Questions About Plan Going Forward

[nyc_user_1995]

Hi Terri, hope this message finds you well. Appreciate all the work you do for people with HSV related concerns, your forum has been invaluable to me over the past week of dealing with a scare.

In March of this year I broke up with my partner who I had been with for 3 years. We both tested negative for all STDS including HSV before we began dating Since breaking up in March, I have had a total of 6 sexual partners, 3 just oral and and 3 both oral and vaginal intercourse.

About twelve days ago (6/30/2022) I had an unprotected sexual encounter, which included both giving and receiving oral sex, and vaginal sex. Two mornings later (7/02/2022) I woke up with a slightly “hot” feeling in my pubic area, and upon inspection, I had three very small clustered blisters on the base of my penis / the beginning of my scrotum. It seemed like there might have been a tiny amount of fluid in them, but they certainly weren’t large pustules. Despite having dealt with folliculitis as well as chaffed and irritated skin post-sex before, this was clearly something different. Other than the “hot” feeling, I didn’t have any pain or itchiness. When I noticed them, it was less than 48 hours after having sex – probably 35-40 hours. I went into urgent care for testing several hours later. By this time, the blisters had rapidly scabbed over and there was no sign of fluid. The doctor told me that although the blisters appeared to her as “atypical for herpes”, the situation was enough reason to swab, so she conducted a culture as well as a blood test and urine for other STDs.

In the next couple of hours after going home from the doctor, my physical condition rapidly deteriorated. I became feverish, developed extreme body aches, and was fatigued to the point that I could not walk around easily. These symptoms lasted for almost a full week, and I also began experiencing nerve pain in my right thigh/groin and pins and needles up and down both legs. My blisters completely disappeared after 2 days.

[nyc_user_1995]

However, after about 3 days, new, flat, white spots emerged in the same area as the blisters. They are still slightly noticeable after 10 days but have not progressed into blisters, pustules, or scabs. They are painless although I have noticed a slight itch – not terribly uncomfortable though. I also developed a sore throat and bad headache that passed after a couple days.

Both my swab tests and my IGG blood test came back negative for HSV.

The doctor had put me on 1g Valtrex 2x/day right away, I took it for the first 5 days before learning through your forum that it may skew future testing, so I stopped. Over the last two days, I am feeling close to back to normal, although still with some strange nerve feelings on my right side and slight tingliness in my legs as well as some soreness in my testicles.

Despite the fact that my blisters were described as “atypical” in their appearance as well as the lack of pain and itchiness, my situation seems indicative of an initial outbreak of GHSV. I’ve never felt this particular type nerve pain and tingly feeling before, and the fact that the pain is centered in my thigh and groin area seems not coincidental. Also, just the fact that I got so severely ill immediately after developing the blisters seems to indicate an initial outbreak.

My questions are:

1.) Since it seems like it’s an initial outbreak, is it almost guaranteed that I was infected sometime in the two weeks before I noticed the blisters? From 6/01/2022 to 7/02/2022 (date of outbreak) I had four sexual partners, 1 unprotected oral, 2 of them unprotected oral and vaginal, and 1 unprotected oral and protected anal, each of whom I’ve spoken with, none of whom have had any indication of an outbreak, and claim they have tested negative for HSV recently. Is there any possibility that I could have been infected further back than a month from my outbreak? Should I be reaching out to other partners from longer than a month back?

[nyc_user_1995]

2.) I’m still holding on to some slight hope of being negative for HSV and this just being a strange coincidence of random blisters and a flu bug – going forward, do you recommend another IGG test at 6 weeks from initial OB, and if that indicates negative or very low HSV numbers, a Western Blot at 12 weeks? Based off my symptoms, do you think there’s any chance that this could be something else?

3.) Is less than two days too quickly for me to develop these symptoms? Is it likely it was an earlier encounter or could I have been infected by the partner I had sex with just 35 hours before the blisters appeared?

Thanks very much, apologies for the long post but hoping that providing more details helps with your assessment of my situation. Have a good week!

[Terri Warren]

Hmmmm. Blisters are never really good in the genital area. But what you describe as a blister and I might describe as a blister could be different.

Two days is not too soon to develop symptoms, no. It is on the low end but I’ve seen it before.

I have to say that it is interesting that all four women with whom you had sex had done HSV antibody testing – that’s kind of unusual. Sometimes, people think a full STI screen includes herpes antibody testing but it often does not. Have you actually seen these results from all four women? It is also unusual that all four women would be negative for HSV 1 when half the population is infected, but it could be, certainly.

If you were my patient, I would recommend antibody IgG testing at 6 weeks out and western blot testing at 12 weeks out.

But if you continue to have sex during that time period, it will always be a moving target. Condoms reduce transmission of HSV 2 from women to men by 65%.

Thoughts?

Terri

[nyc_user_1995]

Hi Terri, thanks so much for your response.

One of the women had done HSV testing recently, the others all went and got tested after I let them know that I was experiencing what I thought was a HSV breakout, and they all came back negative. But I haven’t seen a picture of their test results so I guess it’s possible I’m not being told the truth by someone!

Just to follow up with my first question, do you think the severity of my illness plus the blisters indicates a first outbreak, and (if it is HSV), it’s likely I was infected sometime before in the month leading up to my OB? Basically trying to figure out if I should get in contact with partners from more than a month before.

[Terri Warren]

If this was an outbreak of herpes and we have no idea if it is, I guess you could go back to any partners that you had between March and the end of June. If everyone in the past month tests negative, then it is an older infection, if an infection at all.

Terri

[nyc_user_1995]

Thanks Terri. The combination of blisters emerging alongside such specific symptoms really makes me think herpes is likely. I will keep up with testing at 6 and 12 weeks and talk to all partners.

Thanks again and have a great week!

[Terri Warren]

Sounds like a good plan to me!

Terri

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