Herpes scare/BioKit availability?

[sadsherpa]

Hi, Terri!

Here’s the situation:

May. 19th – Had sex with a friend, condom broke, noticed that right away, pulled out. Possibly in checking the condom exposed a bit of penis to “the outside” a bit more.
Girl assures that she had a clean HSV-2 test about 2 months prior.
About a week later, a single small painful sore on a crease in the left forward part of the upper foreskin appears out of nowhere (possibly following a heavy masturbation session, but I remember being surprised). I start worrying. However, it quickly stops hurting (in a day or two I think) and skins over with flat see-thru skin in about another day. I start relaxing. Doesn’t scab but leaves a scar. There’s also some stinging on the head of the penis, urethral tenderness after urinating and ‘heavy’ bladder feeling but nothing too specific. Being very alert to all these things, I notice, but sadly don’t write exact dates down/take photos – as girl’s assurance is in back of mind.

June 15th – girl takes a full checkup, gets results back, 9+ for HSV2 likely acquired from a contact a month before our interaction, and informs me.
June 17th – requestatest/labcorp IGG IgG Abs (so 4 weeks after encounter) is taken, comes back on the 18th as <.91 negative.

Questions:
– With my sore being so short-duration – and thereby unusual, especially for a primary – is there any hope that it’s not HSV-2 related? The big question, obviously.
– Can/should I take the POCKit test anywhere nearby to get more info (Seattle/WH) to provide quicker resolution to this? How to? Who does it around here?

Thanks a lot, Terri!

[Terri Warren]

I’m not sure who does the Biokit around Seattle. It’s not a favorite of mine because it can be difficult to read.
I actually think your chances of becoming infected based on the encounter, are low but definitely not zero. They aren’t zero because she may have recently acquired infection which is concerning in itself because she would be shedding more given new infection. There is really no way to provide quicker resolution to your question because regardless of the test that you order, the slower part is the making of antibody which really cannot be rushed. It can be slowed if you take antiviral medicine which I hope you will not do. If you test again around the 1st of July, you will be 6 weeks out and if you test negative then, there is a 70% chance that you will stay that way. I don’t think there is any way around waiting longer for the most accurate test result.

Of course there is hope that your are negative and in fact more than hope. But the sore is still concerning.

Terri

[sadsherpa]

Thank you for the reply, Terri.

All the things you say are the ones that are making me not sleep at night. What a stupid mistake on my part. And I had so many chances to not do this!

I guess the only thing keeping the flame of hope alive is the duration of the sore/its presentation – because if that sore is likely H, then it’s a non-question whether I have it or not and I just need to wait for the official confirmation.

Dr. Handsfield was adamant that if a (primary especially) sore goes away faster than 7 days, it’s not H. Was searchin’ and leadin’ and hopin’ for possibly more thoughts in that direction. 🙂 Grasping at straws, we all understand.

Thanks again.

[Terri Warren]

I would certainly agree that a short outbreak is not consistent with a true primary but if you have HSV 1 on board already, that can change that picture. If 80% of those infected with HSV 2 don’t know it, then it probably isn’t likely that every first outbreak lasts more than 7 days, right?

You missed the part about my saying I think herpes is a low probability. I don’t think you are grasping at straws to think this might be not herpes.

Terri

[sadsherpa]

Thanks again, Terri.

I didn’t have HSV1 via IgG about 10 months ago, haven’t noticed any signs since then either. So I’d presume I still don’t have HSV1. Does that change the situation? The sore is worrying me soo much. Did I remember correctly? Did this or that or… bahh. Alcohol and staying busy. That’s a good way to keep the mind occupied.

Thanks, Terri. Don’t think I have any questions remaining.

Thanks a lot for your help in doing this.

[Terri Warren]

The problem is that the HSV 1 antibody test isn’t great in the first place – it misses 25% of HSV 1 on screening. The western blot is far better if you want to have that, our clinic can help you obtain that.

Terri

[sadsherpa]

Thank you for the reply, Terri. Because WB takes 3 weeks, it didn’t seem like a worthwhile undertaking.

Took another test yesterday, 5 weeks 5 days after the event. It came back today as <.91, yaaay! But I realize it’s way too early to relax.

Questions:
Would the very short duration/small size of the sore correlate with low IgG numbers – as in, the infection was very ‘top level and light’ and the body didn’t have to work too hard to tamp it down…for a lil’ while? Are there any other reasons for slow IgG ramp-up?

The sore (while looking pretty scary for a bit there) went away painlessly and without a ‘crust’ but it was still being noticeable as a ‘covered up red spot/scar’ for a good bit longer – would that be included in the ‘sore still present’ timeframe? I.E. Is its ‘very short duration’ something that I’m misrepresenting?

Thanks again, Terri!

[Terri Warren]

Well, you have about 70% reassurance about HSV 2 at this point which is good. Not great, but good. The index value does not correlated with anything clinical really.
I think it is also very important to remember that his partner told you that she tested negative for HSV 2 two months before you had sex, right? That needs to be factored in to all of this. If she is truly negative, then you didn’t get this from her, right? Do you believe her?

