1st STI panel: 07/11/2023 (negative)

2nd STI panel: 07/24/2023 (positive for HSV1)

3rd STI panel: 08/14/2023 (positive for HSV1)

Urinalysis 08/24/2023: normal except appearance came back cloudy  

Symptoms: ulcers/lesions in urethra/meatus, mild burning sensation during/after urinating, dull ache in testicles. 

I was exposed via receiving oral. No other sexual contact was made. I started to feel symptoms a few days after exposure. Doctor diagnosed me with HSV1 in my urethra/meatus. One month after having symptoms I started/completed 1 cycle of valacyclovir and a 7 day round of doxycycline. That treatment was unsuccessful so I did another round of valacyclovir. All treatments have been unsuccessful and I am still experiencing the same mild symptoms. All STI panels included a 4th generation HIV test. 

Curious as to why the treatment(s) are not working and if this could be something more serious such as HIV that the panels are not picking up one 

The last full panel std screening also include mycoplasma screening that also came back negative. 

The HIV test have all been fourth generation. 

A doctor diagnosed hsv1 infection in urethra/meatus through physical examination. Positive results followed the physical exam to confirm exposure to hsv1.

Are you saying that no swab testing was done of the lesions in the urethra for HSV? 

What are the index values associated with your positive HSV 1 antibody testing results?  And were they IgG or IgM tests?

Did you have any lesions on the outside of the penis at all?

If this was indeed a new case of genital HSV 1, which is certainly could be, I would not expect continued symptoms two months out - that just isn't how that works.  I sure wish I knew what was going on here but for now, I don't

Terri

Thank you for the response. They did a HSV1 swab and a blood test. The swab came back negative but blood test came back positive on the second full panel screening. 

The value of the HSV1 in august was 27.7 and in July it was 25.10. 

There were only lesions on the inside of my meatus/urethra.

I have always tested negative for HSV1 until after the exposure at the end of June. I

The urgent care doctor diagnosed me with a physical exam and stated that it was HSV1 that had been passed to me via receiving oral from someone with the infection. I was testing negative at that time but tested positive for HSV1 shortly after. He prescribed me the first round of antivirals and 7 days of doxycycline. 

The symptoms were still there so I visited a urologist and hematologist. The urologist said he did not have much experience in this but prescribed me another round of antivirals.  

The second round still did not rid all of the symptoms. I was curious if it was something else so I tested again 7 weeks post exposure on 8/24/2023 and everything came back negative again except HSV1. 

It does appear that you acquired HSV 1 between June and July, if you are certain that all of the other testing that was done was IgG, not IgM

Terri

Any recommendations on next steps? I have visited a urologist and he was unsure what was going on. I have no clue what this could be but the symptoms are having a negative impact on my life and I would like to determine the best resolution. 

Is there any reason why 2 cycles of valacyclovir would not have cleared this up? The only thing I can think of is that my urethra/meatus is constantly wet due to urinating so the lesions don’t have the opportunity to dry out completely.    

the lesions were there quite a while ago - late June, as you've written.  I doubt that they are still present, causing these symptoms.

Terri