what's happening here?

[in need of clarification]

i’m an uncircumcized man in his early 20’s and 13 days ago I got very intoxicated and ordered a csw over. she performed fairly rough and deep protected oral sex on me for 5-7 minutes and I did not ejaculate. I felt some pain during this and upon later inspection noticed a minor abrasion near the corona of the head (this has happened in the past as well). i’m fairly certain the condom remained intact. after this was done, I was so drunk I forgot to take the condom off and simply just put my penis back in my pants, only remembering to pull the condom off about 5-10 minutes later, allowing oral fluids to contact the inside of my boxers and thighs. no cleaning occurred after this, and I promptly went to sleep. exactly one week after this exposure, my scrotum turned bright red and I felt a burning sensation in the back of my thighs and buttocks. it is now roughly 21 days from the time I first felt these symtoms and there are no visible lesions or marks whatsoever on my body (i’ve been checking constantly). now what I am primarily feeling is a slight twinge of discomfort in either armpit and a dull but noticeable ache + slight icyhot burn in my right buttock and thigh and twinges of minor muscle pain in my right leg. is this indicative of herpes? Im not positive but I think ive had hsv1 orally before. could this be hsv2 that I just got and thats why the symptoms arent visible? even so, would these nonvisible symtoms be going on for this long? (3 weeks) thank you so much.

[in need of clarification]

my mistake, the exposure was 28 days ago, not 13

[Terri Warren]

The most likely thing anyone would get from oral sex is HSV 1, which you think you likely have already. Once you have HSV 1 orally in one location you are extremely unlikely to acquire it in a new location. Having said that, getting HSV 2 from oral sex, especially from a CSW, is not impossible. However, your symptoms sound nothing like herpes to me. While some people can get thigh pain, it is usually transient and happens for just a day or two before an outbreak. There are exceptions, of course, but let’s go with the usual. Also, herpes symptoms don’t go on and on and on. They occur then stop then may recur weeks or months later. The red scrotum sounds more fungal.

Having said all of that, I’m wondering – have you ever had a herpes antibody test?

Terri

[in need of clarification]

no I have never had an antibody test – every morning when I’ve woken up for the past three weeks (one week past exposure) I ‘ve felt a dull ache in my right hip and buttock and a sort of stiffness in my right leg as opposed to my left. scrotum only was red that one day – never again after. then, over the course of the day, the icyhot burning feeling comes and goes, sometimes in the thigh or calf or buttock but always only on the right side. no lesions, bumps, marks – nothing at all now a month past exposure. genitals feel completely fine with absolutely no marks but I do get a minor burning feeling here and there during urination. slight twinges of pain and possible swelling that comes and goes in my armpits as well. could this still be caused by hsv2 and just not be showing anything visibly due to the possibility I might already have hsv1? I’m pretty much at a loss as I’m constantly checking for marks that i’m pretty certain at this point won’t appear and don’t know how long these symptoms will last. could her saliva have gotten into the abrasion on my penis due to the fact that I left the condom on in my pants for a couple minutes before pulling it off, allowing fluids to get on the inside of my boxers and possibly my thighs and just went right to sleep? if so, would that cause these symptoms? thanks a million, you’re really helping me out here and I’m incredibly appreciative

[Terri Warren]

The symptoms of muscle pain and stiffness are not typical of herpes, without the lesions of herpes. Honestly, I don’t think that’s what is going on here. Even when people do have HSV 2 orally, it is very rarely active and given off.

Terri

[in need of clarification]

I read that usually people with oral hsv2 simultaneously get it genitally too and that they tend to shed simultaneously as well. also having hiv increases shedding rates. I don’t recall her lips ever going past the condom, but I want to know whether hsv2 oral can be transmitted through saliva alone, as it could have gotten into the abrasion after the fact (which still wouldn’t explain the lack of penile lesions). also as a final question, do you have any idea what else could be causing this? thanks for your assistance

[Terri Warren]

You are correct about how people shed orally and genitally at the same time often. But HSV 2 orally shed WAY less often than HSV 2 genitally – perhaps 1% of days vs. 13 or 14% of days. If you got it genitally, that’s where the lesions would show up. I honestly don’t think your situation with old saliva around is a risk for herpes acquisition – virus die really quickly when off the human body. I don’t know what might be going other than a pulled muscle which would likely last a lot longer than a herpes outbreak.

