Your thoughts on this situation?

[helpplease]

Hi,

I’ve had a few symptoms that I’m worried are herpes. I’m hoping for your thoughts on the situation.

I’ve been sleeping with my girlfriend for about 5 months now. We have always used condoms. Here are my symptoms as they unfolded:

Last Monday: In the shower, I noticed a strong sensitivity/tingling as I washed the head of my penis. Had not experienced tingling prior to touching it. On the head of my penis, I noticed a small red patch, with the beginning of three small red bumps.

Tuesday morning: The bumps had become somewhat more pronounced. I looked closely to see if they appeared like “vesicles” I saw in pictures, and couldn’t determine it one way or another. If they were vesicles, they were very small. I then showered again, and after leaving the shower, the bumps had become “raw” from the washing–i.e. the skin had slightly broken or chafed. Still somewhat sensitive to the touch, but not otherwise painful. (Would herpes vesicles be so delicate that they would break from washing in the shower?)

Tuesday afternoon: Panicking about herpes, I went to a primary care doctor. She said it didn’t look like herpes necessarily, but she did a swab test. This eventually came back negative. However, I am skeptical about the validity of the test. From what I read online, you have to do this test when there are vesicles present which you can break and collect the fluid. If I had vesicles, they would’ve broken earlier that day, and had begun to heal.

Over the next few days, the raw skin began to heal, and the three red spots sort of re-emerged, but then began to fade.

Friday afternoon: I saw a dermatologist. By this point, the three red bumps were still there, but not as prominent. She said she couldn’t tell exactly what it was, but she scared me by commenting along the lines of, “well, the rawness/chafing you experienced could’ve been herpes breaking open. You never know–herpes is sometimes minor and hard to detect.” She gave me a prescription for a blood test. Annoyingly, she said I could get tested right away and would see elevated iGM levels if i were infected. Everything I read online says that is not true, and igm tests are very unreliable. I plan to wait 8 weeks and get tested to look at the igg results.

What do you think? Does this sound like herpes?

• This topic was modified 7 years, 10 months ago by helpplease.

[Terri Warren]

I think there is a possibility that it is herpes, yes. And you can do an antibody test now and repeat it when 16 weeks have passed since the symptoms first appeared. I would also recommend that your partner be tested by IgG – never ever IgM. If both you and your partner are negative now for HSV 1 and 2 then it is very unlikely that that will change over time. However if she is positive for something for which you are negative, then there is a possibility that your antibody test results will change over time.

If you get more lesions, be certain to have them swabbed right away and preferably using PCR vs. culture. Both are swab tests – PCR is just far more sensitive than culture.

Having said all of that, I rarely see herpes lesions on the head of the penis only – I have, but again, rarely.

Terri

[helpplease]

So I just got my initial results back, which were 3 weeks after symptoms. I came back positive for HSV 1 (3.43 igg, <.91igm) and negative for HSV 2 (igg <.91, igm <.91)

This is weird b/c I’ve never had any oral or genital symptoms until now. Is it possible I have a HSV 1 genital infection that would’ve showed up 3.43 igg after 3 weeks?

haven’t gotten my girlfriend’s results yet.

• This reply was modified 7 years, 10 months ago by helpplease.

[Terri Warren]

Yes, it is possible that you could reach a 3.13 in three weeks, yes. But it is also possible that if you acquired a new HSV 2 infection, it would not show up at all yet. Let’s see what your partner’s results are to help sort this out.

Terri

[helpplease]

Unfortunately, her provider only gave her a non-specific igm test, which came back borderline. From what I understand, that is a completely useless result which tells us nothing. Very frustrating that doctors don’t know this. She is going back and is going to ask for a type-specific test.

While I wait, I wanted to ask a few more questions and a bit more context. I understand this is my last reply so I’ll re-subscribe later once we get her results.

I have never once had any oral symptoms of HSV, and have been tested every so often (negative for both, until now), so I know I don’t have a long-standing infection since childhood. Based on this, right now I think it’s most likely I got HSV-1 genital. We’ll see, I suppose.

If this is true (and we’ll see what her results are), is it correct that anyone who has ever had HSV-1 oral, would be entirely immune from getting HSV-1 genital from me? i.e., I could not transmit my genital herpes to anyone who’d had a cold sore in their life?

[Terri Warren]

I’m sorry you had to wait for a response – I’ve been dealing with some personal health issues.

People who have had cold sores (and remember that those are different from canker sores) are extremely unlikely to acquire HSV 1 in a new location. So yes you are correct.

I think it is important that your partner get the correct testing. Is that being redone?
And you are certain that your previous testing included HSV 1 and HSV 2? Sometimes it is skipped and sometimes, only HSV 2 is included in an STD screen.

Without a positive swab test from the lesions on your penis, you cannot know if your infection is oral or genital, even though you think this is genital HSV 1. We just don’t have enough evidence to prove that at this point.

Terri

[helpplease]

Thanks–re-subscribing since we now have both our test results. Like me, my girlfriend came back positive for HSV 1 igg and negative for HSV 2 igg. She says she’s never had any genital or oral symptoms that she knows of.

So I guess there is no way to know the location of either infection, or who gave it to whom.

I suppose this means as far as our relationship goes, we don’t have to worry about giving each other anything moving forward, right?

[Terri Warren]

Right, you can’t know where your infection is unless either of you gets a lesion to swab test, but the important thing is, in my opinion, is that you are both infected and don’t have to worry about this anymore, which is great! Best possible result, actually.

Terri

[helpplease]

Thanks. Since I have one more post on this account, I just thought I’d mention how much misinformation I we both encountered from our doctors along the way. It’s really astounding. Her doctor only gave her an igm test at first, and then when she went back and asked for a type-specific test, her doctor wrote her a prescription for “HSV 2 igm” (which obviously does not exist). She had to explain to her doctor exactly the test she wanted, at which point her doctor got annoyed and angry. My doctor was also totally misinformed about the distinction between HSV 1 and 2. She said there was basically no difference between a genital HSV 1 or 2 infection when it came to the frequency of outbreaks. She also said that an HSV 1 infection in one location didn’t offer immunity against an HSV 1 infection in another place.

I know this is all false based on my research on this site, on MedHelp, and other sites where experts publish information. But it’s so infuriating how little doctors know about this, and how much misinformation must be given to other patients who don’t do as much independent research. It’s a simple and common infection. Doctors should be held accountable for knowing what they’re talking about.

[Terri Warren]

You’re preaching to the choir on this one! When there were branded drugs (Valtrex and Famvir) on the market, and those drug companies were paying clinicians to go talk about herpes to other clinicians, the knowledge set was so much better. Say what we will about big pharma and it’s influence on prescribers, this was a time when it was a huge help. Now that none of that is going on, the misinformation level has skyrocketed. It makes me frustrated and angry. Yesterday I saw a physician as a patient for something else and he totally blew off the value of HSV testing and thought I was pretty ridiculous to suggest that it be done. I was so discouraged. They really aren’t following the CDC treatment guidelines in terms of offering the correct testing. Stick with me here and I’ll try to never give misinformation on this site, to the best of my ability. If I have questions that I’m not certain about , I always run them by experts in the specific specialties (neonatal herpes, pregnancy, etc). I also have some wonderful colleagues in Seattle who specialize in herpes that are available to help as needed. It might not be a bad idea to go to the CDC STD treatment guidelines 2015 and print out the section on herpes and send it to both doctors with a note suggesting that these updates might be useful for them (in a nice way of course).

Terri

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