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- This topic has 20 replies, 2 voices, and was last updated 7 years, 10 months ago by Terri Warren.
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March 4, 2015 at 5:54 am #5308Nervous10Participant
Hello Dr. Warren,
I’m a male. I’ve had two sexual partners. The first was protected sex with unprotected oral. It was a one time thing and it happened late November/ early December. I got STD tests done, however, much later found out they did not include HSV. My second partner and I began with protection but after STD tests decided to stop using protection. She had a similar situation to me actually and had protected sex with someone early/mid November. One time thing same as me. Her tests did include HSV and she tested negative for both HSV-1 and HSV-2, however, her test would have put her about 4 weeks after exposure and the blood test probably did not do any good. Now to my problem.
Late January: Friday I shave with a razor, on Saturday, after having sex she and I both notice a strong fish odor coming from her. and she decides to make a gynecologist appointment, as the following days she has a white discharge, but did not have other symptoms typical for STD’s. Around Tuesday or Wednesday (3-4 days after having sex). I begin getting what I describe as an “Icy-Hot” feeling in my genitals, thighs and sometimes even feet. A feeling I have never felt before and if I had to localize it anywhere in the genitals I would say I felt it most in the scrotum/upper thighs. I told the girl about it and she told me it was probably anxiety as I had been very worried and bugging her that I had something. Now, that started on Tue/Wed. Following Saturday, the feeling is still there and now 3 or 4 red bumps show up along with a bigger raised bump on my scrotum almost where it meets the shaft. I had an Ingrown hair (that I could see the hair in) near there so I didn’t worry about it at first… I wake up the following morning and the small red bumps are gone but the bigger one is still there. With the Icy-Hot burning feeling still there (It’s worse when I’m sitting down or going to sleep) and this bump; I’m starting to think more about HSV.
Tuesday I go to the doctor and she takes a look at it says its foccilitus and said it looked a little irritated had I been picking at it which I admitted to. I asked her to run a full STD panel including a IGG blood test. The doctor prescribed me doxycycline for the infected hair, my UTI that I tested positive for in my urine test and for what she thought might be chlamydia (pending test) to explain my icy-hot feeling.
Later on after research I realize I should have gotten a swab test done (guess doc didn’t think it was necessary) and decide to go to a different doc because a weird looking scab showed up close to the area. It was about the width of a hair and the length of a tip of your finger, there was no redness surrounding it, was not raised or anything, just looked almost like a paper cut or maybe a fingernail cut? There was never an open wound leading up the scab because I would have noticed (being paranoid and checking myself 4 times a day). The bump had not changed really. I did try to pop it several times with a lot of pressure and the following day it had a small scab on it.
The new doctor swab tested it by basically breaking my skin until it started bleeding and sent me on my way. The girl went to her gyno the same day. She got a pap-smear and doctor said she had nothing that looked like HSV and told her to stop taking scented baths.
All STD results came in negative including swab, except my HSV-1 came back low-equivocal. The RN actually said negative till I probed and she said well its equivocal actually but nothing to worry about. This test would put me about 7 weeks almost 8 weeks since my first exposure. The icy-hot burning feeling eventually dies down after being around for about a week and a half to almost 2 weeks. I try to move on and focus on work and chalk it up some kind of bacteria/fungus that got in my pores after shaving. I basically stopped taking the doxycyline after the feeling stopped, I finished maybe 1/2 the dose. Still think I have HSV and I just waited to late on the swab and to early on the blood test. Now my questions
Is it typical for a paper cut lesion to appear in the primary outbreak on the scrotum?
During the initial outbreak does the burning (What I describe as Icy-Hot) or prodrome feeling last up to a week; sometimes longer and encompass a large area or is it generally localized?
Wouldn’t 5 days be to long for an accurate swab test? Basically I got a false-negative?
Thanks
- This topic was modified 7 years, 11 months ago by Nervous10.
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March 4, 2015 at 3:20 pm #5316Terri WarrenKeymaster
I think if the clinician looking at it thought it was likely folliculitis, then it likely is. That is what it sounds like from your description, actually as well as the fact that it was near a shaving time. No, the primary outbreak is not normally on the scrotum or look like a paper cut. The first outbreak, if symptomatic, is different than that, both in location and appearance.
If your partner has neither HSV 1 nor HSV 2, this would likely not be a primary infection unless she has not had time yet to seroconvert, based on the dates of her last experience prior to you.
I think 5 days is pretty far out to swab, yes. I think you should finish the doxycycline.
