negative herpes test but confused

[ds987]

4 months ago I had protected oral and vaginal sex with a csw from the dominican republic. My first sexual experience. Became extremely anxious right away and began checking genitals repeatedly for herpes. 4-5 days after the encounter I got a jock itch on inner thighs both sides. Day 8 noticed a white speck on my penis and immediately went to the planned parenthood. The nurse checked the spot and jock itch and said it was nothing and wouldn’t recommend a herpes blood test and the jock itch was caused by heat. I got another spot exactly like it maybe an inch away next day. They both look like whitehead pimples and the pimples would disappear when i rubbed the white substance off the top and both went away within 48 hours. They didn’t itch, hurt, or burn. The nurse told me about some more herpes symptoms which aggravated my anxiety and I began to look for those things too. I got another whitehead pimple on day 16 with a hair sticking out of the middle which popped when i got an erection and white hard puss came out followed by some clear liquid. Disappeared within 48 hours but a scab was found a week later. Day 19 i got another red spot which I showed to my PCP and he said it was nothing and it also disappeared but scabbed 2 days later. Day 29 and Day 31 I got whitehead pimples similar to the first ones I had that had a white pus in the middle and went away within 48 hours. The white puss was rubbed off by me. All of the pimples appeared one by one and most appeared on lower part of the shaft and on hair follicles. I tested negative for hsv 1 & 2 IGG and syphillis at week 5 and again negative at week 14. Was negative for all stds. I took many pictures of the pimples and showed them to many doctors online and been told it was folliculitis. I also began getting huge painful pimples on my face by my beard. Is it possible I became colonized with staph bacteria and spread it through my body? Should I get another herpes blood test at 6 months? How accurate is the blood test?

[ds987]

Some more information and questions. Right after the encounter I became extremely aware of my genitals and every sensation. I began feeling random tingling and crawling sensations in my genital area. I noticed whitish skin on my inner thighs which was the jock itch. I also began checking my lymph nodes a lot and I think they became sore cause of that. I am confused at this point whether the symptoms I had were just anxiety or were real. I have spoken to doctor handsfield about this situation and he believes I do not have genital herpes based on the atypical symptoms and negative blood test. Although I want to believe him, the fact that I even had pimples on my penis days after the encounter is quite alarming. I would not use the word blister to describe the pimples. Also the pimples that occurred on my face were definitely caused by something bacterial considering the huge amount of pus that was in them and some pimples left scarring on my face. Just a couple weeks ago I got folliculitis on a hair follicle in my pubic area almost under my stomach and by my waist. Unfortunately nothing has been swabbed. I really don’t want to live in the uncertainty of whether I have herpes or not. Some questions for you.

1. Is it possible I became colonized with staph bacteria and spread it through my body?

2. Should I get another herpes blood test at 6 months or get a Western Blot at 6 months?

3. How accurate is the Herpeselect blood test? How accurate is the western blot for HSV 1 & HSV 2 at 6 months?

4. Hearing my description of the pimples I had does it bring up herpes to mind for you? Have you seen cases where people get folliculitis after their first sexual encounter or other weird skin issues other than herpes?

5. The protected oral I received was probably for under 2 minutes and was limited to the area covered by the condom. Is it possible I could’ve gotten HSV 1 from the oral sex? Also is HSV 1 transmitted genital to genital?

I would really appreciate your help Terri

[Terri Warren]

It is certainly possible that you were colonized by a bacteria that you did not have before, and in fact, that’s what I think did happen by your description.

I do not think another test is warranted nor a western blot unless you just can’t relax with the results of the screening test alone.

The herpeselect, compared to western blot, picks up 98% of HSV 2 at 12 weeks and 75% of HSV 1.
There is no better test than the western blot so we don’t have a comparison to that.

I most definitely have seen cases of folliculitis that come up after a first sexual exposure, most certainly!
I also don’t think you got something from receiving protected oral sex, no, not at all.

Terri

• This reply was modified 5 years, 4 months ago by Terri Warren.

[ds987]

Hi Terri Thanks for your response!

It was really reassuring that you’ve seen folliculitis after a first sexual experience before. I have since stopped getting pimples altogether on my face and penis. Most of the pimples on my penis came up a couple hours after masturbation. My IGG herpeselect numbers at 14 weeks were 0.15 for hsv 1 and 0.21 for hsv 2. I have never had a cold sore in my life so I definitely didn’t have HSV 1 before this encounter. I have a few more questions.

