sex (much longer this time, I’m not too proud to say!), and unprotected oral, for her, and finally unprotected oral for me. In the heat of the moment, I forgot about my HSV1; I wasn’t having any symptoms at all, and I know that genital shedding is rare. Also, I have reason to think that she gets coldsores.

Anyway, in talking to her afterwards, she mentioned that she had been attacked by a guy she met online a few weeks previously, and sexually assaulted. And that two years ago, she had been arrested for being a sex worker….much to my surprise, and growing alarm.

So, two days ago,5 days post, I noticed the same slight burning feeling under my skin in the groin, and a few red spots show up, on the outer thighs, and butt. Not in clusters, but spread out. Then, I found a small bump on my glans last night when I got out of the shower. It reacted to peroxide, I cleaned it up and have been watching it’s progress. It hasn’t gotten larger or turned into an ulcer. A few other spots have appeared on my buttocks, but again, very small (and when I say small, most of these are the size of a pinhead). None of them appear fluid filled yet, some have a red base, and some do not. There might be 10 or so that I can see, spread out, not really in groups, again, they don’t hurt or seem like blisters yet.

I guess, what I am trying to figure out is, is it possible that reexposures to other strains of HSV1 are just triggering outbreaks? I know that antibodies to one type are suppose to protect against more of the same, but I can’t help but wonder if that is so. Also, I have been trying to follow a low arginine, high lysine diet (I know there is conflicting ideas on the impact of that), but I used to find that eating certain things would seem to trigger an outbreak. I also know that it may not be nothing herpes related at all, or that I may have gotten HSV2 finally, but I find it odd that in each instance the presentations of symptoms, and timeline, is virtually identical. Given that I have antibodies to type 1 already, would I need to adjust my time to wait to take yet another WB, or should I still shoot for the 12-16 week mark? I guess I am just looking for some feedback and ideas. I should add that I haven’t been getting the burning, or tingling feeling much at all between the initial bouts each time. And that I never had any coldsores that I am aware of, before all this.

Thoughts?

[Terri Warren]

It sounds like you are really focused on herpes. That’s three sexual encounters that you’ve described over a period of more than a year (there could have been others but I think you would have told me) and each time, you believe that you’ve likely contracted herpes. I don’t think so. None of this sounds anything like herpes to me and I”m so glad that you arranged a western blot to know that you don’t have HSV 2. The HSV 1 could be either oral or genital but with the brief encounters, I’m thinking maybe oral. Have you ever in your life had a cold sore on your lip?

Men who still have a foreskin are far more vulnerable to acquiring bacterial and fungal infections and my guess is that the bumps are likely related to one of those two things rather than herpes. The bumps you describe just don’t fit with herpes. They do sound, on other parts of your body, like clear folliculitis.

The odds of getting herpes at a single encounter are very low to start with and you are adding to that low risk for wisely using condoms. So in my mind, your risk of acquiring HSV 2 is really low. And we know you already have HSV1 (though we don’t know if the bumps are HSV 1).

The research suggests that people rarely get another strain of the same type (1 or 2).

Terri

[thirdstrike]

Hi Terri,

Sorry for the delay; I was out of town traveling for work, and was hoping to get some pictures that might clarify what I am experiencing. I managed to get a couple, but I am not sure if you can really see them well enough.

Anyway, I can see what it seems like I am focused on herpes. I was the very first time, and very apprehensive, but I have managed to handle these situations calmly. The reason why HSV popped in my mind as a culprit is because they seem to come and go over time, and because of the irritated nerve feeling that often comes with them. These were the only penetrative encounters that I had over this time. I never had cold sores as a kid, and the first “outbreak” was the most severe, which I’ve read GHSV1 tend to be. But anyway, I hope it is just folliculitis, but I did get more that I noticed today, and did manage to get a few pictures of (not easy to do when they are on your backside!). The two largest ones are on my waistline, and right buttock; and the one on the buttock is like a pimple, and seems like it may have a little fluid in it. It def has a center. Small amount of pain, about as much as pimple would be, but it did itch slightly earlier. The other patch is on the bottom of my left buttock. I would go and try to get them swabbed, but I have to leave town again for work early, and will be gone until the weekend. Would already having HSV1 impact my testing window at all if I did get HSV2? Also, I’m not sure if I mentioned this, but I have never shown up as positive for HSV1 on any test other than a WB, even after the first WB. I know the tests miss 10-20%, but is that per test, or people, consistently?

Thank you again for you input.

[Terri Warren]

None of these looks anything like herpes to me. They look like pimples or folliculitis.
Yes, if the screening antibody test misses HSV 1, it will likely miss it every time and will only be picked up by western blot. And yes, having HSV 1 can slightly delay developing antibody for HSV 2, maybe 1-3 weeks?

Terri

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