Terri

[in need of clarification]

hi terri,

I purchased additional questions because I’m literally at my wit’s end. I went to a pcp to get bloodwork done. they obviously don’t suspect herpes either, as they are pretty much strictly trained to look for lesions. going on close to 4 weeks of right hip/leg/buttock stiffness/pain with no lesions or marks at all. burning sensation in right buttock/thigh when sitting for long periods of time. I’ve read every post by HHH and EWH from as far back as 2006 and in every case remotely similar to mine they completely disregard herpes as a possible culprit. however, there are literally no other diseases that fit what i’m feeling and these feelings only started a week after exposure. I doubt this is an asymptomatic occurrance because this has been ongoing for weeks from the second I wake up till I go to bed. could it be I have hsv1 orally and this is causing the occurrence of hsv2 to be muted in the sense of lesions but apparent as far as the ner e pain on one side etc? could a coinfection of another std be prolonging the outbreak process? possibly even hiv? thanks for your help

[Terri Warren]

I honestly do not believe for a second that this is due to herpes – not at all. Herpes just does not behave in this way in my experience or in the reported literature. Herpes is not a disease that happens with constant symptoms such as those that you are describing. I’m not sure how else to reassure you about this!

Terri

[in need of clarification]

lower back pain (once again on the ride side) which started occurring about a week ago as well. all feelings are experienced on the back of right leg. skin on right leg is very sensitive to heat/cold as well. my sister is a doctor and i’ve pretty much stumped her with this as well…not a single indicative mark on my body but all these (seemingly) nerve related symptoms all located on the back side of the lower right part of my body that have been ongoing for weeks and only started one week post exposure. I got blood drawn for a full panel std screen but I know that it’s only been a little over a month so it won’t really tell me much in terms of a herpes diagnosis. at least i’ll hopefully be able to confirm whether or not I already have hsv1. my questions are:

is 12 weeks conclusive as far as herpes testing is concerned?

does my right sided lower back pain change and right leg skin sensitivity change your opinion on this being herpes at all?

thank you so much for taking the time to help me

[Terri Warren]

I think that 12 weeks with the ELISA test is quite good – I like 16 weeks with the western blot but the ELISA probably becomes positive more quickly since it is only looking for one protein associated with the HSV antibody where the western blot looks for a the whole range of proteins.

When assessing whether a symptom is related to herpes or not, I always go back to the concerning incident. In this case, the incident is very unlikely to have infected you with herpes. People don’t understand, usually, that herpes, in adults, doesn’t come from a tiny amount of virus – there has to be a certain amount of virus present to infect someone and it isn’t small. Your incident really doesn’t present a big risk in my mind.

I see that you have posted on the ASHA board and let’s see what either Dr. Handsfield or Hook think about your situation.

Terri

[in need of clarification]

thank you so much for your help. I posted there mainly to assess my hiv risk which i’m really concerned about now given the timing of some other symptoms i’ve been having. once again, thank you for your time and patience it is much appreciated

[in need of clarification]

hi terri,

so my bloodwork came back today. to my complete and utter surprise I’m negative for both hsv1 and 2! both <.90 I know it’s too early to really tell because I tested at four weeks but this way I at least know I most likely don’t have 1 meaning I would have had a severe and standard breakout by now if this was herpes related. just waiting on my hiv test which I had to get blood redrawn for but just wanted to let you know what came back as far as herpes is concerned. I’ll still retest at 3 months but this seems like a good sign I think. once again thank you for e everything you do!

[Terri Warren]

I’m very pleased for you and I know you must be relieved about your results so far. Keep me posted if you like on your future testing.

Terri

[in need of clarification]

hi terri,

tomorrow will be the 7th week from exposure, and the 6th week straight of the same constant symptoms on the right side if my body. three or four days ago, I noticed a small red spot on my lower right back in line with my waistband. I’d been checking it to see if any changes occurred and noticed yesterday that it developed a white head that has gotten more prominent as of this morning and looks nothing like any herpes lesions I’ve seen on the internet. it slightly pains/burns on and off but I’m fairly certain its because I wear dress pants and a belt to work so it has constant pressure on it. other than this, there have been no noticeable changes as far as marks or lesions on my skin. my questions are as follows:

have you ever seen someone have constant (morning till night) herpetic like symptoms for a month and a half without developing lesions who ended up having herpes?

