Red bumps, high anxiety

[Orlandosmith]

Hi Terri,

I’ve been here before during a previous scare that ended up being a false alarm. This time I did my due diligence and made the person I was dating get tested (I tested as well). She sent me negative results for everything, but turns out she altered the results and tested positive for HSV1 (index 6.2) she also lied to me about not sleeping with anyone else and admitted that after testing she was sleeping with her ex unprotected, his status is not known.

My cause for concern is that we had protected intercourse and unprotected oral (she gave me oral). 8 days went by, and I woke up with 3 red bumps in very different locations. One red bump on the head of the penis, one on the lower shaft, and one on the right side of scrotum. The red bumps are very slightly raised but look flat , don’t hurt, and don’t cause too much itching. They are circular. This has been going on for 2 days without any changes or additional symptoms. I went to a fast care doctor who thought it didn’t look like herpes since it was a blister, however what I’m worried about is this: is this how herpes lesions begin? My results prior to sleeping with her was HSV1 equivocal (1.01) HSV2 negative. Previously my HSV1 index was anywhere from 1.10-1.65. Im concerned that she gave me gHSV1 or even HSV2 that she might’ve acquired after the test. What’s the timeline on how herpes sores begin and develop? Your insight is greatly appreciated.

[Terri Warren]

If someone were to develop sores from a new herpes infection, they would show up 2-10 days after an encounter, with the average being 5.5 days. Your lesions are pretty scattered to be consistent with herpes and don’t actually sound like herpes to me but an in person opinion is far better than what mine might be.

terri

[Orlandosmith]

Hi Terri, thank you for the response. The 3 spots started to fade away, never became blisters or sores, just flattish circular bumps. This morning too small pin size red spots appeared on scrotum and are very itchy, almost like a rash. I have some follow up questions regarding this.

1) does herpes present itself with bumps that don’t become fluid filled sores/blisters?

2) I often hear people associate rashes or itching with herpes. Do rashes or redness precede an outbreak? Would a rash mean that an outbreak is on the horizon?

3) do atypical bumps happen for some people with herpes? Meaning do some people just get it more “mildly” to the point that there’s no open wounds or blisters and more like flat dull red bumps?

4) in the past I tested negative for HSV2 and 1.2-1.65 for HSV1 with the last test being equivocal at 1.01. I remember as a teenager I had herpes in the nose only, for a couple years frequently (I don’t anymore for many years), why wouldn’t my index value be higher? Could it be false positive?

Really appreciate your input

[Terri Warren]

1) does herpes present itself with bumps that don’t become fluid filled sores/blisters?
Not usually, no.

2) I often hear people associate rashes or itching with herpes. Do rashes or redness precede an outbreak? Would a rash mean that an outbreak is on the horizon?
What you would call a rash, I might never call a rash so that’s tricky. Normally, I would not call herpes lesions rashses

3) do atypical bumps happen for some people with herpes? Meaning do some people just get it more “mildly” to the point that there’s no open wounds or blisters and more like flat dull red bumps?
Not usually, but that is possible.

4) in the past I tested negative for HSV2 and 1.2-1.65 for HSV1 with the last test being equivocal at 1.01. I remember as a teenager I had herpes in the nose only, for a couple years frequently (I don’t anymore for many years), why wouldn’t my index value be higher? Could it be false positive?
If you truly had herpes lesions in your nose, then you have HSV 1 orally. Your index value is not important in that situation.

Terri

[Orlandosmith]

Thanks for the the response. So the initial “bumps” that started on the penis and scrotum have now spread all over my body and are behaving like itchy mosquito bites. Some of my back, thighs, hand, chest, and 4 more on scrotum. I don’t have bed bugs and haven’t been exposed to bugs. I read somewhere about an immune response to the virus can create rashes or bug bites type of itchy bumps.

1) this started with very small flat mush red bumps, one on the head of the penis, one on the side of the scrotum and one on the shaft…they didn’t itch at first but the ones on the body did..since these itchy bites started on the penis/scrotum and spread to other body parts does it seem like herpes? (No sores/lesions, just very textbook bug bite looking bumps that really itch)

2) could this be my immune system responding to an HSV infection?

3) I definitely had nasal sores as a teenager, how come I tested equivocal on my last hsv1 test? Would it be safe to assume I’m a carrier of hsv1 even at equivocal results?

4) in your many years of practice has anybody with a new HSV infection present symptoms like these?

5) what would be considered atypical herpes? Is there a criteria that needs to be met to be considered herpes? (Painful, watery blister, open sores)

[Terri Warren]

1) this started with very small flat mush red bumps, one on the head of the penis, one on the side of the scrotum and one on the shaft…they didn’t itch at first but the ones on the body did..since these itchy bites started on the penis/scrotum and spread to other body parts does it seem like herpes? (No sores/lesions, just very textbook bug bite looking bumps that really itch)
It sounds absolutely nothing like herpes to me

2) could this be my immune system responding to an HSV infection?
When people get that immune response to herpes, it is called erythema multiforme and it looks just like targets – look it up. This doesn’t sound like that to me from your description

3) I definitely had nasal sores as a teenager, how come I tested equivocal on my last hsv1 test? Would it be safe to assume I’m a carrier of hsv1 even at equivocal results?
The IgG test for HSV 1 misses 30% of HSV 1 infections compared to the western blot. it is also possible that your nose sores were not HSV 1. A western blot would clarify this for you.

4) in your many years of practice has anybody with a new HSV infection present symptoms like these?
NO

5) what would be considered atypical herpes? Is there a criteria that needs to be met to be considered herpes? (Painful, watery blister, open sores)
well, for one thing, they aren’t spread out all over the body, that’s not the case with HSV.
The best thing for you to do right now is to go in to see a clinician and have your bumps evaluated – let me know what they think

Terri

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