1. If I do get a western blot done what would be the best time to get it done? Its already been 16 weeks since the encounter.

2. Is it possible that I am one of those people that take longer than 6 months to produce antibodies? If so would the western blot pick it up earlier?

3. Is it possible I got hsv 1 from genital to genital contact? Only asking because i know hsv 1 blood tests are not that accurate.

4. If I am one of those asymptomatic herpes cases would the blood test still pick it up?

5. Is it possible the jock itch was caused by the same bacteria? The jock itch is still there but mild.

I am very grateful for your help. Have a nice weekend!

[Terri Warren]

1. If I do get a western blot done what would be the best time to get it done? Its already been 16 weeks since the encounter.

You can get it any time now – you have waited long enough.

2. Is it possible that I am one of those people that take longer than 6 months to produce antibodies? If so would the western blot pick it up earlier?

The western blot can pick up a positive any time from about 3 weeks after infection on. Most everyone who is going to make antibody detectable by western blot will do so by 16 weeks from exposure.

3. Is it possible I got hsv 1 from genital to genital contact? Only asking because i know hsv 1 blood tests are not that accurate.

That is really unlikely

4. If I am one of those asymptomatic herpes cases would the blood test still pick it up?

Yes

5. Is it possible the jock itch was caused by the same bacteria? The jock itch is still there but mild.

No, jock itch is normally fungal, not bacterial

Terri

[ds987]

Hi Terri,

I am considering waiting longer maybe up to 6 months before I get the western blot done to increase the reliability of the result. I am having a hard time getting over this but I think a negative on the western blot will help me finally put this behind me.

1. Is it true that the western blot is over 99% accurate for both HSV 1 and HSV 2?

2. With symptoms and lesions very similar to those of folliculitis and a negative western blot can I be sure I don’t have herpes?

thanks

[ds987]

Continuation from the previous questions:

3. How common is it for people to experience atypical genital herpes? I’ve heard doctor handsfield say that most atypical cases are actually quite typical but are misinterpreted. This has got me confused since my pimples were not looking like blisters.

4. I have shown photos of the pimples I had to about 20+ doctors on the healthtap app. The doctors ranged from dermatologists to urologists to infectious disease. They all believed the pictures were not herpes and was most likely folliculitis. Would you say most doctors would be able to tell the difference between herpes and folliculitis? Can herpes present in a way where its difficult for doctors to determine if its actually herpes or folliculitis?

5. What percent of people would you say never test positive for herpes on the western blot but still have it?

6. Would you agree with doctor handsfield’s following response to me; “If you will carefully read my replies, you will understand that my opinion you do not have herpes is based on several independent reasons. Could any one of them be faulty? Perhaps, but unlikely. But the chance that all factors (low risk exposure, no typical symptoms, negative blood test) would break the wrong way is astronomically low — zero for practical purposes.”

thanks for your time.

[Terri Warren]

1. Is it true that the western blot is over 99% accurate for both HSV 1 and HSV 2?
I would say it is 99+% sensitive for HSV 2. I think the sensitivity for HSV 1 is less well documented but well over 95%.

2. With symptoms and lesions very similar to those of folliculitis and a negative western blot can I be sure I don’t have herpes?

Yes!

3. How common is it for people to experience atypical genital herpes? I’ve heard doctor handsfield say that most atypical cases are actually quite typical but are misinterpreted. This has got me confused since my pimples were not looking like blisters.

I would agree that most of what we think of us typical symptoms are actually atypical and the reverse is also true. I think your pimples are just pimples though

4. I have shown photos of the pimples I had to about 20+ doctors on the healthtap app. The doctors ranged from dermatologists to urologists to infectious disease. They all believed the pictures were not herpes and was most likely folliculitis. Would you say most doctors would be able to tell the difference between herpes and folliculitis? Can herpes present in a way where its difficult for doctors to determine if its actually herpes or folliculitis?

A good clinician can certainly distinguish between folliculitis and herpes yes!