I plan on getting tested again next week at the 8 week mark. I know you’ve said 6 weeks is about 70% accurate, approximately what percent accuracy would you say 8 weeks is?

thanks so much for your time and consideration

[Terri Warren]

I have honestly never seen someone with constant symptoms such as those that you describe with no apparent skin lesions show up later with herpes but I am not saying that is impossible. I’m sorry but we don’t have studies that look at seroconversion rates at 8 weeks, only 6 weeks, but it would definitely be more than 70%!

Terri

[in need of clarification]

hi terri,

still no change, same symptoms on the right hip/thigh/buttock/lower back/leg with no lesions. I’ve also been constipated the past couple weeks and read that that’s a potential symptom as well. I’m paying next time I post here which will be with my blood results next week. I’ve just been driving myself crazy reading posts by people on various sites who say these symptoms are definitely herpetic so I think I need to just relax and let the results speak for themself. it’s just crazy to me how I went from a completely healthy young person to feeling like a cripple seemingly overnight with no relief of symptoms or indicative lesions or marks for a month and a half. (especially given the circumstances of my encounter) I guess my question (and I have no clue if you’d know the answer) is does hsv1 or 2 tend to cause more nerve related pain? thank you so much for putting up with me

[Terri Warren]

I am not aware of a difference between the viruses in the amount of nerve pain that they cause. In reality, neuralgia from herpes is usually present just for a day or two prior to an outbreak for most people.
Yes, please let the tests speak for themselves and get off of other sites, and just stick to this one ‘-)

Terri

[in need of clarification]

hi terri,

just paid for additional questions so here goes. by the way i’m the guy with constant right sided symptoms (tightness in lower back/buttock/hip/leg accompanied by burning sensation on right buttock/lower back/thigh when sitting and slight feeling of skin irritation in those areas as well.) going on 6.5 weeks with no lesions or sores. I’m getting blood drawn today at 7.5 weeks post exposure then I have a lab slip for another blood draw at a later date. anything that comes up with testing has to be related to my recent exposure as the only other girl I have been intimate with was my ex in college who was a virgin when we meet in high school. at this point I literally am beside myself with frustration and feel like I hit the lottery for the most unlucky encounter of all time. I’m hoping if anything this turns out to be ghsv1 but given how unlucky I feel to even be feeling symptoms right now I wouldn’t even be shocked if I had gotten hsv2 from her mouth. (please read my first post for my exposure since I knew you are very busy and in all likelihood forgot.) I came up negative for everything at 4 weeks even though that’s too early. I almost wish I had started with a western blot given the inaccuracy of the hsv1 test to see if I have been previously infected by it (which looking back on it I don’t think I was). my questions are:

are these symptoms persisting for this long because my body is still making antibodies and is slow to do so?

if this was herpes, would antivirals even help stop these symptoms?

in your honest personal opinion (don’t pull any punches please) do you think I’ve acquired herpes through this encounter and that’s what is causing these symptoms?

thank you. I’m forever grateful for your professionalism and expertise.

[Terri Warren]

If your symptoms are from herpes, then you will continue to make antibody for the rest of your life. If this was herpes, antiviral therapy would likely help, yes, but it would also influence your test results AT THIS POINT in the process. I do not think you have acquired herpes at this encounter, no, but as you said, you really have no idea if you were positive for HSV 1 at the outset or not and I am worried if the western blot is positive for HSV 1 that you will decide that HSV 1 is causing all these symptoms and that you acquired it at that encounter, which I might find erroneous.

You are most welcome. You have two posts remaining.

Terri

[in need of clarification]

hi terri,

got my 7.5 week test results back. <.9 for both types once again. right sided symptoms still remain. the PA that ordered me the lab knew absolutely nothing about herpes (and probably everything else) and basically sat silently after giving me some bogus information that I immediately corrected after informing her that i’ve been in direct correspondence with you. I show up to quest for my blood draw and thank god I asked the phlebotomist what type of test she ordered because apparently the PA ordered a spinal tap! my sister told me that’s for herpes meningitis when it has infected your brain…first time I’ve genuinely laughed in weeks. either way I had her change it to a type specific igg antibody test like I had gotten previously and thankfully she did it without making me go back to have another appointment. my questions are as follows:

are my test results encouraging at all?

why does quest not provide numerical values? would I be able to call the lab directly to obtain them?

I have a lot of friends and family in the medical field and they all tell me herpes does not present constantly and without lesions. do you think I’m some kind of atypical case? also, after reading stories from posters such as badtimeinmylife, I’m nervous the tests may never catch for an infection.

