Which nerve root is affected?

[JustsomeQs]

Hi Terry, thanks for taking a look at my question. Before I knew I had ghsv1, I infected my partner, literally about 12 hours before prodromal symptoms of my first (noticeable) outbreak. 🙁 We used a condom, but he got the infection in what I believe was a break in the skin, maybe bug bite, equidistant between the top of the base of his penis and his belly button. I’ve heard the “boxer shorts area” thing meaning anywhere boxer shorts would cover is a genital infection. But he would be just, just barely outside that.

We went to a doctor together at planned parenthood. She advised that the infection will typically only show up along the path of the same nerve root where the initial infection occurred. Together in the appt we looked at a map of nerve root dermatomes. She basically told us we should still take precautions if we are going to have sex because this wasn’t a genital infection because of the area. That because of the area of skin that was affected, it would be difficult for the virus to ever come back up.

I’m not so sure tho, and I would hate for him to go through life just having to wonder. I would also not want him to go through life assuming he doesn’t have it genitally because of the area, then somehow pass it while showing no symptoms, like I did.

I’m trying to figure out which nerve root would be affected. For the area, I think it goes to either the T12 through the iliohypogastric, or it may miss that completely and be above that. Although some diagrams show the iliohypogastric coming out much lower than he has it. Do multiple nerve roots cross cover the same area of skin? I also see that the iliohypogastric merges to the ilioinguinal and the genitofemoral before they reach the spine. Would that mean that if it affects there, it could re-emerge anywhere in those areas?

To be honest he is handling this like a champ and it may just be me who cares/feels bad. I guess I am looking for clarity and certainty when I may not be able to have that. Thanks!

[Terri Warren]

I’m confused. If you think you infected him during your first infection, where did that infection come from? He had a bug bite on his penis? Are you sure he didn’t have genital HSV already? So he had the outbreak kind of the pubic hair area? And he had it swab tested and the lesion was HSV 1?

that’s the boxer shorts area for sure, and the virus lives in the area of the sacral ganglia and can travel on the nerves that come out of the ganglia. This is genital herpes. It can show up anywhere now in the genital/boxer shorts area. is this what you are asking me?

Terri

[JustsomeQs]

Hi Terri thanks for your response. No. I had HSV1 and infected him. We used a condom. The break in the skin where he was infected was outside of where boxer shorts would sit on a person, but barely. About 2 inches below his belly button. His doctors thought it was shingles at first. Wondering whether that is genital herpes because of nerve paths.

[JustsomeQs]

Hi Terri, I wanted to give you a timeline for clarity:

In high school (10 years ago) I was diagnosed, visually, by a doctor. She said it was probably ghsv1 from my boyfriend’s ohsv1. Both a swab and antibody test came back negative.

A few months ago, I have what is probably my second ever outbreak, 2 days after sleeping with my current partner, using a condom. I am diagnosed via a swab test with ghsv1 which I think I have probably carried for 10 years. I start valacyclovir and tell my partner.

A few days after that, he says he noticed a “rash” on his stomach, 2 inches below his belly button. He said that he had had a break in the skin there when we slept together. Rash looks like a cold sore. The nurses at the doctor told him it looked like shingles. He gets a swab test and it’s hsv1.

This is 2″ below his belly button. He’s very healthy / “immunocompetent” – should this be considered genital herpes?

[Terri Warren]

OK, now I understand.
Yes, this is likely genital herpes. The area you describe is kind of on the edge of two nerve groups, but I think it’s likely in the sacral ganglia area. he should observe for any genital outbreaks. Was this partner different than the one you were with when you had GHSV 1 diagnosed in yourself by swab test?

Terri

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