Also, the fishy odor is likely either trich or bacterial vaginosis. Was she checked for those?Terri
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March 4, 2015 at 5:19 pm #5326Nervous10Participant
She said the gynecologist did a swab test and everything came back normal. That her PH levels were high and asked her if she had been taking scented baths. She said yes, and told her to stop for a while. She did and the discharge/fishy odor subsided.
I ended up finishing the Doxcycline because the feeling came back last week. It was also accompanied by a dull pain at the head of my penis. Hard to describe it even as a pain more of a general discomfort and it almost felt internal. This feeling started last Wednesday and ended today. So lasted a week. I was then concerned this might be my 2nd outbreak and this might be my prodrome feeling. Called my doctor and he said unless I see sores there isn’t any reason to come in. I finished the doxycyline and put an anti-fungal cream on it after it being present for a week. 1 day after putting the cream on it it felt better and went away by day 7/8. However, I did notice this small scratch on the head of my penis that began to worry me. The girl said it was probably from checking myself 3 times a day or a typical scratch.
To follow up from earlier: What would my equivocal HSV-1 result at 8 weeks exposure tell me, if anything? Retest I know, but does the equivocal at 8 week mean I could be beginning to create anti-bodies? Would a retest and a positive result mean that I have genital HSV-1 with atypical symptoms from my one time exposure in early December?
I know I’m really focused on this papercut appearance of herpes.. but would this picture resemble what a papercut lesion would look like? As you can tell it is so small the only reason I even noticed it is because I was checking myself so often. You really can only see the scab when it’s zoomed in with the camera and when I stretch the skin.
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March 5, 2015 at 3:31 pm #5343Terri WarrenKeymaster
The equivocal test can mean a couple of things:
1) yes, it could mean that you are in the process of making antibody and you are going from a negative value to a positiev one, and you had your blood drawn as you were passing through the equivocal range.
2) a more likely explanation is that you are actually already infected with HSV 1 and because the test is poor at picking it up (misses 10-20% of infections), the test is showing a slight reaction.
3) the other possibility is that you are completely negative for HSV 1 and the test is reacting to something else in your blood sample.This does not look at all like a paper cut lesion that you read about.
You have one more question on this subscription.
Terri
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March 6, 2015 at 6:10 pm #5367Nervous10Participant
My girlfriend got her test results today and everything was negative. The good news is that I didn’t get it from her so I guess that lowers my chances of having it now. Now my only concern is that I have genital HSV-1 from my one-time sexual encounter 3 months ago and am just now showing symptoms.
1.) With dealing with symptoms such as pain/burning/tingling etc. How often are these symptoms present even when there is no visible sores? Would it be unusual for them to last for a week?
2.) Say with my given history. One time sexual encounter 3 months ago. Protected sex, unprotected oral. (Don’t know her status) and current sexual partner negative for HSV-1 & HSV-2. If a re-test does show a positive HSV-1 result as opposed to equivocal. Do I then come to the conclusion that my symptoms of mild discomfort at head of penis and icy-hot feeling in thighs and scrotum are attributed to a new genital HSV-1 infection received from my exposure 3 months ago?
3.) How common is an outbreak consisting of one lesion/sore?
4.) If I have already been positive for HSV-1. How likely is it to obtain HSV-1 again in a different area from a different person?
5.) If I do test positive do I then start disclosing as if i’m positive for genital HSV-1? Since I don’t have a positive swab in either area couldn’t I risk spreading my Genital HSV-1 infection to others if it’s not oral? Should me and my GF start using protection until its confirmed?
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March 7, 2015 at 6:53 pm #5384Terri WarrenKeymaster
1.) With dealing with symptoms such as pain/burning/tingling etc. How often are these symptoms present even when there is no visible sores? Would it be unusual for them to last for a week?
They can happen without lesions, yes and it could last a week but that would not be common, for usre.
2.) Say with my given history. One time sexual encounter 3 months ago. Protected sex, unprotected oral. (Don’t know her status) and current sexual partner negative for HSV-1 & HSV-2. If a re-test does show a positive HSV-1 result as opposed to equivocal. Do I then come to the conclusion that my symptoms of mild discomfort at head of penis and icy-hot feeling in thighs and scrotum are attributed to a new genital HSV-1 infection received from my exposure 3 months ago?
No, I think that is a huge jump. I think you need confirmatory test since your HSV 1 is kind of variable.
3.) How common is an outbreak consisting of one lesion/sore?
That can happen, yes.
4.) If I have already been positive for HSV-1. How likely is it to obtain HSV-1 again in a different area from a different person?
