Many symptoms but had negative IGG type specific test 4 months after exposure

[northern72]

Hi Terri,

I had mostly protected vaginal sex with someone I barely knew once on January 1 and again on January 4 of this year. Both times were mostly protected but there was a period of probably 10 minutes unprotected that I’m worried about. Maybe a week or two after the exposure I felt like a sudden warmth come over me at night and mainly in the groin area. After that, mainly my scrotum felt unusually warm almost constantly but not really painful. Around a month later on February 2-3, I developed a small pimple that I didn’t feel at all at the top of my scrotum but just below the base of my penis on the more thicker part of the skin but on an area not covered by the condom. I brushed it on accident with my nail and it easily broke open it seemed and some blood and puss came out but it didn’t really hurt. The worse feeling was a prickly burning sensation in my groin and mainly scrotum and night sweats for a few days. I also had sweating and sore armpits as well as the unusual warmth in groin. Burning in the feet and sometimes nerve pain in legs was also very discomforting. I asked my lady friend at this time if she was tested for herpes but didn’t think so and said she didn’t notice any unusual symptoms. She may have lied and it was hard to get any information out of her. The pimple like lesion healed in a few days but remained slightly visible for what seemed like 3-4 weeks. I had burning prickly sensations throughout my body around February 20 and got severely dehydrated and fainted so I went to the hospital and they checked everything but not stds and said I was alright. It seemed like I had a feverish feeling throughout the month of February as these symptoms were occurring. I figured this was the my primary outbreak of HSV. After this event I would get these symptoms almost weekly with more intense genital symptoms every few weeks with a red bump in exactly the same place as the first pimple. I’ve never had pimples on my scrotum before. Another one showed up in my groin at edge of scrotum around April 5, and I popped it but this one was under the skin but had the same blood and puss like substance come out. Anyway I had an IGM test done for type 1 and 2 on April 10 which came back negative along with all other stds and hiv. I then had a herpes IGG type specific test on May 7 (4 months after exposure) and came back negative for both types which completely surprised me. Doctor said I had no worries even though I still have symptoms that are making it hard to do my daily activities in life. Should I take another IGG herpes blood test? What other than herpes could this be? Sorry about so much detail.

Thanks!

[Terri Warren]

I think you should rely upon the accuracy of the antibody test. I agree with your doctor on this one.
First, 10 minutes of unprotected sex is unlikely to result in a herpes infection, very unlikely, statistically.
Second, your pimple does not sounds like how herpes presents and almost never has blood or pus as part of the first infection.
If you continue to have symptoms, I would leave the bump alone and let your doctor swab test it for herpes before it has broken open, but I am so guessing that it will be negative. These could just be a simple pimple!

Terri

[northern72]

Thanks Terri!

It wish I could believe the antibody test but I keep having constant symptoms that seem like could likely be herpes related.   There is usually a red painless barely visible bump that reappears every week or two in exactly the same spot as the first pimple. It seems so likely this is how herpes behaves. Another symptom I didn’t mention was a burning sensation at the tip of my penis.  It was kind of bad the first time in mid February but was usually at night and only a few days.  It seemed like there was some sticky discharge one time with pain the first time.  This pain at the tip of penis comes back occasionally and usually for a few days.  It doesn’t hurt to urinate but is usually before and after.  It seems like it is worse hours after masturbation but I don’t do that very often because pleasure is the last thing on my mind most days. The pain is always on the tip though but doesn’t hurt to touch or really any visible manifestations.  I always get a really warm and moist feeling in the groin area when I get the nerve like pain. It seems like this could be nerve damage from the initial outbreak.  It sounds similar to others stories I have read on medhelp.  