5. What percent of people would you say never test positive for herpes on the western blot but still have it?

For HSV 2? maybe 0.3%

6. Would you agree with doctor handsfield’s following response to me; “If you will carefully read my replies, you will understand that my opinion you do not have herpes is based on several independent reasons. Could any one of them be faulty? Perhaps, but unlikely. But the chance that all factors (low risk exposure, no typical symptoms, negative blood test) would break the wrong way is astronomically low — zero for practical purposes.”

I would definitely agree with Dr Handsfield. We have been colleagues for years and I know we agree on this one 100%

Terri

• This reply was modified 6 years, 7 months ago by Terri Warren.

[ds987]

Thanks Terri. I think the best I can do at this point is just get the western blot done. At least I can live knowing I did the gold standard test for herpes. There is a possibility this is HSV 1 so I want to clear the situation up with the blood test.

1. Did the people you said had folliculitis after their first sexual experience have pimples similar to mine? My pimples seemed sort of superficial and went away very fast. They were unlike the deep folliculitis I had on my face.

2. I still sometimes feel weird sensations on my genitals which I can’t explain. Can this be anxiety?

3. So after the Western blot I can be 99.7% sure I don’t have hsv 2?

4. What about my pimples makes you think they are just pimples? Is it their appearance or their behavior?

5. Have you ever seen anyone test negative on the western blot at 16 weeks and then go on to become positive 6 months or after?

6. I know anxiety can cause symptoms but can anxiety actually create pimples?

7. What would be the best course of action in your opinion. Most people after sexual encounters don’t have any genital symptoms but I had symptoms. I hate being stuck in this uncertainty. Would your advice be to get the western blot done if it will improve my anxiety?

[Terri Warren]

1. Did the people you said had folliculitis after their first sexual experience have pimples similar to mine? My pimples seemed sort of superficial and went away very fast. They were unlike the deep folliculitis I had on my face.

I don’t know anything about the folliculitis that you had on your face but the folliculitis that happens below the waist is normally little pimples that resolve quickly and are often in hairy areas.

2. I still sometimes feel weird sensations on my genitals which I can’t explain. Can this be anxiety?

It could be, that’s pretty general so Id don’t think I can help much with that question

3. So after the Western blot I can be 99.7% sure I don’t have hsv 2?

Correct

4. What about my pimples makes you think they are just pimples? Is it their appearance or their behavior?

Both

5. Have you ever seen anyone test negative on the western blot at 16 weeks and then go on to become positive 6 months or after?

I have yes, but I believe only in people who have taken rather long doses of antiviral therapy.

6. I know anxiety can cause symptoms but can anxiety actually create pimples?

No

7. What would be the best course of action in your opinion. Most people after sexual encounters don’t have any genital symptoms but I had symptoms. I hate being stuck in this uncertainty. Would your advice be to get the western blot done if it will improve my anxiety?

Yes, that’s what I think you should do for sure!

Terri

[ds987]

Hi Terri,

I am starting to move on and accept the fact that I had normal pimples and do not have herpes. It took me a very long time to accept this because my fear guilt and anxiety were all making me think I had it. I want to ask you if I should still get the western blot done? I don’t know if its worth the hassle. Also can herpes be spread by sharing drinks? Finally if I get another IGG test done what are the chances I might see a false positive? I haven’t seen any false positives on my tests yet.

One last question terri. I have read through a lot of medhelp and other forums with responses from you and dr hook and dr handsfield. Why do you all say that blood testing is not reliable? In so many cases when someone thought they acquired something they were advised not to get tested since their symptoms were not totally like herpes. With what I have discussed with you on this thread I have learned blood testing is somewhat much more accurate because so many times the swab test leads to a false negative. With the western blot though over 95% of people get picked up. Do you guys still have the same viewpoint or do you now encourage people to get the blood test while in doubt?

I really appreciate your help and your time.

[Terri Warren]

You have not seen me say that blood testing is not reliable. Yes, there are some false positives on the tests and they can be clarified with western blot. I do suggest that people get the western blot when they are wanting either 1) the best testing available or 2) they just can’t believe the diagnosis (or lack of one) and need a bit more reassurance either way. Whether it is worth the hassle and expense can only be your call.

Terri

• This reply was modified 6 years ago by Terri Warren.

