Possible Herpes or other infection

[Emr63]

Hi Terri, thank you for everything.

I am a male, had a possible exposure with a sex worker 16 days ago. She stated she is clean. She gave me unprotected oral, and we had protected sex but the condom broke at some point during. I immediately got a full panel test 4 days after and everything came back negative which I am aware now is too soon. I received a shot in the back as well as a week of doxycycline and 1 dose of 4 pills of metronidazole. I have had issues in the past with post urination drip and at times had also noticed very minimal thin clear watery discharge either after going number 2 or after sex which I have had checked by a urologist years ago. Stress, anxiety, and guilt have seriously affected me. The only symptoms I have had has been a very slight general discomfort in genital area which I felt was coming from guilt or some other type of infection but it has never been persistent and is very minimal. I noticed that after urinating typically in the morning but not limited, to an extremely thin clear discharge but only after urinating and doesn’t always happen. I have no visible sores anywhere and have not had any pain whatsoever urinating. There is a tiny patch of red just below the meatus that look like penile papules which have been there for about 13 days and they do not itch or burn and have not gotten any worse, just has remained the same if anything they seem to go down in color at times and I can’t tell if they have been there before as I am now inspecting myself looking for something 24/7. My urologist believes the red spot to be a tear and not a herpes lesion and the doctor at urgent care seemed to think the symptoms I am having are not herpes related. Do you think that this could possibly be herpes and do you think the discharge could be related to herpes even though I am having absolutely no pain urinating? I have been losing my mind and feeling extremely depressed. I appreciate your help. Thank you.

[Emr63]

I am now at the 16 day mark and I don’t really feel much discomfort if at all in the genital area. I did have loss of appetite for a while and a weird taste in my mouth which I was associating with having to take the doxycycline by emptying the capsule due to trouble swallowing pills and with all the stress I have been dealing with. I informed my urologist of the loss of appetite which he also attributed to my guilt and the medication but just wanted to make you aware of that as well. I have done extensive research as this encounter has been eating me alive and was wondering if you think it’s possible it could be either balanitis or trichomoniasis ? Are there any other steps I can take to start easing my mind ?

[Terri Warren]

This sounds nothing like HSV to me. Herpes does not cause loss of appetite. Nothing you’ve described here is typically associated with a new herpes infection. I’m sorry that the condom broke and gave you these worries, but I really don’t think you need to worry.

Terri

[Emr63]

Hi Terri,

I appreciate the quick response and thank you again for all you do. I am glad to hear you think this is nothing related to herpes. Just to update:small spot on the tip of penis is still there but at times it’s barely noticeable. Looks like fordyce spots or papules and still not itchy burning or irritated. Only symptoms I’ve really had still to this day is increased urge to urinate, I have had issues with this in the past but it seems more noticeable than prior to exposure. I am also still having discharge after urinating. It is clear and extremely thin but doesn’t happen every time id say I notice it about 2x a day and only if I’m inspecting my penis after urinating. It always remains in the urethra and never comes out on its own. Absolutely no pain urinating at all but definitely still noticing dribbling. Anxiety and guilt still remains at an all time high which I honestly feel is affecting my entire body.

With all this in mind do you still think that this is not HSV related? Is it possible it could be HIV related?

[Emr63]

Not sure if I have reached my limit of posts, but along with my above question I was wondering when I would be able to take a western blot for both ghsv and hiv just so I can put this entire situation behind me and how accurate it would be. Thank you again.

[Emr63]

Just an update. Woke up this morning and for the first time noticed it at the tip of my penis still clear and thin. Still freaking out

[Terri Warren]

Still, nothing you have said makes me think you have herpes. You can take the western blot for greater clarity about 12 weeks from a concerning encounter.

Terri

[Emr63]

Hi Terri,

I just wanted to follow up from our e-visit on 11/29 with a few questions as this is still killing me mentally. As we discussed in the video conference you still believe this is nothing related to herpes, but I had addressed that her test might have been equivocal even though she is saying her doctor told her it was negative. Given that information and the symptoms I described and the details
Regarding the initial exposure. My questions are as follows

1. If her test was indeed equivocal, but she seems to be living her life with no symptoms and the belief that she’s negative, what would the transmission rate be to me if she was indeed infected given the details of exposure
? (Half of encounter protected, half not when condom broke)
2. If my symptoms were somehow herpes related even though you have said they weren’t herpetic to you, would it be normal they be lasting this long which is now 6 weeks?
3. Would pelvic pain alone, intermittent pain near the side obliques be indicative of a herpes infection if no tingling or burning or any sores are present?

I had mentioned I am probably getting retested at 6 weeks or 7 weeks to see if my igg score went up at all. Again, I am sorry to be a bother to you with this, but it is difficult for me to live my life normally again with this hanging over my head. I attached to this thread in hopes you remember our video conference and for reference. Thank you and I look forward to hearing from you.

[Terri Warren]

1. If her test was indeed equivocal, but she seems to be living her life with no symptoms and the belief that she’s negative, what would the transmission rate be to me if she was indeed infected given the details of exposure
? (Half of encounter protected, half not when condom broke)
We honestly don’t have transmission data on a single sexual encounter that is reliable.

2. If my symptoms were somehow herpes related even though you have said they weren’t herpetic to you, would it be normal they be lasting this long which is now 6 weeks?
No

3. Would pelvic pain alone, intermittent pain near the side obliques be indicative of a herpes infection if no tingling or burning or any sores are present?
No

I had mentioned I am probably getting retested at 6 weeks or 7 weeks to see if my igg score went up at all. Again, I am sorry to be a bother to you with this, but it is difficult for me to live my life normally again with this hanging over my head. I attached to this thread in hopes you remember our video conference and for reference. Thank you and I look forward to hearing from you.

You could get tested again and see if there are changes – that’s fine, but remember that this test has many false positives.

Terri

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