Extremely unlikely
5.) If I do test positive do I then start disclosing as if i’m positive for genital HSV-1? Since I don’t have a positive swab in either area couldn’t I risk spreading my Genital HSV-1 infection to others if it’s not oral? Should me and my GF start using protection until its confirmed?
Experts do not agree on this question – some encourage full disclosure. Others don’t because more than half the population has HSV 1. How long have you and your partner been having sex without condoms. If it has been a while, adding condoms now may not be very helpful. Plus we don’t know if you are infected yet, correct? You should do what makes both of you the most comfortable.
Terri
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March 10, 2015 at 2:21 am #5443Nervous10Participant
Hello Dr. Warren I purchased some additional questions.
What was the accuracy of my IGG blood test at 8 weeks?
Say my one time exposure 3 months ago was positive for HSV-1. Since we participated in unprotected oral and kissing. What are the chances that I could have been infected both genitally and orally at the same time (if she was indeed shedding.)
Finally how common is it for me to just now be showing symptoms 3 months after this one-time exposure? I know many people can have dormant infections.
To answer your question: We have been having unprotected sex for about 2 Months and 2 weeks. She got her results in 3 days ago and was negative for HSV-1 & HSV-2.
Also I’d like to ask your opinion on this picture. Is this something that I should go get swabbed in the morning? Does it resemble a typical oral herpes lesion? About 2 weeks ago I had one that looked identical to it that was a little farther up right in the corner of my mouth. If not HSV-1 what could it be? Angular Chilitus? Just a cut from weather/dry lips?
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March 10, 2015 at 2:07 pm #5449Terri WarrenKeymaster
If you were my patient, I would swab test this for herpes yes. Having said that, I think it is more likely from a change in weather or it could be angular chelitis. The thing is, if the antibody test is negative for HSV 1, it is certain with about an 80-90% accuracy but that’s not great. A western blot is better for HSV 1. So in terms of answering the accuracy at 8 weeks, you need to take into account the lack of sensitivity of the test for HSV 1, so I guess I can’t really answer that for you. The lack of sensitivity of the screening test applies to both of you.
Not everyone who gets a new infection has symptoms right away so it isn’t impossible that you could have acquired this years ago and just having symptoms. I just can’t say! You need lab testing
Terri
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March 17, 2015 at 12:14 am #5611Nervous10Participant
Hey Terri.
I got another lab test done and results came back today. My GF also got re-tested
To recap: both of us had exposures in early December.
Her Results both Negative for HSV-1 & HSV-2.
My results came back negative for HSV-2 and positive for HSV-1 at a value of 1.10. I got testing done back in Late January and the results were the same except HSV-1 was at .99 instead of 1.10. So a equivocal result followed by basically another equivocal result.
So what’s the deal? I know that HSV-1 tests missed 10-20% of cases but what are the chances of it showing almost identical values back to back?
Does the small difference in numbers from January to March mean anything? Or it is pretty much negligible?
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March 17, 2015 at 2:47 am #5624Nervous10Participant
Also does this look like something I should be concerned about? It wasn’t there all day then after me and my GF had sex twice in a 2 hour period it showed up and i noticed it as I went to the bathroom. I assumed it could be from friction from her Nuva Ring.. but I don’t know. It showed up Saturday night and it was gone by Monday or Tuesday.
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March 18, 2015 at 1:24 am #5631Terri WarrenKeymaster
The HSV 1 result is difficult to interpret but could certainly be a false positive. Are you certain you are reading the result correctly? It would so unusual to have exactly the value that is the cutoff for positive! The difference between the two numbers (if they are correct) is not significant.
The picture does not look like herpes to me.
Terri
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March 18, 2015 at 3:04 am #5636Nervous10Participant
Yes both numbers are correct Equivocal followed by another equivocal. I just double checked.
I’m looking at the paper right now it reads 1.10- FLAG HIGH HSV-1 positive with <0.90 = NEGATIVE >1.09= POSITIVE My value was listed next to it and it reads 1.10. Then next to HSV-2 it just reads <.9
It was done by labcorp.
Does this mean something in my blood is tripping both times? If I am reading it correctly would a double equivocal give me the go ahead to stop testing and assume im negative? I’m tired of the unknown..
- This reply was modified 7 years, 10 months ago by Nervous10.
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March 18, 2015 at 3:13 am #5638Nervous10Participant
HSV-2 has no value next to it while HSV-1 has 1.10
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March 18, 2015 at 2:44 pm #5641Terri WarrenKeymaster
Well, if it is actually 1.10 then it is just barely but technically positive. So two things could be going on here with your HSV 1 value:
1) it could be a false positive since it is just barely over the cutoff point
2) you really do have HSV 1 and test test is just barely picking it up. The HSV 1 screening test is not great. So once again, if you really want to know your HSV 1 status, the western blot is the way to go.The cutoffs are the same for HSV 2 as they are for HSV 2, even though they are not listed on your lab form, which is pretty odd that they are not.