[ds987]

Hi Terri,

I am contacting you after a long time. It’s been almost a year to the incident that I explained in my first post. Since then I went stupid again and ended up getting protected oral from a massage worker in January and in March. 2 different women. After that I realized my stupidity and decided never to do that again. In the past year I have gotten some pimples on my penis but they didn’t seem worrisome to me. I had a pimple almost the entire month a May. It was hard to the touch and it seemed like it was a clogged hair follicle and was on the LEFT side of my penis shaft. I had to apply some warm compresses to it to bring it down in size. I just got another pimple like that on the Right side of my penis and it hasn’t lasted as long and has gone down in size. Long story short, I was still worried about potentially still having herpes and not knowing so I went and got another blood test done on June 22nd and it once again came back negative for both HSV1 AND HSV 2. There was no numerical value on this test and it just showed <.90 Negative.

1. How reassuring are these results especially since they have been taken after a year of the encounter? Is it still 98% accurate?

2. The 2 pimples I described above do they sound like herpes to you?

3. The protected oral I received from the massage workers had contact that was limited to the condom. Very little contact was made outside of it. Some saliva might have made contact with the area outside. The workers didn’t have any lesions on their mouth as far as I could tell. Was I at major risk in these encounters of getting herpes or any other stds?

4. Would you recommend further testing to me? Is 10-11 months after the encounter enough time for your body to produce adequate amount of antibodies to get detected in the screening test?

5. If I had herpes this whole time since last year is it likely that I would have gotten an outbreak of herpes that I would’ve recognized?

I really appreciate your help Terri.

[ds987]

I have another question Terri. The pimples I had last year still haunt me. I showed pictures to many doctors who said that they are more like folliculitis and showed it to doctor in person who said it wasn’t herpes. Also showed the first one I had to a nurse at the planned parenthood who said it was nothing of concern. The thing is that those pimples only happened one by one and I thought folliculitis usually came out across an area of hair and were always multiple. Another thing i would like to add is that almost all my pimples showed up a day or couple hours after I had masturbated which led me to think the friction during masturbation could’ve irritated the hair follicles on my penis and led to the folliculitis. Is this a possible scenario? Does folliculitis work that way? I don’t use any kind of lube during masturbation. Also some pimples had dry scabs a couple days later. Does folliculitis leave scabs during healing?

I am trying to find a legitimate cause of the pimples I had so I can move on. Another thing I want to add is that 2 of the pimples I had might have appeared in the same location twice. So the pimple I had on day one could’ve been in the same location as the one I had on Day 30. Is this a cause for concern and reason to believe herpes is at play.

I really appreciate your time. Thanks.

[Terri Warren]

1. How reassuring are these results especially since they have been taken after a year of the encounter? Is it still 98% accurate?

I would say that HSV 2 is about 95% accurate and the HSV 1 about 70% accurate

2. The 2 pimples I described above do they sound like herpes to you?

They do NOT.

3. The protected oral I received from the massage workers had contact that was limited to the condom. Very little contact was made outside of it. Some saliva might have made contact with the area outside. The workers didn’t have any lesions on their mouth as far as I could tell. Was I at major risk in these encounters of getting herpes or any other stds?

You are not at risk for herpes or other STI’s given contact only with the condom

4. Would you recommend further testing to me? Is 10-11 months after the encounter enough time for your body to produce adequate amount of antibodies to get detected in the screening test?

I would not

5. If I had herpes this whole time since last year is it likely that I would have gotten an outbreak of herpes that I would’ve recognized?

Yes. I think you can stop worrying now.

[ds987]

Hi Terri,

In a previous post you told me the following:

“The herpeselect, compared to western blot, picks up 98% of HSV 2 at 12 weeks and 75% of HSV 1.”

Has something happened now for you to have lowered your estimates to 95% and 70% respectively.

[Terri Warren]

We got more data in on our study comparing IgG to western blot, that’s what happened.

Terri

[ds987]

So is the Western Blot still 99.7% accurate for HSV 2 and +95% accurate for HSV 1 according to your new data?

Also how would I go about getting the western blot done now if I wanted to?

[Terri Warren]

The thing is, we have no test better than western blot so it is difficult to come up with exact percentages, but the best we can do is compare the western blot results to swab test results and yes, I think those percentages are correct.

