herpes, dermatitis, irritation?

[Jjmar330]

Terri, thank you in advance. In March I received unprotected oral sex from a gal 3x (2x first Sat. of month and 1x 28th). I don’t know much about her history (dumb mistake). We also kissed deeply however no sexual intercourse took place. Fast forward and two weeks later I came down with a sore throat, felt sick, slight fever, viral in nature etc…I immediately became anxious/paranoid and about three weeks (4/20) later went and got tested for STD’s. Everything came back negative except HSV1 was at equivocal at .97. A week later (29th of April) I went back and got the same tests. This time HSV1 was now 1.01 (still equivocal) (Quest labs). Keep in mind I have never had a cold sore in my life and have never tested anything other than negative for HSV1 (previous life insurance tests, etc) so I assumed I got HSV1 from her. At about 7 weeks post incident I noticed a red area/irritation (not raised) on the R side of my penile head/crown maybe 1-2mm in size. I started to feel tingling/raw/irritation coming from this area. There was no ulcerations/scabbing/oozing…nothing just constant raw/sensitivity. After a week I went into a walk in clinic and the NP stated he didn’t see anything, ran more STD tests which were negative and gave me some antibiotics. These didn’t help and after a few days I went back and he said well it could be HSV1 and gave me acyclovir which I took but it didn’t seem to do anything. Within 2 weeks the tingling stopped however the area is still constantly red (not the same as surrounding tissue). I also went to an MD Derm and he said he wasn’t 100% sure what it was but that the area had some erythema. He also asked me if sex and/or stress seems to make it worse. He prescribedhydrocortisone cream and lidocaine which didn’t seem to help. After hearing him tell me he was confident it wasn’t herpes (Said the blood tests aren’t positive and is far too low a level) I felt like things got better (no tingling anymore but the redness seemed to stay). Fast forward about 6 weeks than the tingling starts again on the 4th of July. Keep in mind I do deal with depression/anxiety issues that def. are worse in the summer (reverse SAD) so am highly stressed plus I own a large business. For 3+ weeks this constant tingling/irritation went on and nothing helped. I even had refilled my acyclovir thinking in my head this is hsv1 and took 400mg 3x/day for 7 days (July 4-10). This did nothing and it lasted 2 weeks after that. About the 2nd week into this (7/15) I got into a urologist who looked and said she didn’t see much of anything but little redness and mentioned using hydrocortisone cream. She said it may be nerve damage? I do recall feeling my penis being irritated/sensitive while the gal gave me oral sex. She also said if it was herpes it would be a subclinical outbreak. She also retested me for the STD’s and this time (15+ weeks post exposure) and this time everything came up negative including the HSV1 (below .90) (Quest labs again). About July 23rd/24th the tingling seemed to stop and I went about life. 6-7 days later it kicks up again. In the last month i’ve had this raw/irritation/redness/sensitivity constantly less maybe 7-10 days. Terri I talked to you two weeks ago and ordered the WB. I took it last Monday. I’ve convinced myself I have herpes and am in terrible sorts. This is ruling my life and i’m really struggling. Does HSV1 come and go with 3-6 days in between. Do herpes lesions remain constant. Aloe seems to help some and I did put lotrimin on it which was horrible (burned and caused area to be red). I do have a few patches of redness on my chin and R Cheek that are constant as well. Just seems this has all started after having the oral sex. Any ideas/thoughts? Can I obtain a PCR swab kit from you?

[Terri Warren]

No, HSV 1 does not come and go as you are describing in the genital area. As we likely discussed, the HSV 1 screening test isn’t great, and the western blot will be the telling thing for us. If you are HSV 1 positive by western blot, we will send you swabs, yes. But honestly, nothing sounds like herpes here to me.

Let’s wait and see what happens with the western blot, OK?

Tingling is not herpes specific.

Terri

[Jjmar330]

Terri thank you in advance again. You have a ministry and I as well as many others are very grateful! I pray blessings and favor over you and yours! Please have some mercy and patience with me 🙂

Terri so we did the WB at 18 weeks and 1 day post oral encounter and both HSV1 and 2 came out negative. So thus far i’ve had 2 HSV1 equivocals at both 3 and 4 weeks, an HSV1 negative at 15.5 weeks ( I took a week of acyclovir the week before the test and stopped 5 days before the bloodwork).