I plan on getting retested with the same test at 12 weeks and a western blot at 16 weeks. only problem is I live in PA and I’ve read that’s a state that didn’t offer this service. would I have to drive to a different state in order to have this done?

as always terri, thank you so much. I surely would have gone even crazier than I am right now without your advice.

[Terri Warren]

Your test results are very encouraging! I don’t think you need the negative index values – knowing it is negative is adequate in your situation.
Badtimeinmylife is an exception. We know that the testing misses a few people, but picks up about 98 out of 100 infections.
I agree with friends and family that herpes does not present in the way that your symptoms are presenting and I really don’t think you have herpes.
We can do the western blot, even though you live in PA as part of a study we are doing. In order to do this, you need to set up a phone consultation with me and we will work through our research department to get you tested as part of our research program.

Terri

[in need of clarification]

hi terri,

last question before I pay again to discuss my 12 week results and western blot procedure at 16 weeks. right sided symptoms still persisting and driving me up the wall with zero lesions or marks, I’m going to try and see if aspercreme gives me any relief. my questions are: do you think I should continue testing through quest or use labcorp next test since they provide values? is the captia better than the elisa? finally, in your opinion, is a 16 week western blot conclusive enough for me to be done with this and look for other potential causes of my symptoms? thank you so so much. I won’t nag you again till my 3 month results are in in a couple weeks

[Terri Warren]

I always get index values from Quest so I am very surprised you aren’t getting them. If you are going to do the western blot, I see no point in redoing the IgG test anyway. Neither test is necessarily better than the other. 16 weeks should be the telling test, yes. You aren’t nagging me, no worries.

And just so you know, you have paid for 9 questions and have posted 12 (not counting one oneliner. Not sure how that slipped through but you are behind one subscription. Please pay for your back questions fully before posting more and then you’ll need to renew for more questions. Just tryin’ to keep this all straight and fair!
Terri

• This reply was modified 6 years, 8 months ago by Terri Warren.

[in need of clarification]

hi terri, I just paid twice as you instructed. i’m the strictly right sided symptoms guy. I’ve been trying to stay optimistic as I’m doing my 12 week test a week from today, but I came across this post that honestly terrifies me and I was wondering if you could take a look.

http://www.medhelp.org/posts/STDs/Constant-Neurological-Problems-from-Genital-Herpes/show/245914

this person lists my exact symptoms to a t but his were on the left side and he tested positive at around 3 months. I feel doomed now and my symptoms have remained constant with no lesions whatsoever. the only confusing part of his story to me is that he said his index value was around 9 which seems high for a new infection via an elisa test. also he claimed that the antivirals did not provide any relief to his symptoms. this is only very minor comfort for me and I feel like i’m grasping at straws at this point. could you please weigh in with any possible insight? I would greatly appreciate it. also, if I somehow test negative on my western blot which I will be taking in 5 weeks, would you consider that to be conclusive? thank you so much once again. I feel as though i’ve ruined my life and youth overnight and hearing from you always gives me some comfort.

[Terri Warren]

Wait, I don’t think this guy had a baseline negative antibody test, or did I miss it? I just read that he tested positive at 4 months. We don’t know if he might have had this for 20 years before he tested!
Yes, if you test negative in five week, I would absolutely consider this confirmed negative.
Sorry, I took the weekend off to camp with my family.

Terri

[in need of clarification]

hi terri,

right sided guy. constant stiff/aching buttock/lower back/hip/leg. burning/cold sensation when sitting on buttock and thigh, skin sensitivity on skin of right leg, random pulses/twitches in my legs and right hip, and all these symptoms have persisted for 11 weeks now with no lesions or marks. (1 week post exposure) I have my 12 week igg test scheduled in 2 days.

if I’m still negative, with what percent certainty could I consider the accuracy?

also, would your clinical trial for the wb still be valid in 4 weeks when I plan to test? (I live in PA) thank you so much!!!

[Terri Warren]

given that the constant muscle sensations are extremely unlikely to be related to herpes, and your negative 7.5 week test, I think the chances are excellent that you are negative for HSV 2.

Terri

[in need of clarification]

hi terri,

right sided symptom guy again. (stiffness/burning/ache) i’m sorry if i’m annoying you by restating that, i just know that there are a lot of people that post on this forum so keeping everyone’s individual situation fresh in your memory is most likely a challenge. i took a test at a little over 12 weeks (86 days) post exposure at Quest and the results were negative for both HSV1 and HSV2, both <.9. I’ve recently began physical therapy to see if it makes any difference. I’m trying to take encouragement from my results, but reading other stories on here just shows me how difficult it can be to mentally put herpes out of the picture, due to some people testing negative but showing visible symptoms, people seroconverting at various different times, or people even never testing positive despite positive swabs.