Terri

[sadsherpa]

Hang on, Terri, I’m confused. I think you might be missing the part of the first post – skipping the part where she did come up positive for it on a test taken a month after our encounter.

I guess the question of ‘what delineates the ‘sore still present’ time-frame’ is about the only one I still feel that could be addressed until further index value info.

Thanks, Terri!

[Terri Warren]

AAh, you’re correct, I missed that, sorry about that.
So – what defines the sore still present. I say that when new skin has replaced the lesion completely then it is healed. That does not mean that if it is herpes that it will then stop giving off virus, necessarily.

Terri

[sadsherpa]

Hi, Terri! To resurrect a long-ago thread…

First things first, I have about a week ago taken a 16-weeks since exposure test, and am still coming in as Igg negative at <.91.

However… There’s a spot on the foreskin/head of the penis (pretty sure same area that the original sore was at) that has at this point 3 times developed a weird thing.

First, August 1st, some pain was felt on the spot and then a day or two later I noticed small scabs – shown in the attached picture. Went away in a day or two. (picture 1)

August 26th, on the same spot, one small (tiiiiny, pin-prick like) scab was noticed. Tried, but didn’t get a good picture. Went away in about a day or two.

And now September 18th, on the same spot, a bit of a growth has appeared (picture 2) and on the morning of the 19th there was a single spot in the center of it, and now on mind-day of the 19th it is already pretty much going away/gone. (picture 3) There are no bubbles, open sores, it is not painful. Just a tiny scab appears, and disappears within 2 days or so.

I have pictures up at http://imgur.com/a/sj9ZU

Thoughts: This is progressing way faster than a HSV 2 sore would. It is not typical in presentation. It is happening a bit more frequently than HSV 2 recurrence should – 3.5 weeks between the last 2 episodes.

But what the heck else could it be!?!

Thank you!

* I have been abstaining from using any chemicals that might affect seroconversion; however there was some recreational ketamine use (I read something about how that might have a s-conversion effect) on week 14-15, I’d say. Not sure if that’d affect much, but, to have full transparency.

[Terri Warren]

Sorry, my assessing pictures is just too close to practicing medicine over the internet.
No antivirals, right?
I don’t love to hear about scabs and painful little sores honestly, but the rest of it doesn’t sound like the behavior of herpes to me at all.
would you consider a western blot, just to be certain?
Ketamine would have no impact on herpes seroconversion.

Terri

• This reply was modified 7 years, 4 months ago by Terri Warren.

[sadsherpa]

No antivirals. Nothing even resembling antivirals. No alcohol for the past 3 months.

Doing western blot would result in 3 more weeks of scared depression and then possibly a great crash at the end of it all? Oh fun. Can order blood drawn (to be forwarded to you guys) at my regular physician’s right? Is it worth it to, or can the subject be dismissed from the negative results of the IgG? Heck, that’s a question for me, I suppose.

To ask in a different way – is there anything else this could be the result of, though!?

The spot noticed on Friday and that was a single pinprick scab on Saturday is gone to clear skin on Sunday morning.

Thanks!!!

[Terri Warren]

That was actually your final post on this subscription please renew if you have more questions I can help with.

Terri

[sadsherpa]

I’m more than happy to pay to thank you for your help here.

So, I guess the questions would be:
– what else could it be!?
– should I get a WB test?
– how to do the above?
– in this case, what are the chances of it being confirmed HVS through WB?

Thanks!

[Terri Warren]

I’m not really sure what else it could be- sometimes a severe fungal infection will cause breaks in the skin. Yes, I think you should get a western blot, given what you are describing as a sore, especially when you had sex with a woman who has relatively new genital herpes infection. You have now waited almost exactly 4 months from time of possible infection. If you call our clinic and set up a phone consult, we will arrange for the testing at a Quest lab near you. I feel very clear that you will get a better idea about all of this from the western blot.

Terri

[sadsherpa]

Just to clarify… there have been no breaks in the skin – all of these three events occurred with no open sores – just with a pin-prick scab-looking thing – which only stays for a day.

I guess I’ll be in touch via phone in the near future. Thanks again!

[Terri Warren]

OK, well, you don’t have to do it! Your call. I think the odds are definitely in your favor. If you can relax with your testing, then stop testing.

Terri

[sadsherpa]

Hi, Terri

Is it possible to order the blot faster? I called WH and am being told I need to wait more than a week to consult with you… To get some reference, I’ve a phone consultation scheduled for 4:20 on the 29th…but it is seemingly not necessary as you’ve recommended the course of action already! 🙂

Thanks!

[Terri Warren]

No, we need to do a phone consultation. But I do have openings on Wednesday and I think even tomorrow I have an opening at 3:40. I have written to my office manager tonight and let her know to open up that schedule time. I think they didn’t schedule it as I have so many patients already on my schedule for those two days after being gone for three weeks but I don’t mind being a little busier – the phone consult takes only 10 minutes but I must have some relationship with you to order this test that has been established – does that makes sense? I purposely do not want to know the names of the people who are talking to me on this board.

terri

• This reply was modified 7 years, 4 months ago by Terri Warren.

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