Varying Symptoms Indicating Potential HSV1?

[sherbetlemon]

Hey Terri,
I am a 20 year old male. Previously, I have only had one sexual relationship with a female partner, for a year and we were monogamous, and she had no STDs. This relationship ended nearly 2 years ago. On New’s Year Eve, I had an unprotected oral sex encounter with a different female (one time only). She told me she had never had a cold sore in her life and no visible symptoms were there the night of the encounter. Right before the encounter, I nicked my penis while zipping my jeans. A very small cut was made – the size of a pin prick – on my penis head, which drew the tiniest amount of blood. I didn’t think anything of it at the time and proceeded with the oral encounter.

4 or so days later, some form of tingling/itching – this may have just been anxiety. In the following days my symptoms became considerably worse, with general nausea, more genital itching, swollen lymph nodes, testicular pain/swelling and perianal pain/swelling. The pain/swelling was so bad I needed to use ice packs to ease the pain. I would wake up sweating in bed, with the sheets completely rinsed-potentially a fever. My penis shaft appeared to be redder than usual, but no lesions could be seen. On January 12th, I went to a GUM clinic, where a doctor diagnosed me with epididymitis. I was given and took doxycycline for 2 weeks. This seemed to make my condition better and after finishing my course all symptoms had disappeared. I tested negative for chlamydia, gonorrhea, HIV and syphilis. However, they found a number of pus cells in my urine, which indicated an infection had been there.

2 weeks after I finished my course of doxycycline (around 12th Feb), I started to get a genital itching sensation again, followed by some testicular pain/swelling again. There were times where I had intermittent lower back discomfort but didn’t correlate this with a consequence of my encounter. My swollen lymph nodes returned as well. I went to the clinic again and was diagnosed with epididymo-orchitis and given ofloxacin for 2 weeks to eradicate any other potential bacterial causes. Again the symptoms subsided after taking the meds.

Since then I have had 2 incidences of genital itching that lasted for about a week, occurring at the start and end of March. However, my right lymph node still seems to be large as every time I exercise I feel like my hip is weighing me down. No lesions have been noticed, and I have been checking regularly. Nonetheless, there are occasions where my penis seems redder than usual. I fear that the doctors may have misdiagnosed, even though both times they have said it’s certainly not herpes.

I feel like I have cause for concern to believe HSV1 may be the cause. Reading my symptoms, do you have any idea of what this could be? Also, do you have any advice on what I should do next(I live in the UK btw)? Thank you for your time

SherbetLemon

[Terri Warren]

It sounds like you are battling some kind of bacterial infection rather than a herpetic one, to me. Testicular pain is not a symptom of herpes. Genital itching alone is rarely due to herpes unless it is accompanied by other things, like lesions. It is possible for you to get antibody tested in the UK?

Terri

[sherbetlemon]

Thanks for the reply. Usually the itching is accompanied by enlarged lymph nodes – is it typical to feel your hip sort of weighing down during exercise in the case of enlarged lymph nodes and to have enlarged lymph nodes intermittently for so long?

The closest things I’ve had to lesions are redness on my penis and something that looks like a tiny skin tear/crack (not red, same colour as skin) that has reoccurred 3 or 4 times.

As well as this, is it possible that my (possible) outbreaks could have coincidentally ended before the end of my antibiotics course rather than the antibiotics were effective?

One point of concern and curiosity for me is the pain/swelling that was present in the perineum. Does this maybe suggest that I have urethral herpes?

In private clinics in the UK, the Igg antibody test is available. However, due to the not wholly accurate nature of the test for HSV1, I would rather want to be able to do the Western blot instead. I read that a man was able to order your kit from the UK and sent it back to your clinic and wonder whether a similar option was available for me. Do you believe I have a substantial reason to do so?

Thanks for your time yet again.

[Terri Warren]

No, enlarged lymph nodes would have nothing to do with feel weighed down during exercise.
redness does not count as a lesion but a tear or crack might – it would have to be swabbed to determine if this is a lesion from herpes.
Yes, that coincidence could have happened.
No, pain and swelling is not part of urethritis
If you do want the western blot, you can contact Roger in our office and he can set that up for you IF there is somewhere in the UK that will draw your blood and spin it down to return to us. If you want the best answer, yes, the western blot is useful

Terri

[sherbetlemon]

Hey Terri, I have now received results of the IGG test I conducted on the May 2nd, which is just over 17 weeks after my last encounter and tested negative for both HSV1 and HSV2. The Western Blot, in regards to finding a place to draw the blood and spin it down, was a bit of an issue so I decided to take the IGG. The specific numerical values were not given, but the range was:

HSV1: <0.0100
HSV2: <0.500

Do these numbers seem low enough for there to be little worry that I have genital herpes? Also, why the significant difference in the levels of the antibodies?

I continue to have genital itching, which has persisted for the past 5 or 6 weeks, and an infrequent minor ache in my left testes (noticeable after exercise such as running) for the past week. 4 doctors have now seen me (2 for the episode of epididymo-orchitis earlier this year, 2 for the genital itching) and said that there were no rash and no symptoms/appearances that suggest genital herpes. My last doctor couldn’t directly diagnose, but assumed the most likely cause was a fungal infection. He prescribed me clotramizole cream, which hasn’t helped, but he has now prescribed me a stronger anti-fungal cream which I am due to try today. Is it safe to assume that these symptoms are not the cause of genital herpes and that I do not have genital herpes at all? Especially as this whole episode came after a one-off encounter? Is it ok to engage in sexual behaviour again?

I know I pose a lot of questions here but I value your opinion.
Thank you very much for your informative replies and this invaluable resource.

[Terri Warren]

Your results for HSV 1in particular are very low and if you are unable to obtain the western blot, then I think you should just go with this result and move on. The differences between antibody levels of the two types, do you mean? It has to do with the sensitivity of the test and your sample vs. the control sample, nothing significant. ‘

And it is OK to engage in sex again – you’ve done the best testing you can do there.

This is your final post on this thread. I think you’re good, but if you have more questions, feel free to renew.

Terri

• This reply was modified 7 years, 9 months ago by Terri Warren.

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