In your professional opinion, do you think my 12 week results are a good sign?

I plan on taking the western blot at 16 weeks because I’d rather have the best test done than keep questioning the screening test’s accuracy/results. I live in Pennsylvania. is your clinical trial still running and will it be open to me when 16 weeks for me is up in about 3 weeks? If i become a phone patient soon can i arrange to have the blood drawn in a couple weeks? Will that be my final, conclusive test in your opinion?

THANK YOU SO MUCH!! you really have no idea how much you’ve helped me through this ordeal, I sincerely appreciate all your advice and consideration from the bottom of my heart.

[Terri Warren]

I think your 12 weeks results are an excellent sign, yes! For sure!
Yes, you can still get your western blot through the clinic through the research study, correct. But be sure to wait until the 16 week time. You can make your appointment about a week before you want the blood draw as it takes about a week to get everything set up and ready for you. Yes, that is your final test.

Glad to be of help!

Terri

[in need of clarification]

hi terri,

right sided symptom guy. we spoke on the phone 2 days ago as I’m ordering a western blot (which I’m very grateful for) I saw you wrote about phn to another poster here and said it’s not constant, and I have just a couple questions, as I’ve been experiencing pain/stiffness/burning/skin sensitivity in my right leg/hip/lower back and buttock constantly from morning till night for 3+ months now with no lesions. I plan on even getting another igg test done sometime next week just to see if I could have possibly turned positive for 2 in case I already have hsv1 despite my negative results at 12 weeks. my questions are:

you said if the western blot comes back positive for hsv1 then you wouldn’t attribute my symptoms to that. does this mean you feel as though my symptoms are likely to be hsv2 provided I already had hsv1 and the test just keeps missing it?

would herpes symptoms occur in the manner of the symptoms I’m experiencing? like I said before, ive only been with one partner and she was a virgin so I’m pretty positive I could not have been infected before this event.

thanks so much! it’s just that sitting and waiting for another three weeks is going to be nerve racking for me and I know I’m being a little crazy here bit these symptoms are a constant reminder.

[Terri Warren]

No, I think if you test positive for HSV 1, these symptoms are likely something else completely, not HSV 2.
No, herpes symptoms would not occur in the way that you are feeling traditionally. Your sexual history definitely does not suggest HSV 2 infection. Period.
I know the waiting is hard but there is just nothing to take it’s place!

Terri

[in need of clarification]

hi terri,

tomorrow marks 16 weeks post exposure and I’ll be getting my blood drawn for the wb in the morning. these nerve/neuralgia related symptoms on the right lower half of my body have plagued me for 15 weeks now with no lesions or marks and are seriously having a negative impact on my life. I can’t remember the last time I could walk or sit without discomfort or pain. I saw you write to another poster that although contracting hsv2 from oral sex is possible, you have never seen it in your career and I pray that I don’t turn out to be your first case. my questions are:

will you be emailing my results? you can even post them here if it’ll end up possibly helping someone else in a similar situation.

should I get another igg test done in the interim just for the sake of possibly relieving some anxiety or do you think that’d be worthless?

thank you so much!!!!!

[Terri Warren]

I will be emailing you the results yes and I will leave it to you to post here if you wish to do that. I would say DO NOT test with the IgG again, just no point in that.
I seriously think your leg and muscle pain is related to something entirely different.

You’re welcome

[in need of clarification]

hi terri, I took my western blot at 18 weeks just to make sure and the results were emailed to me this past friday. negative for both type hsv1 and hsv2! I’m still experiencing all the nerve related (burning/skin irritated feeling/skin sensitivity/twitching/aching pain) on the right lower half of my body, but now i’m more inclined to believe it is not related to hsv. what would you say the percent accuracy for me being clear is given the time tested from exposure and the results? THANK YOU SO SO SO MUCH FOR EVERYTHING. you seriously have helped me through one of the most (if not the most) stressful periods of my young life. thanks again!!

[Terri Warren]

I’m so glad I could be helpful to you. You waited plenty of time for an accurate test result.
There is so much to say that you are not infected, starting with a protected encounter and following through to a negative western blot, the best antibody test you can get to detect herpes infection!
It’s time to let it go now and start living your life normally. You’ve done all that you possibly can to sort this out.

Terri

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