HSV-2 concern after swollen inguinal node

[memphis]

Hi Terri,

I asked a question about a year ago that is similar to what I’m here to ask now.

Testing and Risk Assesment

I’m sure you have access to my previous post, but I thought I should update. This was a particularly trying time emotionally for me, and I was often thinking unreasonably. I’ve accepted my HSV-1 status, and it has not been a negative factor in my life. I did not test again.

I currently live in Germany. On Dec. 3-4th I had protected as well as unprotected sex with a new female partner that I know little about. This was a lapse in judgement, but it happened. On Dec.11th, exactly 7 days after this encounter, I was showering in the morning. While washing I noticed that I had a swollen inguinal node on the right side. There is no mistaking that it was enlarged, a node, and unlike last time; it was also quite painful and tender to the touch. The night before I had been drinking and eating unusual food at a holiday party.

Besides the swollen node, I had no other symptoms that I could find. I also inspected myself for other sorts of injury or infection, and beyond a couple of blocked hair follicles on my thigh (normal), there was nothing i could see or feel. The pain and swelling were slightly less the second day, even less the third day, and by the fourth day to now the pain is completely gone along with most of the swelling. The node is still a bit larger than it prob should be, but I think this is expected.

In your work have you had any patients that exhibited only a unilateral swelling of an inguinal node and no other symptoms that turned out to be HSV-2? Is it possible?(I’ve read conflicting opinions)

I plan on getting tested at the 6 week mark for other STD’s, but was curious if you would recommend HSV-2 testing as well? I would love to believe that this was coincidental, but the timing of the onset of the swelling is what has me worried. Your thoughts, answers, and time are appreciated.

[memphis]

I was just reading over my post, and the thought occurred to me that this was worth noting as well: Two days before the swelling started, I was made aware that a colleague I share a working space with had contracted Chicken Pox from his child. I don’t know if this would contribute to my symptom, but maybe it’s helpful. I had chicken pox as a child, and again I have no other visible or detectable symptoms aside from the swollen inguinal node. I look forward to your reply!

[memphis]

I apologize for the repeated posts, but I came across LGV Lymphogranuloma Venereum in my searches. I’m going to be in the U.S. next week and have decided to go ahead and test for Chlam., Syph, Ghon, HIV while I’m there. Will a normal Chlam. test from quest diagnostics show LGV?

A also came across some older posts by Dr. Handsfield related to my symptoms, so I can imagine your response will be similar to his, that this is most likely not HSV related, however your independent thoughts and recommendations are still appreciated!

[Terri Warren]

I do doubt that this is HSV related, yes. The lymph nodes in the groin can enlarge from anything happening below the waist, from an ingrown toenail to jock itch to a scraped knee. These nodes drain that entire area and respond to issues below the waist. We don’t see LGV here and I doubt it is there either, such is the problem with the internet. I also don’t think the chicken pox has anything to do with your nodes either, honestly. Without other symptoms, I’m not sure herpes testing is really necessary. If you are in the US, you might as well do it while you are having your blood drawn, right?

terri

[memphis]

Thanks Terri. I didn’t order the HSV-2 test, because I was still well under any useful testing time. Everything else was negative though :), and I moved on. Seeing as how I still have my follow-ups, I’d like to change the line of questioning a bit.

The woman that I’m currently seeing informed me last week on Friday 11/15 that she has a cold sore on her mouth. I saw her her a few days before on Wednesday. I’m not sure exactly when her symptoms started, but she has informed me that this is not her first cold sore, and that it’s been over 2 years since the last one. So we know that my asymptomatic HSV-1 is not the cause of this. She informed me that everything has healed (I haven’t seen her) today. I plan on seeing her Wednesday 11/20. So…

My HSV-1 site is unknown, but we assume that it’s most likely oral. Now…

1) Is 5-6 days enough for a cold sore to completely heal and leave new skin? Again I don’t know what it looks like and haven’t asked.

2) I’m aware through yours and your colleagues work that it is highly unlikely that I will contract HSV-1 in another location than I already do (but we don’t know where that is). However, it is “possible” I would assume? So, if it’s healed should I wait any longer to kiss or receive oral from her, or do you think my worry is unfounded in thinking I might develop an infection that causes symptoms somewhere in my body? Would your answer change if it was in a scabbing state?

Any advice or thoughts are appreciated. Thank you!

[Terri Warren]

1) Is 5-6 days enough for a cold sore to completely heal and leave new skin? Again I don’t know what it looks like and haven’t asked.

Yes some people have only about a week of a cold sore, totally possible.

2) I’m aware through yours and your colleagues work that it is highly unlikely that I will contract HSV-1 in another location than I already do (but we don’t know where that is). However, it is “possible” I would assume? So, if it’s healed should I wait any longer to kiss or receive oral from her, or do you think my worry is unfounded in thinking I might develop an infection that causes symptoms somewhere in my body? Would your answer change if it was in a scabbing state?

Since you are both positive for HSV 1 (I am making the assumption that her recurrent cold sores are caused by HSV 1), then I would not worry about having any kind of contact with her. Is is possible to get HSV 1 in a new location? Yes, possible, I have seen it once in 33 years and heard about it twice (for whatever the telling is worth). Having contact with her HSV 1 would not cause you to start having symptoms, no, I can’t imagine why that might happen. My opinion would not change if it was in a scabbed state, no.

Terri

Any advice or thoughts are appreciated. Thank you!

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