HSV2 or not?

[Unsure12]

Recently 9/3 Saturday after a sexual encounter (unprotected) I had with a reoccurring partner they revealed to me that they had genital herpes. This was the first time we slept together unprotected. Almost Immediately after I had symptoms, burning, itching but no bumps or sores. I went to the sexual health clinic 9/7 Wednesday and was seen and tested for everything and they stated I was positive for NGU from a gram stain. They gave me azithromycin. (A day later I had like shedding of the penis shaft with dry skin) they didn’t see anything that resembled herpes or think that was the case after evaluation.

9/9 I even went to Labcorp for a blood test and it came back negative .91 for Igg antibodies. I know this could be too soon for it to detect or show up in your blood and it could also be too soon before I develop lesions.

On 9/12/22 I began to notice some bumps around groin area so I went back to SHC and was seen again. They stated it doesn’t look like Herpes so they didn’t swab anything.

9/14 I notice some more red look bumps maybe sores?? and it’s slightly irritating but not painful really. Should I go back into the SHC a 3rd time to see if they can swab anything?? Should I ask for Valtrex somehow to prevent a possibly painful outbreak if I do have it? The past week I’ve also had all the other symptoms that are listed for herpes beside the lymph nodes being swollen.

I know that I have HSV1 orally already and from past research it’s very rare to spread that to another area of body once already infected in one area. However partner wasn’t sure what type of HSV she carried she just knew she was diagnosed years ago and it was a long time before getting an outbreak. She stated it’s been years.

I was attempting to upload a picture. Not successful.

[Unsure12]

Hello Terri-

Update 9/16 I went and seen my PCP this morning and she stated that what she seen look like a yeast infection that maybe my body is fighting something off. (That makes 3 providers stating nothing looks wrong with my skin?) It did resemble some photos I’ve found on the internet that are herpes on the genitals. However no big sores or lesions still. My PCP took some blood today and tried to swab the irritated area on my skin in the genital region. It’s sometimes frustrating because they don’t know a ton about the virus. She stated after 2 weeks an IGG test should be accurate which after doing research for 2 weeks I know myself that is false. I also told her I almost want to go on Valtrex to see if It will help with symptoms or prevent a possible crazy outbreak If I am positive. However I know that effects an accurate blood test for the future. My symptoms are at about a (1-2) from a scale of 10. However they lasted (6-7) since the 3rd and were very accurate to what is described for symptoms of herpes online and on these forums. The only reason I think I may not have contracted it is because the individual I had intercourse with stated she hasn’t had an outbreak in years. Plus I have HSV1 and I haven’t developed any classic herpes sores or lesions. However I know that none of this matters.

I will have results back from the IGG test and the swab next week and I guess that should help clarify things. Until then it’s just a waiting game?

Should I go on Valtrex?

What’s suggested topically to place on redness/breakout/discomfort areas of the skin?

Should I go to an urgent care every time something pops up? or wait to schedule with health clinic or PCP?

Can I send pictures to you?

Also the right side of my penis hurts like internally maybe and I do often get the feeling as if something is happening or a possible outbreak may happen so it doesn’t help with trying to not think about it for awhile.

I don’t think I’m missing anything Thanks in Advance

[Unsure12]

Hi Terri-

Sorry for so many questions. Not sure when you will be able to respond so I figured I would ask everything now and seek clarity sooner than later. So after my PCP visit where I did the swab and bloodwork for GHSV2. My PCP prescribed Acyclovir just because I requested it in case I had a bad break out of sores or for future cold sores, so I started taking that 1G morning and night to see if it helps subside remaining symptoms I have. Along with that I have been using clotrimazole as well. Still some very light itching and discomfort in groin/genital region. I have like the nerves in my upper quads twitching and feeling strange as well. Other than that feeling much better.

More questions

1.) If I do have HSV2 how do I know if I’m potentially at higher risk due to lingering symptoms of an outbreak or not. Just for the future I would want to be as safe as possible with a partner to not transmit it to them.

2.) I went to labcorp for my first blood test and for the second one with the swab from my PCP it looks like they’re using quest diagnostics. Are these the same? Is a .91 considered negative or equivocal? What’s the gold standard for all testing considered to be equivocal because I feel like it changes often with different test.

3.) Why is it suggested that so many folks take the western blot with equivocal IGG if only one has ever come back positive in your years of practice. I noticed you mentioned this on another persons thread. Sorry I been frantically doing research all month and scanning through other peoples post.

Thanks again!

[Terri Warren]

I will have results back from the IGG test and the swab next week and I guess that should help clarify things. Until then it’s just a waiting game?
Correct

Should I go on Valtrex?
NO

What’s suggested topically to place on redness/breakout/discomfort areas of the skin?
There is no suggested topical medicine in your situation because we have no idea what it is so don’t know what to apply

Should I go to an urgent care every time something pops up? or wait to schedule with health clinic or PCP?
Do you think you might be a little bit too reactive about any redness or abnormality on your skin? The things that you suggest really don’t sound like herpes to me.

Can I send pictures to you?
No, sorry.

Also the right side of my penis hurts like internally maybe and I do often get the feeling as if something is happening or a possible outbreak may happen so it doesn’t help with trying to not think about it for awhile.
I wonder if you are paying a bit more attention than you need to for any sensations in your penis area? If you didn’t know she had herpes, would these sensations worry you?

1.) If I do have HSV2 how do I know if I’m potentially at higher risk due to lingering symptoms of an outbreak or not. Just for the future I would want to be as safe as possible with a partner to not transmit it to them.

