[Question #1190] Herpes symptoms?

50 months ago
Hello doctors,

I recently posted and got great insight from Dr. Handsfield re: a recent possible exposure to herpes. I was reassured by him that it wasn't. I had unprotected reciprocal oral sex with an unknown status partner nine and a half weeks ago. I developed back pain six days after the episode which Dr. Handsfield said was unrelated to a herpes initial outbreak, but in my paranoid mind I was wondering if it was possible it could have been a mild outbreak? It was followed a half month later with a rash on my right inner thigh that several  doctors looked at it and diagnosed as jock itch and Dr. H agreed. Cortisone Cream was applied and the physical signs of the rash pretty much went away, save for an occasional burning sensation that persists off and on to this day (a month and a half post exposure). I was wondering if this length of time post exposure would still result in nerve play in the thigh that could be from herpes infection? I am undergoing IGG testing, the most recent test was done at seven weeks post exposure and HSV2 was 0.08. If not herpes, could the back and rash be related to sciatica resulting in inner thigh nerve burn and just have been a coincidence? I am testing again at 12 weeks for HSV2 and Dr. H assured me that the result would be negative, but I am a little freaked out due to my marital situation. My mind is definitely racing. My last post I was not aware that it may not be rash that is causing the intermittent burn, but it could be neurological. Any comments would be welcome, hopefully to ease my worried mind! I have had no other symptoms other than those. Thanks so much!
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
50 months ago
I am in agreement with Dr. Handsfield that this is extremely unlikely to be herpes-caused.  Jock itch would not be related to sciatica but the nerve pain in your thigh could be and that could either be a result of nerve compression coming out of the spine or something called piriformis syndrome.  The thing also is, oral sex is very unlikely to result in an HSV 2 infection because HSV 2 doesn't like the mouth.  And if, by some chance, this partner did have HSV 2 orally, which is rare, it is rarely shed from the mouth -perhaps only a few days per year.  So what is the likelihood that all of this would occur on one of those days, with no herpes lesions on your penis?  It's all just so unlikely that I think you can relax about it, even though I know that's very difficult in situations like this because there is so much at stake, right?  I hope you can begin to feel more reassured and if you have other questions, please, feel free to ask, OK?

Terri
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50 months ago
Thanks Terri. I appreciate you and Dr. Handsfield's responses. Back to the herpes symptoms, I just found it weird that my lower left back back would ache six days after possible exposure and a rash would have developed 22 days after that. It may have been stress related but those physical symptoms were hard to ignore.  The back pain developed after a flight to Florida, stressed out and sleeping in air conditioning , which I am not used to. Could be coincidence, but would that have happened if this incident hadn't happened? You are right, there is a lot at stake here, and my mental and physical being is taking a well deserved beating. I am now at 10 weeks post exposure and was thinking of going in for another blood test today, but should I just wait until 12 weeks and be done with it? Do you consider 0.08 a low value for HSV2 after six weeks and five days? As for oral transmission of HSV2, couldn't she have has HSV1 and transmitted it to my genitals? Is that possible? I am not believing it as my HSV1 value was <0.01 after six weeks, indicating she probably didn't have HSV1. BTW, the jock itch that developed looked like tiny paper cuts, but it was diagnosed by several doctors as fungal related. The burn still comes and goes with no visible signs of rash, but i will research piriformis syndrome. Thanks for you input. Also, it appears I have undiagnosed (with a biopsy) genital warts from this experience, from the reciprocal oral sex.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
50 months ago
I very much believe that 0.08 is a nice low negative, absolutely!  And yes, you are correct that she could have transmitted HSV 1 to you, yes.  But with a negative HSV 2 result, if you acquired new herpes on your penis, I would expect you to see lesions.  But so far you do test negative, which is great. 
So you had a biopsy of a lesion that turned out to be a genital wart?  How long after the encounter did the wart show up?  It would be quite unusual to get genital warts from receiving oral sex.  Is the wart something you have never noticed before this?  Can you tell me more about that?

Terri
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50 months ago
Thanks Terri. In my worried state i just returned from having a blood test for full panel STI, including the dreaded herpes again at 10 weeks and one day post exposure.  I want to see if the values remain consistent. As for the suspected genital warts, I went to the dermatologist for the rash I described, and they saw two bumps on my abdomen, one small, clear and round and one that looked like a raised pimple that they said could be genital warts. I had no idea about HPV at the time, so I stupidly told them to freeze them off. These were discovered August 28, 50 days after potential exposure. Then they noticed on the next visit a small brownish wart-like abrasion on the shaft of the penis, which could be a genital wart but I didn't want a biopsy due to location. Very small and never changed shape. Then a few days later I noticed, on the tip of the penis, another small teardrop shaped abrasion that the dermatologist didn't see, but it is definitely there and wasn't there before. My wife even saw it and had to look, but noticed it. I don't know how reliable this is but I put white vinegar on both and neither turned white. Just pinkish and more pronounced (slightly) probably because I was soaking the tip of my penis in vinegar!I am worried that this may seep into the urethra. I am terrified (no pun intended!) that I will give my wife HPV. I am pretty sure she doesn't have it, but don't know. Could I have protected sex with her while these supposed lesions are showing? In answer to your question, there was never a biopsy on any of these. The one on the tip of the penis could be uncomfortable, either with freezing or biopsy. Although you say unusual for oral to lead to HPV and genital warts, that may have been what happened. It is possible, and if it is, maybe I could be the poster boy for it! There absolutely was no intercourse, just unprotected oral, me giving her and her giving me. Lasted all of three minutes. Thanks so much!
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
50 months ago
Larry, I see that you are discussing the HPV situation with Dr. Hook.  I am going to let you talk that one through, OK?

Terri
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