HSV 2 Exposure Scare

[Grody]

Married 41 year old male who had a drunken one night affair with an HSV1 and HSV2 positive female. On October 17 I had both unprotected oral (giving and receiving) as well as vaginal intercourse with a family friend. I told her I felt bad about the whole thing and she told me I should get checked out for STD’s. She was pretty vague, but her roommate informed me she had HSV 1 and HSV 2 and that I better get looked at. I was also told there was no breakout at the time but I can’t know for certain.

Of course guilt and anxiety start kicking in and I had a friend get me a week’s worth of Cephalexin and and a dose of Azrithromyacin the Monday immediately following the exposure just in case. I made an appointment for a full physical. By the end of week 1 I began urinating frequently and have an incredible thirst due to a dry scratchy throat as well as some slight urethritis. I wasn’t sleeping and was having chills and night sweats, but I never ran a temperature. I gave blood and urine on the 28th, and the appointment was on the 29th, a week and a half after the incident.

The day of my appointment, my throat became swollen (not hurting just really scratchy) and my tongue was white with a nasty film, there were bumps on my tonsils going all the way down my throat. I could also tell my prostrate was swollen and I was drinking what seemed to be a gallon of water a day at this point. My throat didn’t really hurt, it was just really scratchy. I was given an injection of Ceftriaxone just in case it was gonorrhea. They hadn’t run any of the STD tests that I had asked for with my urine and blood samples, just the ordinary physical stuff that said I was old and fat. The white blood cell count was not abnormal though, but I was drinking so much water and urinating so much I don’t know if you could really tell. The doctor didn’t seem to be too concerned about Herpes since I didn’t have any lesions and wasn’t much help at all. My appointment was late in the day and the lab was closed so I didn’t give blood and urine until Friday the 31st for my STD screening, and they wouldn’t swab my throat and just told me the injection would take care of it.

I started feeling better immediately after the injection, but my thirst continued and my throat and prostrate were swollen again by Monday the 3rd of Nov. This is a little over 2 weeks since the incident. My doctor was on vacation that week and another doctor gave me yet another injection of Ceftriaxone as well as 10 days worth of Doxycylene. The test results weren’t back from the lab yet to know if it was actually Gonorrhea or not. I took the pills and my urinary problems came and went. On Wednesday the lab results all came back negative for genital Chlamydia and Gonorrhea, but when I asked about herpes they told me that they don’t test for that, they only swab any lesions that you may have. I requested the HerpeSelect test which was drawn on Friday, Nov 7 three weeks after exposure, I again asked for a throat swab to find out what it was exactly in my throat, I suspected maybe it was thrush instead of gonorrhea since I had taken a truckload of antibiotics at this point. I told them I wanted a full culture done not just a strep one.

The next week I just felt crappy overall with flu like symptoms and my throat issues would come and go as well as my Urethritis. I was having pain in my buttocks and the back of my thighs as well. My lips and hands would feel tingly and I also had a scratchy right eye so of course I thought I had HSV1 and got it in my eye. About the middle of the week I started to get a burning on the tip of my penis that just stayed there all of the time and the head remained sore, yet there were still no lesions. The herpes test came back negative for 1 and 2 and they told me I didn’t have strep. Of course they didn’t culture it see if there was anything else in my throat like I had asked. My urinary symptoms went away for the most part for the rest of the week, but my throat continued to be scratchy. I began to use a little Monistat on my penis and that seemed to make the pain on the end stop after a few days. I met with my doctor again on Friday, Nov 15 and he gave me some throat medicine for Thrush to take for the next week. Somehow I was able to reconcile things with my wife through all of this and managed to have intercourse on Saturday the 16th. A few hours later the urethritis came back worse than before and the tip of my penis began to itch like crazy. I broke out the Monistat again and that seemed to make the itch go away again after a few days. On Monday I e-mailed my doctor about the urethritis and told him that I thought I had a genital yeast infection as well as the oral thrush and he told me to take a couple of diflucin pills over the next few days.