Terri

[ds987]

Hi Terri,

Hope you are doing well. I am contacting you today to discuss a spot I had on my inner thigh. A couple of days ago it looked to be a painless white head pimple but today I noticed the skin to be loose and something of a blister. It was painless and did not itch. I ended up peeling the skin off the top and some clear liquid came out and it also burned and stung. The pain went down after 5 min and now only the center is a bit tender. Does this sound like herpes to you? I have gotten tested multiple times and have always been negative but this is also the first blister type thing I have seen in my genital area.

I have shown a couple doctors pictures and they have told me this doesn’t seem like herpes. I am still confused so I am writing to you to get your opinion. I am also interested in possibly getting the western blot done since I am still worried about this after almost 2 years.

Finally has research led to more information on the accuracy of the igg blood test? Is it still 95% accurate for HSV 2? Please let me know. Looking forward to your response.

[Terri Warren]

You are out of questions and actually owe for three back questions. If you want me to respond to these questions, you will need to purchase two additional sets of questions. Thank you

Terri

[ds987]

Hi Terri,

Okay I purchased additional questions now. I am re-posting the question below.

Hope you are doing well. I am contacting you today to discuss a spot I had on my inner thigh. A couple of days ago it looked to be a painless white head pimple but on tuesday 2/21 I noticed the skin on the top to be loose. It was painless and did not itch at the time. There is a hair coming out of the spot. The hair wasn’t exactly in the center but a bit to the left but it was coming out of the spot. I ended up peeling the skin off the top and some clear whitish liquid came out and it also burned and stung after i had popped it. The pain went down after 5 min and then only the center was a bit tender. 2 days after it was completely painless again and is now healing. Does this sound like herpes to you? I have gotten tested multiple times and have always been negative but this is also the first blister type thing I have seen in my genital area. I have spoken to some doctors on the healthtap app and they have told me it to looks to be like folliculitis. Some are saying the location and features do not seem to be herpes but told me to get it cultured if it happens again. I wanted to get your opinion on this. Does this seem like herpes to you?

I have not had sex with anyone since that incident almost 2 years ago that I posted in my first question. This could not be a first outbreak. I have tested negative on the IGG blood test twice. First time was 13 weeks after the incident and then 11 months after. First time the result was HSV 1 0.15 & HSV 2 0.21. Second blood test results were just <0.90 negative for both HSV 1 & 2.

I am interested in possibly getting the western blot done since I am still worried about this after almost 2 years. Please give me instructions on how to go about doing this.

Finally has research led to more information on the accuracy of the igg blood test? Is it still 95% accurate for HSV 2? Please let me know. Looking forward to your response. Thanks.

[Terri Warren]

The lesion that you describe on your thigh sounds nothing like herpes to me- it does sound like folliculitis.
Yes,the test is still about 95% sensitive compared to the gold standard western blot.
If you want to do the western blot, I can work with you to get that test. You would need to make a video conference appointment with me to do this – I do those on Tuesday mornings.

Terri

[ds987]

Hi Terri,

Hope you are doing well. I spoke to you via video call a week or so ago about getting a western blot done and since then I have ordered the equipment and have gotten it shipped to me. Something just happened today though that has me worried and I would really appreciate your help with it.

I ended up going to a strip club with a couple of my friends and got 2 lap dances from 2 different girls. In the first lap dance I just touched the girls Vagina once during the lap dance and that is all. She was just grinding on me while I was sitting on a couch. In the second lap dance however the girl grinded on me but also licked my penis. I was wearing pants and underwear and she licked from the outside of my pants. I don’t know if her saliva came out but the area her mouth touched felt warm. She did this twice each time going for 5-10 seconds.

I am worried that this could have possibly led to a transmission of some sort of STD including Herpes Hsv 1 or 2. I am confused about how to proceed and whether I should wait 5-6 months before getting the western blot done because of this encounter. Can you please let me know what you think?

Also in terms of other STDs how much risk was I in and should I get tested for all stds in s couple weeks? I am worried about all stds that could be spread via saliva.

I would really appreciate your help on this.

[Terri Warren]

I am not concerned about the transmission of HSV through clothing, no. Nor am I concerned that this could result in the acquisition of any other STD. There is no need to postpone getting the western blot, given this experience.

It appears you have one more question to post given your subscription payments

Terri

• This reply was modified 5 years, 3 months ago by Terri Warren.

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