After this pain at the tip of my penis I scheduled an appointment with a different doctor and basically begged him to give me a trial run of Valtrex to see if it would lessen the symptoms.  It did seem to help one day, but symptoms came back for the next four days and then it seemed like it helped the last four days I was on the generic Valtrex.  I only took 8 days of it.  I was supposed to take 1000mg twice a day but I took it three times a day twice because I was desperate to lessen the discomfort and nerve like pain.  I took the antiviral from May 12-20 which was after my IGG hsv blood test.  The pain usually waxes and wain every week so not sure if the antiviral helped but I believe it did.

 So, yesterday I was desperate again and went to my PCP and tried to get him to order another IGG blood test or suppressive Valtrex but he strongly suggested I don’t do it and prescribed me one month of generic Cymbalta to see if it would lessen my nerve pain and depression/anxiety.  The depression and anxiety is due entirely to my very discomforting physical symptoms. I feel like if I treat my physical symptoms there would be less of a need for Cymbalta.  Do you see any other explanation other than herpes?  It just makes the most sense with all my symptoms.  I believe PHN could be a possibility and I feel trapped because no doctors would even consider that as a possibility.  I thank you so much for helping me in this situation.

[Terri Warren]

Your antibody test is negative. If you had herpes, it would be HSV 2 because of the frequency of the symptoms, but the antibody test is very good for HSV 2 and picks up 97 out of 100 cases of HSV 2. I really do hear all the details of your symptoms but none are typically herpes and then there is the matter of the negative blood tests. Have you had these bumps swab tested?

you can order your own IgG antibody tests online- I like healthcheckusa.com. It does not require a doctor’s order at all.

Terri

[northern72]

Thanks again Terri!

I really appreciate you listening to my situation. There hasn’t been anybody to talk to around here and the doctors have been quite dismissive of my symptoms especially since receiving the one negative antibody test. They even tried to say that the IGM blood test was further proof that I don’t have HSV, but I know that is not true. I live in a rural area and it is hard to find anybody to take me seriously. I just think I’m one of the lucky 3 out of 100 of cases of HSV 2 that doesn’t get picked up on the test. There is no other explanation for my symptoms. When you say none of my symptoms are typical of herpes, do you mean that you have never seen people who have herpes with symptoms like mine? I heard that most people have atypical symptoms with herpes.

I did check that website you listed and it looks like the nearest lab would be about a 5 hour drive from my town. I’m not sure if that is possible in the short term, but what would you recommend I do for swab testing? I heard there are two different ways to do it and one being more accurate. Does there have to be fluid in the bump/sore for it to be tested with swab? My trouble is my pimples/sores are not typical and it is mainly just a red bump that maybe a day or two has fluid/pus or tiny amount of blood when popped. Can I do the swabs at home or how would I go about doing it?

Would it change your mind about my symptoms if I said the person I was with confirmed she had HSV 2? Technically the only thing that tells me I don’t have herpes is only one herpes blood test. Would a western blot test be helpful in my situation or just another herpes blood test if I went that route? Sorry for all the questions and thank you again so much for taking your time to listen. I will renew my subscription for more questions if needed.

[Terri Warren]

The western blot would be more definitive, yes. The clinic can order that for you but you would need to get to a Quest lab to have your blood drawn. that might help you move on from this concern.

This was your last post on this subscription. If you have more questions, please feel free to renew, but I don’t think anything is going to help you until you have a negative western blot. You seem pretty convinced you have herpes at this point.
We can send you swabs to gather at home. You would need to make an appointment to become a phone patient of ours to arrange that.

Terri

[northern72]

Thanks again!

Would the western blot come from the University of Washington? All I have to do is go to the quest website and make an appointment and they will do the test there? I feel like that is likely my next step. Do I need to call your clinic first? I’m physically and emotionally drained from my physical symptoms and I will travel and spend any amount of money to figure this out. I have extremely discomforting symptoms almost daily now in my scrotum and groin as well as nerve like pain in feet and legs.

I just want to prove this is herpes and get on some suppressive therapy so I can move on. Will my doctors accept this western blot if positive and give me the medicine since the test would be ordered from Quest? I’m probably one of the few people praying for a positive result so I can have closure. Is the western blot really any more accurate than the IGG type specific test for HSV? I just want to know if this really is a good idea to get this test.