If you decide to do the western blot, we can help you at the clinic to obtain this with a blood draw near you or you can contact the UW lab directly to have a kit shipped to you and your health care provider can draw it and ship it back to UW.
If you are really sick of not knowing what is really going on, that is my suggestion.
Your subscription has run out of questions. If you have more, feel free to renew.
Terri
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March 18, 2015 at 3:36 pm #5643Nervous10Participant
Okay, I updated subscription.
I know IGG is not perfect for HSV-1 but back to back testing with similar results doesn’t really show anything?
So just to understand what you are saying. Either I have had 2 false positives in a row. (That seems rare, no?) OR I am positive and the test just didn’t read the correct level of antibodies both times. Giving me 2 equivocal’s in a row.
Something in my blood tripping it to an equivocal level isn’t an option?
The reason I wanted my confirmation is because I am/was scared that I got genital HSV-1 from my onetime oral encounter back in December. And I did not want to infect my new girlfriend. However, I haven’t had a typical outbreak down there other than the little scratch that I showed you earlier and the bump I got visually checked out by a doctor. I’ve never had a typical oral outbreak either..
But i’m sure the chances of me having oral HSV-1 are high considering my mom gets 3-4 outbreaks a year and my best friend also gets 3-4 a year. Again I’ve never had one or anybody else in my family (my mom was really careful about it honestly) but it wouldn’t surpise me if I did. I’m just thinking now if it is positive that without a genital outbreak the chances of my +HSV-1 being oral are almost 4x the amount of getting it from a one time oral encounter. More of a vent than a question ha but would you agree with this?
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March 18, 2015 at 5:32 pm #5644Terri WarrenKeymaster
Well, false positives are sometimes DUE to a cellular protein tripping the test artificially.
Having an outbreak, typical or otherwise, does not indicate infection.
Yes, I would say in your situation oral infection is more likely than genital infection. But it would be good to know if you have HSV 1 at all if you are worried about your new partner acquiring infection from you.
Terri
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March 18, 2015 at 6:27 pm #5645Nervous10Participant
Ah okay I understand now. So you think it’s more than likely 2 false readings as opposed to a cellular protein tripping my results to an equivocal twice. Why is it that equivocal is considered negative then? Or at least my doctor told me such when reading me my results.
I agree with you. But even if I did know that I had HSV-1 without outbreaks how would I even prevent infecting my new partner? Just abstain from oral sex?
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March 18, 2015 at 7:00 pm #5646Terri WarrenKeymaster
I’m not making myself very clear and I’m not sure how else to put it. My understanding is that 1.1 is a positive result on this test. Not sure where the equivocal is coming in except your prior test? Equivocal is neither positive nor negative. It is equivocal! However, the screening test could also just be missing a very firm HSV 1 infection that the western blot would pick up.
If you were HSV 1 positive (regardless of location) and she is HSV 1 negative, then you might consider taking daily antiviral therapy to reduce the risk of infecting her.
Terri
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March 19, 2015 at 1:58 am #5647Nervous10Participant
1.10 is a positive result on this test. I just assumed since it is right on the cutoff and pretty close to my previous equivocal result from a different lab that this one is basically of the same value as my equivocal value of earlier and basically lumped it into a equivocal result, although techniquely positive. I guess I was the one that was being confusing!
I heard labcorp values can be a little higher. Is this true?
That’s interesting I’ve never heard of anybody taking daily antiviral therapy for HSV-1. Taking a pill every day for the rest of my life for something that isn’t bothering me with outbreaks doesn’t sound like to much fun, but is an option I will consider and talk over with my partner to decide if she is comfortable with me not doing that.
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March 19, 2015 at 2:23 am #5648Nervous10Participant
Also one more question. Couldn’t edit last box.
Is it pretty common or rare to get a genital and oral HSV-1 infection at the same time (exposure).
Thanks Terri
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March 19, 2015 at 3:49 pm #5664Terri WarrenKeymaster
Your two values are very close together and are basically the same except their classification, which is what I think we were going back and forth about. The LabCorp values sometimes are higher, yes, but not every time I am discovering.
I have many discordant couples for HSV 1 where the infected person takes daily antiviral therapy. I would say it is not very common to get it in both locations at the same time but we certainly see it.
Terri
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