I have since the encounter been on (2) 7 day cycles of Acyclovir (The 2nd time to the NP he saw my equivocal and said we can try this as it may be herpes 1) which I think may have prolonged my conversion of antibodies.
1)Any thoughts on that?
BTW the last OB i thought I was having i took it day 1 for 7 days and my symptoms/OB went for another 2 weeks plus????….is this common with HSV1?

The WB results gave me relief from my anxiety for about one day however my symptoms still remain in full force. I still have a red area on the R side crown of my penis that feels raw/irritated/sensitive in that one focal spot. It is constantly there and has been as long as i can remember and at times (when rawness the most, looks slightly inflamed/swollen). The intensity varies however it is almost constantly there and has been on and off 90% over the last month+. I honestly believe it is a cold sore/herpes that for some reason is not strong enough to crack the skin/ulcerate. I’ve seen 2 dermatologists who both did not know exactly what it was (they did see some yeast/fungal on my inner thighs that they put me on fluconozale for…i sweat alot and am running around at work constantly) but nothing definitive on my spot/area but they both agreed they can see it.

2)Is is possible to have such a weak/small amount of the virus that the symptoms will do this…not ulcerate just irritate the surface of the skin? W

Terri I don’t know what to do. I strongly feel I have HSV1 received through oral sex. For whatever reason my body is not making antibodies and this thing is running rampant. I’m in excellent shape and am a health care provider myself. I eat right take supplements and am very optimistic by nature.

Is there a chance I will never seroconvert? Is there a chance my body will not recognize this virus and make antibodies? I’ve heard 10-15% percent of folks never test positive on an IgG HSV1 test.

3)Everyone says ow GHSV1 is so mild…that is not the case with me if this is what this is. I’ve had constant symptoms or rather I would imagine outbreak over the last month. When it let up then I had anal itching, then just today Ive had a sharp pain in my R testicle.

What else could this be Terri? Have you seen any other viruses cause these symptoms (red bump that feels raw and stays constant) after an oral sex encounter? Whatever it is my body is not fighting very well.

4)What is the reliability of the Western Blot at 18+ weeks? I’m assuming for whatever reason that my body isn’t recognizing this virus and isn’t making antibodies (despite all these lovely symptoms that persist). What’s the latest you’ve seen somebody test positive on the WB after a high risk situation? Should I do the IgG’s again?

5)Should I get the Western Blot done again at the 6+ month mark? If so from which date? From the encounter or from when I first had symptoms (which the raw/irritated red area started or I at least noticed it first 6+ weeks after the encounter for about 10-15 days then was gone).

6)The one urologist I saw said she has seen herpes cases that are “subclinical” go on or present like this. How in the world is my body not recognizing this bug.

Terri I am having a very hard time.
Just hard as all this stuff started after I made the BIGGEST mistake in my life. It’s hard to forgive and move on when you are constantly reminded at least symptomatically of what you did wrong. I’ve always held myself to a high standard morally and have never done anything of this sort and it’s having a severe impact on my mind and life right now. I know this anxiety and regret/guilt doesn’t help but it cannot explain my constant symptoms which seem to never get better nor go away. Thank the Lord my wife is still with me and has forgiven me. She is with me regardless but I am dying here with no definitive diagnosis.

Not sure on my next step. I will probably have to get those PCR swabs from you asap.

I’m 99% positive I have HSV1. I almost wish I would break out in a horrible case, get it over with, have my body recognize it and try to go on. This atypical presentation and/or subclinical manifestation is becoming old very quick.

[Terri Warren]

Just because your doctors can see a skin change doesn’t make it herpes. HSV 1 does not present as a red spot for 90% of days – it just doesn’t. Is there a chance you may never serconvert? There is a chance but it doesn’t make it likely. And the figures you cite are for the ELISA not the western blot. We don’t have exact numbers for how sensitive the western blot is totally, but far greater than 95%. I would believe the western blot. You could do it again at 6 months, certainly, but if you do, remember that antiviral medicine that taking antiviral medicine for an extended period of time can influence the test results

So I would suggest that you don’t take antiviral medicine, and you start doing PCR swabs from the area you are concerned about. How about that.

Terri

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