[Terri Warren]

Yes, I think it is a good idea to do the test. No, you can’t order it directly through Quest but we can do it for you. You would need to make an appointment for a phone consultation and then we will order the supplies to be sent to the lab in your area where you will have your blood drawn.

What will you do if the western blot is negative for HSV 2? You seem dead set on believing that you have herpes and I’m just wondering if you even need to do it if you seem so clear that you are infected. I get what you will do if you are positive but the more important thing is what will you do if you are negative? If you are still going to be unconvinced that you don’t have herpes if you test negative, then it really isn’t worth doing.

I’m wondering if you might be having prostate problem symptoms, did anyone evaluate that?

You have two more questions left on this subscription.

Terri

[northern72]

If the western blot is negative, I will try the swab and if there is no luck with that I will try to convince a doctor to prescribe me Valtrex for a month or two to see if that can relieve my symptoms. Maybe it’s not worth doing the western blot, but if you think it could catch an HSV2 infection better than the other blood tests than it is worth a try.

My prostrate was evaluated a few years ago, but they didn’t think it was a problem this time. The pimples and all the symptoms are highly suspicious especially after having sex with someone who is high risk. I now also remember a rash towards the top of my scrotum that was shiny and red looking that healed within a day or two with no vesicles or blisters but seemed to flake off dry skin as it healed so not sure if that is evidence towards herpes. This was happening shortly after I had my first pimple/sore on scrotum in early February and what I would consider my primary outbreak.

I didn’t think someone as young as me could have prostrate problems. I’m only 28. I don’t know if it matters, but this encounter was also the first time I had vaginal sex. I’ve only been involved in oral sex before. I wouldn’t think problems with the prostrate would cause pimples either or red spots on the scrotum.

1) Do I need to wait until Monday to make an appointment for a phone consultation?

2) What do you think the chances that I will test positive for HSV2 on the western blot?

3) All my pimples/sores have been on the same side of the body, so does that give more evidence towards HSV?

4) Could there be internal lesions since I have head burning at the tip of the penis?

5) Given all the information and details I provided, how likely do you think this is HSV?

[Terri Warren]

The scrotum issue sounds very much like a yeast infection – many women, perhaps most, have some yeast as part of the normal vaginal flora and their males partners can easily acquire it.
Ten minutes of unprotected vaginal intercourse once in your life is so unlikely to cause herpes – so unlikely!
I also think that people forget that when they have sex with another person, they aren’t just vulnerable to the usual STDs, they could also acquire skin flora that you don’t already have but your partner has as normal flora. That could certainly cause some little pimples on your skin if she had a skin bacteria that you don’t usually have.
I think the chance you have herpes and will test positive on the western blot if very very close to zero.
You could have lesions in the urethra, yes but often those can be seen at the meatus.

Terri

[northern72]

Why would a yeast infection start showing symptoms a few weeks to almost month after exposure and cause such variable and systemic symptoms on and off through 5 months after? I thought it would be instant and eventually go away. It also doesn’t seem to explain the weird nerve pain in feet and sometimes hands as well as night sweats and weird sweating in general. The first week after the sex I felt completely normal. The rest of January there was only a slight discomfort but nothing compared to after the first ‘primary’ outbreak in February or the more severe genital discomfort and body wide flu like symptoms I experienced. It’s almost like there was some type of nerve damage after that and it flares up weekly and most days since then. Do you think it is likely postherpetic neuralgia due to HSV? What if it was more like 20 minutes of unprotected sex and somewhat rough? Would that make it more likely to acquire herpes with more friction?

[Terri Warren]

I was just saying that your description” a rash towards the top of my scrotum that was shiny and red looking that healed within a day or two with no vesicles or blisters but seemed to flake off dry skin as it healed” sounded like a yeast or fungal infection. I’m not saying everything you have sounds like yeast.

