What is happening

[Anonymous]

I have been in a monogamous relationship for 17 years and never was unfaithful until recently. I had brief protected sex and exchanged full body massage with an “upscale” escort 7 weeks ago. After three days had burning “electric” sensations in hands and arms mostly on right side. Saw my internist within 48 hours who gave me 10 days Valtrex just in case and a negative initial test for all STDs. After few more days the burning spread to my legs, particularly my right ankle. All of this discomfort kept coming and going and changing in location and intensity. Had few day break and then after burning sensation resumed in extremities, but also in the genital region and along my waistline. Had a negative IGG for all STDs at 4 weeks. Also experienced burning nipples (that had oral contact). Developed an intermittent low grade fever (100) that occurred mostly in the evenings, but never lymph swelling and no obvious breakout. Saw a ID MD who saw no sores and suggested this was all guilt induced psychosomatic symptoms, but ordered a test to occur at 12 weeks for all STDs. Genital pain got more intense especially tip of the penis (odd inflamed skin, but no typical looking sores or breakout) and bottom of scrotum. Fever continued only in the afternoon/evenings. Saw a urologist who prescribed CIPRO 12 days just in case was prostrate related. Still having intermittent pain all over (mostly boxer short are and right extremities) generally less with some really intense periods – always worse after 3 or 4 with low grade fever and recently, headaches. Is this possibly prolonged HSV prodome or other initial STD or merely my mind playing horrible tricks? I can’t imagine I am inflicting this much discomfort on myself. Are any of these symptoms consistent with an STD? Would appreciate any help you could provide. If HSV, what is the risk of non-sexual transmission to uninfected family members/what precautions should be taken?

[Terri WarrenKeymaster]

It is unfortunate that you were given herpes treatment, in my opinion, when you did not have any diagnosis suggesting herpes and that really got this herpes ball rolling for you. I have never heard of genital herpes causing electric sensations in the arms and hands of a single side. You mention having a negative IgG test at 4 weeks for all STD’s. Do you mean for herpes? The other STD tests don’t look for IgG really. When you describe a low grade fever, can you tell me more specifically what your temps were like?

Nothing that you have described here makes me concerned that you might have herpes. And I also don’t think that a single brief intercourse with condom would put you at much risk of acquiring herpes. Is there zero risk? No. But less, I would think, way fewer than 1 in 1,000. But honestly, if you were our patient, we would probably revisit a urology referral for more intense evaluation of the prostate gland. This generalized boxer short area burning would be more suggestive of a prostatitis that might take weeks rather than days of treatment. But these symptoms really aren’t consistent with the STD’s that we normally think about. When will your 12 weeks be up for further STD testing? No these symptoms don’t sound like an STD to me.

Terri

[Anonymous]

Thank you for your quick reply and opinion. I am so hopeful by the odds you present here. Clearly a life changing event worries me greatly. My concern of exposure comes more from manual contact with a possibly infected body part and then touching my mouth (a had a slight cough that day and was covering my mouth (ironic). I got the Herpes ball rolling early when my hands started burning. The burning has been all over intermittent most frequent on right leg, ankle and arm, but on left as well. The weird thing is this has been nearly constant for seven weeks with only brief periods of relief. I was awoken just now by burning on my right thigh, genitals and waistline and with the same bad headache (but so pleased to see your note). The boxer short area reference was regarding my waist, scrotum and tip of my penis) The four week battery of tests included HSV IgG, not sure of other STD test methods. Intermittent fever has been around 100 and as I said occurs most frequently in afternoon and evening. I also have had low appetite and weight loss (but have been very upset). I have taken Valium to help reduce the anxeity off and on. 12 weeks will take me through to the second week of December – 5 more weeks. The only other med history issue with me is eczema and adult chicken pox – not sure if either would impact a possible new HSV infection. Lastly, since you give this even long odds…if this were HSV how do I protect my wife (who is allowing me to stay in my home) and young children? Until I know with certainty, want to keep everyone safe and free from potential infection. Have a follow up with the urologist in a week and will discuss further. Anything else I should pursue before the 12 week mark? Thank you again for your expertise and counsel.

