New possible infection

[Hp3327]

I have been dating a girl a few months. We have had sex maybe a dozen times. We have always used condoms. She recently tested positive for chlymidia and hsv2 at 1.35, quest igg. She tested negative for hsv1. 2 weeks after the last time we had sex, I went and got tested. My results came back negative for both issues. I tested positive for hsv1, but that was expected. I’ve had cold sores since a child.

The thing is that after she broke the news to me, I started feeling nerve pain around my pelvic area, radiating down to my left knee. I waited 2 weeks to get tested. I saw her once after that. While waiting for the results, she did give me oral while she was fully clothed in long pants. From the information I had read I thought that was a virtually zero risk activity. That happened 2 days ago. The next day, yesterday, I woke up with a painful scaly rash on my inner thigh. I have had rashes in my inner though before but this was much worse than usual. Then today I got my results back. I was negative for hsv2. I would like to add that I am a bit of of hypochondriac and I know the mind can be very powerful when under stress. The day before the irritation in my inner thigh I was having nightmares about breakouts.

1. From what I have read, I think its possible that I did get hsv2 from her but have not developed enough antibodies yet. Is that correct? The value of my hsv2 test was 0.90.
2. Is there any questions you can ask me to determine if my symptoms are indeed a breakout? Is there anything that would rule out a breakout, like the area rapidly healing or not blistering? I realize this would be guessing, but I would still appreciate it.
3. Was her giving me oral a low risk activity? How low risk?
4. Do you recommend testing again and his soon?

[Terri Warren]

1. From what I have read, I think its possible that I did get hsv2 from her but have not developed enough antibodies yet. Is that correct? The value of my hsv2 test was 0.90.
The value of your test was likely <.90, if you look closely. And you may not have had time to develop antibody, that is correct. But with using condoms everytime, there is an excellent chance you are not infected. 2. Is there any questions you can ask me to determine if my symptoms are indeed a breakout? Is there anything that would rule out a breakout, like the area rapidly healing or not blistering? I realize this would be guessing, but I would still appreciate it. The rash on your thigh sounds nothing at all like a herpes outbreak to me but perhaps a fungal infection? Have you tried any anti fungal medicine on it? I would look for blistering with herpes. 3. Was her giving me oral a low risk activity? How low risk? It is likely zero risk. 4. Do you recommend testing again and his soon? If you are going to stop having sex with her, then you can test 16 weeks from the last time you had sex with her. But here's the most important thing about your post. Her HSV 2 index value is really low. There is an 85% chance that it is a false positive. She definitely needs a western blot confirmatory test. When was the last time she had sex with anyone else? Terri

[Hp3327]

Thanks for the heads up that her test could be a false positive. I told her that was possible based on what reading but she seemed skeptical. I’ll show her this and help her obtain the western blot. By the way, she is negative for hsv1. To answer your question, she says I’m the only person she has had sex with for over 3 months but I’m not sure.

I did attach a photo. The rash looks less scaly today and looks more blister like. It is not as painful as yesterday. The photo is my inner thigh between my testical and leg. The teste is on top, leg on bottom. This is the only area like this. Do you think it looks like herpes? I sometimes get a rash here anyway. I had lots of issues after antibiotic use. It just seems different this time.

Would a western blot be a good idea for me? I hope my only option isnt waiting 4 months. I stopped having sex since this occurred 2 or 3 weeks ago.

[Terri Warren]

Has someone looked at this rash? I think it might be worth seeing someone about this and asking if is would be good to swab it for herpes simplex virus. It does look slightly blistery to me as well so better safe than sorry here. I doubt that it is but if you were my patient, I would probably swab test it given that 1) it looks somehow different than other rashes you’ve had 2) its a bit blistery looking, at least in the photo and 3) you’ve had a possible recent exposure to her.

Is she reluctant to do confirmatory testing because she has had symptoms consistent with genital herpes?

If you want to be the most certain, 16 weeks is the time. However, if you can get her to do a western blot and she is negative, then you won’t have to wait that long.

Terri

[Hp3327]

Terri, I uploaded a photo from this morning. Fyi the rash erupted 3 days ago and seems to be healing quickly. It was most bothersome the first day. I haven’t had a doctor look at. I’m hoping I can get away from work tomorrow to do that. I hope there is still something to swab at that point.

I also wanted to give you some more information. The last time I had sex with her or anyone else was 2/10. So it has been 30 days. A couple weeks later I felt nerve pain in my leg and developed a pimple like sore on my left kneecap. It didn’t look like a herpes sore. It was painful whenever my pants touched it, like nerve pain. It resolved after a few days. This recent issue im showing you pictures of started 3 days ago.

I also want to add that I developed a sore throat last night and my glands are a little swollen under my jaw and especially under my right arm. Keep in mind that I had an extreme bad reaction to cipro antibiotic a few years ago that really hurt my tendons and gut, so I do have a lot of little issues. I periodically have rashes.

To answer some of your other questions:
She says she has never had a break out ever and was surprised by the test. She says that her last partner was over 5 months ago and that is also the only unprotected sex she has had. She expects she squired both from him. She had symptoms of chlymidia, bleeding after sex and odor. That is what prompted the tests. I think I can get her to do the WB. I just need to get a chance to show her some of the information from this site.

Question 1. You said I should swab it, but you also said you doubt it’s herpes. Can you please tell me why you doubt it’s herpes. That information would really interest me.

Question 2. Does the information about the last time we had sex, 30 days ago, and the onset of symptoms sound like herpes?

Question 3. Do you think there is still a good chance she is a false positive if she never had hsv1, chicken pox etc.?

[Hp3327]

One more: is it typical for a herpes outbreak to resolve as quickly as this is going away. By day 2 it was much better and even better yet today, on day 3.

[Hp3327]

And yes you were correct my value was <90

[Hp3327]

I just made a payment for additional follow up questions. Thank you so much for your help and information.

[Terri Warren]

Herpes lesions can go away in three days, yes, but the normal time for healing is about a week. there is a good deal of difference between individuals in regards to lesion healing time.

Question 1. You said I should swab it, but you also said you doubt it’s herpes. Can you please tell me why you doubt it’s herpes. That information would really interest me.

Because this is an unusual place for a herpes outbreak to show up.

Question 2. Does the information about the last time we had sex, 30 days ago, and the onset of symptoms sound like herpes?

That is a long time after last exposure for symptoms to show up, definitely. Normally, if people are going to develop symptoms after first infection, they do so within 2-10 days, with the average being 5.5 days.

Question 3. Do you think there is still a good chance she is a false positive if she never had hsv1, chicken pox etc.?

Yes, I think there is an excellent chance (85% chance) that this is a false positive (which means there is a 15% chance it is a true positive, of course)

Terri

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