The longer you have sex and the more often, the more likely it is to risk acquiring an STI if the partner is infected. But 20 minutes vs. 10 is a very tiny difference. I doubt that it is significant.

I don’t know what is going on with you, but honestly, I so doubt that it is herpes. Perhaps you can locate this person and ask them to get herpes tested? If they are negative, your worries are over.

You have three more questions available on your current subscription.

Terri

• This reply was modified 8 years, 3 months ago by Terri Warren.

[northern72]

I did contact this person after I first started showing symptoms and told them I possibly contracted herpes from them. I asked if she was tested and she didn’t know. She just asked me if they included the herpes test in the regular STD panel and I said probably not. She said she was negative for all STDs that she was tested for but didn’t know what those included. She did say she had an abnormal pap smear if that matters but they rechecked her and said it was nothing. This test she had was a few months before our encounter so not sure if she had another partner after that. I hinted at her getting tested to confirm herpes but she never responded and haven’t heard from her since. She felt guilty and embarrassed by the whole situation but said she never had any symptoms.

Wouldn’t yeast show up before a month after exposure? I guess I don’t know why you doubt that this is herpes. I’m going by mainly symptoms and not statistics. Don’t a majority of people with genital herpes have atypical symptoms like myself? I’ve read on many online sites about herpes that many people don’t think they have herpes because they just look like pimples. It seems like that is my case, except I’m getting the burning and tingling in the scrotum as these pimples/sores show up.

[Terri Warren]

The yeast is slow growing and slow to leave. And it can come from an overgrowth of your own skin fungus as well, not necessarily from her.
I’ve gone over with you why I don’t think this is herpes several times now – very little risk with the experience, no sexual history suggestive of a reason to have herpes, negative antibody tests, atypical symptoms. You seem convinced that you have herpes despite overwhelming evidence to the contrary.

Terri

[northern72]

Thanks Terri!

Would yeast cause burning constantly everyday for months though? I guess I just read several stories from other herpes blogs online (medhelp and herpes-coldsore message forums) about several people that have almost exactly the same symptoms of me. They then ended up testing positive for herpes eventually even though the blood tests came back negative at 4 months or later.

The burning warm feeling in my scrotum is daily and sometimes accompanied by burning nerve pain in the feet. It is like a crawling sensation in the entire scrotum sometimes which is what was explained in the herpes handbook from your Westover Heights site. It’s not like I want to have herpes, I just want to get rid of this daily extreme discomfort. I can’t really exercise or do anything to physical or it seems like it gets worse. It almost feels like I have a fever or excess warmth throughout my body at the same time.

I will visit another doctor next week and possibly order another blood test. I’m thinking about trying the Western Blot. Otherwise, I guess I will just wait until another pimple appears and swab it but I can’t really stand the discomfort much longer. The reoccurring pimples on my scrotum is the selling point for me that I have herpes. I really appreciate you taking your time reading my messages. I know you specialize in the area of herpes, but would you have any idea what would cause such burning warmth in the scrotum with a burning in the tip of the penis almost daily?

[Terri Warren]

Several people said that? I doubt that. And I think you need to be very careful what you read on the internet – there is a person out there who loves scaring others whose story is not real. Please be careful what you believe.

Yes, yeast could cause burning for months if untreated. Herpes would not burn every day for months. it does not behave in that way.

I am sorry this pain is so severe that you cannot exercise. That is really awful pain and I don’t know what it is but I suggest that you see a neurologist if the pain is this severe. I honestly don’t have any idea what this is. I didn’t know the pain was so severe that you couldn’t exercise or do physical things. That is certainly not the case with a genital herpes infection but something very serious needs to be evaluated here if you are having trouble moving your body.