So that brings us up to now. It is almost 6 weeks after my exposure, my urinary stuff has pretty much went away, except I still feel achy and have a dull headache, have a sore throat and still have lumps on my tonsils, a twinge of prostatitis, and an itchy anus every now an again. I never saw any lesions except for one I noticed two days ago that was on the back of my thigh 6 inches down from my groin which I hope was an ingrown hair. From what I saw it didn’t look to have any blisters on it that would have been able to be swabbed for liquid, but it never hurt or itched for me to notice it, and it didn’t look like an ulcer either. I have had flu like symptoms now for about 3 weeks and just feel generally lethargic. My throat has been scratchy for about 4 weeks and still has the bumps on the tonsils although they don’t seem to be as bad now. I never had any lesions in my mouth, and just the one questionable one on the back of my thigh which would have just shown up in the past few days if I had to guess. The itchy eye lasted about a week and a half. I know I had a lot of crap going on here, just wondering if the persistant body aches and sore throat would indicate an initial herpes outbreak or not without any lesions on my direct genital area? I was going to go in next week (week 7) and get another HerpeSelect test just to see what the results are because I can’t stand all of this waiting around. I know I need another one at 12-16 weeks to be totally sure.

I guess does any of this sound like an initial herpes infection? I don’t know if I have ever had mono but it seems like it could be that along with an all over yeast infection caused by too many antibiotics.

• This topic was modified 7 years, 8 months ago by Grody.

[Terri Warren]

This sounds nothing at all like an initial infection with herpes. Just not at all. Since you are negative for both HSV 1 and HSV 2, I would have expected, since you are looking very carefully, that you would notice some sort of sore, should one have appeared. A negative HSV 1 and 2 antibody test three weeks after the encounter doesn’t mean too much. However, but three weeks past an infecting episode, 50% of people have developed antibody, so at least you aren’t in that group.

As a matter of practice, we don’t treat people without a positive gonorrhea test with ceftriaxone. Different practitioners practice differently, of course. These medicines can cause many troubling side effects and it sounds to me like you could have been experiencing those.

Also, I think that people forget when they have a sexual encounter with a new person, they are in contact with all sorts of germs that another person might have, not only those traditionally thought of as STDs. This person may well have had some virus that causes sore throat and flu like symptoms that you may have acquired.

If you were our patient I would recommend that you sit tight and do nothing for the next several weeks. If you want to test again at 7-8 weeks, that’s fine. If negative at 7 weeks, there is slightly than a 70% chance that your test results will stay that way.

The thigh bumps that you describe do not sound like herpes to me.

You have two more questions if you have additional concerns.

Terri

[Grody]

Well, just an update. I have tested negative again at 7 weeks for both HSV 1 and 2 and I have not seen any more suspicious lesions. My throat has cleared up for the most part, so it must have just been a 6 week long virus of some sort.

I went a couple weeks without taking any meds and my prostratitis got worse. I went back to the doctor and he put me on 3 weeks of doxycycline plus a week of daily fluconazole to treat it. After 4 days of that treatment and having intercourse 3 times, my prostrate continued to feel swollen and my testicles also began to really hurt, as well as my back. I was in an incredible amount of pain so I got a hold of the person I had the affair with. She told me she didn’t have any other std’s but was treated for Bacterial Vaginosis a couple weeks back. I asked her if she had Trich but she said she didn’t think so. I had told my doctor to test me for Trich when I was there, and he said it came back negative. I am not sure what test they did, but I know it was not a culture, I think it was some sort of urine swab. I also know it is sometimes hard to detect in men. I know the treatment for BV is the same as Trich and it could have just went undiagnosed with the BV diagnosis she had treated. Do you suppose I could have had Trich the whole time and it has now infected my prostrate? Now that I am on antibiotics I don’t know what a new Trich test will show. I know this isn’t really a Herpes question, but you obviously have experience with these sort of matters and I had 2 questions left anyway. Do you think I should take metronidazole for this without a clear diagnosis?

[Terri Warren]

Male partners of females with BV are not treated so I doubt that you being treated would make any impact and I also don’t believe that Trich would give you these symptoms. You could talk to your doctor about this, yes. There are also other drugs used to treat prostatitis more commonly I believe. If you aren’t better on 3 weeks of doxy, I would ask him about the quinolones which are very often used to treat prostate problems. Trich in men live in little ducts around the urethra, so since you both pee and have sex with your penis, looking in urine for trich is not completely unreasonable.

Terri

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