I think you should redo the IgG test 6 weeks out and if negative, repeat in 12 weeks out from the encounter with the woman who told you that she has genital herpes.

2.) I went to labcorp for my first blood test and for the second one with the swab from my PCP it looks like they’re using quest diagnostics. Are these the same? Is a .91 considered negative or equivocal? What’s the gold standard for all testing considered to be equivocal because I feel like it changes often with different test.
<.091 is negative. 0.91 exactly is equivocal. both labs use that same standard 3.) Why is it suggested that so many folks take the western blot with equivocal IGG if only one has ever come back positive in your years of practice. I noticed you mentioned this on another persons thread. Sorry I been frantically doing research all month and scanning through other peoples post. People with equivocal results do the western blot just to be certain - they are uncomfortable with a test that isn't a clear negative or positive. The chances of you getting genital herpes from a single unprotected intercourse are really very low. You have no idea if she has HSV 1 or HSV 2, apparently, and since it is has been a long time since she's had an outbreak, it may well be HSV 1 which you already have. And if it is HSV 2, she is likely not shedding terribly often either since her outbreaks are very far apart. I certainly hope you aren't still with this person as your worries and fears would be hard for her. Some people can handle a relationship with someone who has herpes, others just can't. It's not a judgement - just a fact. Terri

[Unsure12]

Hello Terri-

Most recent results…

HSV 1/2 IgM 0.58 IV
HSV 1 Glycoprotein G, IgG 37.90 IV
HSV 2 Glycoprotein G Antibody, IgG 0.19 IV
<=0.89 IV

I tested again about 14 days after exposure and these are my results. The IGM is very low including the HSV2 Antibody, It’s actually lower than when I tested the first week but it was with labcorp which was a .91 so that’s a bit different I believe. My HSV1 is super high however I’ve always had cold sores about every 2 years or so. After 2 visits with my Doctor and 2 visits with SHC they believe it wasn’t herpes however I’m still a bit nervous because the symptoms I was experiencing were spot on with everybody else’s in this thread or on google research. I still do have slight irritation some tingling and odd pain on right side of penis. Questions I have >>

1.) Should I see a urologist?
2.) Should I refrain from sex or anything for 3 months and test IGG again? or western blot?
3.) I guess another option is waiting another 2 weeks or so and then testing again or waiting to see if I have any reoccurring symptoms? I Just don’t know how to navigate this with not knowing a 100% what’s happening.
4.) Is it possible I have HSV1 genitally too?

My doctor, and all other professionals are telling me to take a break and calm down on the research. Doctor also stated that the IGM is not a terrible false test like everyone else in the world has practically said. I think it’s harder being in between and not knowing, If I do have it I just want to move forward and take medication and disclose this to partners.

Also I was never with this individual and it is hard to have empathy when she exposed me without disclosing. We had a FWB thing on & off and were honest and open about all things until now…

So I’m not too concerned about how things may be hard for her. I’ve also dated multiple individuals who have had GHSV1 and GHSV2, they disclosed it prior to engaging in sexual encounters and we did research and took precaution.

[Terri Warren]

1.) Should I see a urologist?
You could. Your symptoms just don’t sound like HSV 2 to me.

2.) Should I refrain from sex or anything for 3 months and test IGG again? or western blot?
You could start with the IgG test and see what you get. If negative,you should know that the IgG test misses 8% of HSV 2 compared to the western blot. In terms of sex with others, if you do have sex, you should use a condom.

3.) I guess another option is waiting another 2 weeks or so and then testing again or waiting to see if I have any reoccurring symptoms? I Just don’t know how to navigate this with not knowing a 100% what’s happening.
Understood, but by it’s nature, there is some ambiguity there.

4.) Is it possible I have HSV1 genitally too?
That is very unlikely given a long history of cold sores.

Terri

[Unsure12]

Hi Terri-

Since my last post I’ve tested again. My results are here.

HSV 1/2 IgM
Your Value
0.57 IV

HSV 2 Glycoprotein G Antibody, IgG
Your Value
0.18 IV

My biggest issue I keep getting like rashes, sometimes pimples or things that resemble similar pics of outbreaks from other people on subgroups and what not. I also still have the tingling and itching on and off. It’s really never left but gets much better then this month around the same time it flared up again. I’ve seen my doctor a total of 5 times and even went back to sexual health clinic 4x now. I’ve also seen a urologist. They don’t think it’s herpes even after looking at pics… I’m honestly just trying to get a diagnosis. I know a month is still fairly soon to test plus I did take some valtrex just because I worried and not sure if it’s helped or it’s a placebo. I only took some on and off for a week. I’ve heard this effects testing when all the medical professionals I spoke with above stated it doesn’t.

What’s your thoughts on what I should do going forward. Wait another 2 months and test igg again?

Should I take daily antivirals for a suppressive and disclose to future partners?

None of the medical professionals think it’s HSV2 however I’m totally convinced due to the symptoms aligning with every other person in the world who’s been diagnosed and research I’ve done.

Like what Else could it possibly be after I slept with Someone unprotected who’s + ?

Thanks for any and all feedback!

[Terri Warren]

I believe that I’ve recommended that you not do IgM testing before, but if I haven’t, don’t do IgM testing.

I believe I’ve also suggested that if you want to know if you have HSV 2, you need a western blot. As of now, you are testing negative and you can believe that or not, and get a better test. It is really just that simple.

Terri

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