[Terri WarrenKeymaster]

If you are asking me what you should do about sex with your wife, I again think it is very unlikely that you would infect her. If you are asking how you might just protect your household members, that is absolutely not a concern. The concerns about manual contact is the lowest part of the risk here. The thick skin of the thighs and abdomen do not shed herpes virus so I don’t believe that the massage is a risk for transmission at all.

You have one final follow up question if have anything else that concerns you.

Terri

[Anonymous]

To be clear, by manual contact I mean hands on genitals – then contact with the mouth or nose. My last follow-up – if I hit your predicted 1 in 1000 odds and these symptoms are atypical HSV (I think you were suggesting that they were not typical,right?.). Is there a possibility (slim or otherwise) of NON-SEXUAL transmission to wife, kids or anyone else? If so, what kind of precautions are warranted? I plan on resuming normal life only after confirming 12 week negative test results given these continuing burning sensations. I believe this not merely a psychological issue.

Thank you again for providing this service. Having access to an expert in this manner is appreciated.

[Terri WarrenKeymaster]

OK, I understand more fully what you mean by hands on genitals. Assuming there were no breaks in your hands and you have no blisters on your hands now I think this is very close to a now risk situation. There are no non-sexual transmission risks to your family for possible genital herpes. Sure wish I could help you more with what is going on with the burning, but I don’t have any good ideas about that.

Terri

[Anonymous]

Are there non-sexual transmission risk to my family if there were “actual” genital herpes?

[Terri WarrenKeymaster]

No, only a sexual risk to others you have sex with.

Terri

[Anonymous]

Very last follow-up. What is the optimal number of weeks past exposure to confirm via HSV IgG test my status. Have read the window is between 12 and 16 weeks. CA department of health protocols suggest retest of initial negative result at 12 weeks….would you concur? Anxious to put any doubt to rest. Thanks again for your service.

[Terri WarrenKeymaster]

Your account now has five question and you have only signed up for the initial question and two follow up questions. If you need further information, please subscribe again for either two or three more questions.

Terri

[Anonymous]

Terri- purchased more questions. My symptoms continue with what I would now describe as genital irritation and burning in three specific spots. I am eight weeks past suspected exposure with no apparent sores. 1) how possible is it that a HSV 2 infection could cause pain ‘/ irritation intermittently for two months without an obvious outbreak?
2) how many weeks do I need to wait post exposure to ensure detection if I was infected (have read 12-16 weeks, but you seem to advise of 16 weeks) will antibody reduce after a period of time?

[Terri WarrenKeymaster]

I don’t know what is going on with the burning in specific spots, but if you have concerns still, you could ask your provider to do PCR swabs from those locations. They can be done without any visible symptoms at all. I think it is very unlikely that you would have intermittent sensations for two months without any lesions and have herpes be causing this.

The University of Washington recommends waiting 16 weeks from exposure to testing for greater accuracy and so that is also my guideline as I believe they are the most respected source of information on herpes testing.

Antibody will not reduce over time because you will always have virus in your body, being active if even with no symptoms, and that activity causes the immune system to continue to respond by making more antibody

terri

[Anonymous]

I am very concerned and feeling so horrible about my careless disregard for my family and myself. I feel certain I have an STI from this regretful decision and suspect HSV,. I will pursue a diagnosis as you suggest, but guess there is nothing else I can do at this point, but cope with discomfort and uncertainty. Your site and words have given me some comfort that I can keep my family healthy and hold out some hope this is not necessarily herpes. Thanks for sharing your expertise.

[Terri WarrenKeymaster]

I know you are feeling badly about this experience, but I would strongly encourage you to take one step at a time, and process through the testing as recommend vs. falling apart.

Terri

[Anonymous]

Terri – thank you the advice-definitely try to keep it together and have tests scheduled for late December. Harder to keep it together when I’m having pain without any sores/lesions. Would it be consistent with HSV prodomal symptoms for a burning genital pain to change in intensity within a matter of hours?

[Terri WarrenKeymaster]

No, not really. I think it is more likely that if you had herpes you would have sores at some point that you notice.
Let’s just hang in there until December. I really believe that you are going to be fine.

I believe we have once again used up all of your posts. If you wish to extend this conversation, please renew your subscription.

Terri

• This reply was modified 4 years, 4 months ago by  Terri Warren.

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