Terri

[northern72]

Yeah, I just wasn’t getting any answers from my doctors so I had to resort to the internet forums. I wouldn’t think all people would lie about their symptoms but I guess you would know better than me. I am quite gullible but here are a few links where I read things that could be similar to my situation.

http://www.medhelp.org/posts/Neurology/Herpes-Simplex-and-Nerve-Pain/show/13333

http://www.herpes-coldsores.com/messageforum/threads/tingling-sensation-on-scrotum.30129/

http://www.healthboards.com/boards/mens-health/859834-burning-scrotum.html

I may have made it sound like I can’t exercise or move without severe pain, but it is mostly moderate to severe discomfort and warmth and burning of the genitals that makes it even more discomforting when I do exercise that causes more warmth and sweating.

I guess I could have multiple problems happening at once. Maybe I have yeast and herpes or something else. I’m not sure. It’s just the prickly sensation near where the pimples were on my scrotum that gets me believing herpes is the culprit. Whatever it is, it is most definitely because of the sex I had almost 6 months ago. Maybe I’m not that good at explaining my symptoms but I better stop commenting on here before I start sounding like a broken record. I do appreciate your expertise Terri, and will renew my subscription if I have any other questions.

Do you think there is at least a slight chance I could have herpes?

[Terri Warren]

I don’t think so, no.
I know this is so hard for you, but please try to go with what is most likely rather than being the huge exception to the rule, OK?

Terri

[northern72]

Hey Terri,

It’s me again. I have a few questions about a sore that popped up on my lower back a few days. I still have ongoing burning and warmth in my scrotum and some burning after urination almost weekly. The doctors here in my city weren’t much help. I really think this sore is herpes but I wanted to see what you think. The first photo is the first day I noticed it and the second and third photo are the second and third days. It is now day 4 and there is somewhat of a scab, but I scratched it on day 2 and it bled. How likely are these herpes sores? I’ve seen at least a few photos online that looked and behaved similar to my sore but you are the expert and I appreciate your answers. Thanks!!

[northern72]

I had the order wrong sorry. The top photo is day 3, second photo is day 2, and bottom photo is day 1. It did burn slightly only when touched or rubbed.

[Terri Warren]

These are in a place I would not expect to find herpes if they are on your back. It’s hard to know where on the back they are. Are they above the waist? Anyway, I can’t tell from the pictures if they are herpes or not. The best way to know is to have them swab tested using PCR swabs.

Terri

[northern72]

They are right on the waist I think. If I dress lines around my waist to the front they would be a few inches below the belly button. They are slightly above the pants line of my shorts. Is 6 days after the appearance of the sore too late to get PCR testing? Here is how it looks today.

[Terri Warren]

I think you could still get it PCR tested today – culture would likely be a waste of time.

Terri

[northern72]

I was thinking PCR was culture. How do I get a PCR test and how much would it cost? Would a small town clinic have it available? Do you think the most recent photo I posted looks like a herpes sore?

[Terri Warren]

I have no idea if that is herpes, honestly. Pictures just don’t do it well for me over the internet. PCR is a form of a swab test – so is culture. with culture, the lab is trying to grow something. With PCR they identify the virus through parts of it’s DNA, which makes it far more sensitive. I don’t know if you a small town would have it – some might – and it is likely to be quite expensive but again,I don’t know about your particular town’s lab – I’ve seen it range from $50 to $400 so there is very little reason to why things cost what they do. Sorry I can’t be of more help with this.

Terri

[northern72]

Hey Terri,

Do herpes sores bleed if squeezed or if the scab is scratched off? If you get leg nerve pain would it only be on the side of breakouts or can it be both legs? My nerve pain is in both legs? I also get burning pain in my urethra. I heard that “prostatis” is a common symptom of atypical genital herpes. Is this true?

[Terri Warren]

Any skin lesion that is squeezed or a scab scratched off can bleed.
Herpes leg pain is normally on one side only.
Prostatitis is a completely separate condition and the symptoms of herpes and prostatitis are not similar.

Terri

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