[Question #1791] decided to move on but trigger stopped me

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92 months ago

Dear Dr.HHH,

Firstly, thank you for the expert advice on my previous thread. After seeing your response, I decided to move on but then something triggered and made me come back. You’re absolutely right that my next test would be negative and the test was negative

 

This is continuation of my previous thread…

22nd Feb Night – Gave blood for test

I decided to move on after our last discussion but the incidents happened that night  (22nd Feb) made me panic again – I started experiencing pain in buttocks, hip joints, knee joints, legs and a small sore with white head on left buttock.

 I also observed that my testicles were swollen/tender/very long than normal. I thought this is the beginning of the outbreak.  

23rd Feb

Felt lower body to be heavy with pain in buttocks, hip joints, knee joints , ankles.,

my testicles were swollen/tender/very long than normal

I have not taken any pain killer apart from my regular antifungal and antibiotic (for anal fissure)

24th Feb

The pain in all locations started going down,  Sore with head remained, it didn’t bother me much.  Testicles became normal

Test 3 – week 26 (Test -  22nd Feb; Report -  24th Feb)

 ( I’m taking antibiotics hope it does not affect this test)

HSV Type Specific

HSV 1 Igg – 0.09

HSV 2 Igg - <0.5

25th Feb

The pain in all locations has gone down,.  Sore with head remained, it didn’t bother me much. 

Testicles became normal

26th Feb  (Today)

The pain subdued and sore on bum disappeared (may be because of the friction) ; Testicles normal

My queries –

Is this an outbrea k ?

Does herpes  OB effect testicles (swollen/tender/v.long)? (I had similar incident in last November; )

From the articles on internet antibody test for HSV 2 is 95% accurate and for HSV 1 is 70% -

There is no change in Seroconversion in my last 3 tests…

So, I believe I’m completely free from HSV2 , am I right ?

However  I’m skeptical about hsv1 after this incident…  Please advise on this… 

When prodrome starts does application of azoles topical suppress the sore/blister that supposed to appear?

Pimple that is on abdomen is in same state since last few days ; so I think this is not atypical hsv symptom. Ideally hsv blister should break in few days and form an ulcer and clear, am I right?

I just want to throw this off my mind asap and concentrate on my other stuff and resume unprotected  sex with my partner.

Hopefully this will be the last thread . J

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H. Hunter Handsfield, MD
92 months ago
Welcome back. But sorry to see you find it neessary.

Having re-read your previous thread and the information above, I remain confident you do not have genital herpes or any other form of HSV infection. Your symptoms are not typical at all: you haver been seduced by online statements about a whole host of various symptoms that some people attribute to herpes but are not documented in any reliable research studies. The evidence against it is not only the blood test result, i.e the chance you have HSV2 is far, far lower than 5%, even though the blood test may miss up to 5% of infections. (Actually, probably closer to 1-2% missed, not 5%.) In any case, the evidence also includes a low risk exposure, symptoms that are not typical, and physicians' (I forget how many) confidence your various rashes etc were not herpes. Putting all these together, there is simply no realistic chance you caught HSV of either type.

I would also point out that genital HSV1 is a very different problem than HSV2, with few recurrent outbreaks, little asymptomatic shedding, and very low likelihood of sexual transmission to partners. So having it really does not (or should not) have anywhere near the level of concern evident in your question. If I knew I had genital herpes due to HSV1, I wouldn't give it another thought! (Here's a discussion of this you might find interesting:  https://thehairpin.com/how-i-found-out-i-didnt-have-the-herpes-i-d-been-living-with-for-four-years-5a30c2ac9efc#.4crjjk5oe .)

To the specific questions:

"So, I believe I’m completely free from HSV2 , am I right ?"  RIGHT

"I’m skeptical about hsv1 after this incident…  Please advise on this… " DONE, SEE ABOVE

"When prodrome starts does application of azoles topical suppress the sore/blister that supposed to appear?" PRODROME IS VIRTUALLY ALWAYS FOLLOWED BY A TYPICAL HERPES OUTBREAK. PRODROME DOESN'T CAUSE THE WIDESPREAD SYMPTOMS OF THE SORT YOU DESCRIBE. AND NO, ANTIFUNGAL CREAMS WOULD NOT HAVE ANY EFFECT ON SUPPRESSING A HERPES OUTBREAK.

"hsv blister should break in few days and form an ulcer and clear, am I right?" YES, AND THE LOCATION OF THIS SINGLE LESION ALSO IS ATYPICAL FOR HERPES. DON'T GET HUNG UP ON THE "BOXER SHORTS" DISTRIBUTION. RECURRENT HERPES CAN BE IN THAT AREA, BUT THE LARGE MAJORITY ARE AT OR NEAR THE SITE OF INTIAL INFECTION, I.E. WOULD BE MOST LIKELY LN YOUR PENIS.

"I just want to throw this off my mind asap and concentrate on my other stuff and resume unprotected  sex with my partner."  UNDERSTOOD. YOU SHOULD HAVE RESUMED SEX WITH YOUR PARTNER SEVERAL MONTHS AGO. I HOPE THIS DISCUSSION HELPS YOU DO SO. MY FEAR IS THAT IT WON'T HELP MUCH. YOU'RE SO OBSESSED WITH THIS THAT MY GUESS IS IT WILL CONTINUE. IF SO, GET COUNSELING, WHICH I SUGGEST FROM COMPASSION, NOT CRITICISM. IN ANY CASE, LET'S MAKE THIS THE LAST DISCUSSION ON THIS FORUM. THERE IS NO ADDITIONAL INFORMATION THAT WILL COME TO MIND THAT COULD POSSIBLY CHANGE THE OPINIONS AND ADVICE YOU HAVE HAD.

HHH, MD



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92 months ago
I'm done with this... 
Thanks a lot for your advise and patience!!! 
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92 months ago
Hi Doctor,

Just an update. I got DNA test on urine sample (26 weeks) for Gonorrhea and Chlamydia - both are negative. 

Final question, just for my knowledge,which is the best test and it's window period for Syphilis?


Thanks in advance!! 


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H. Hunter Handsfield, MD
92 months ago
The two kinds of routine syphilis blood tests -- a nontrponemal test, either RPR or VDRL, or an IgG test -- are equally good. Whatever the lab offers and is cheapest. The window period is 6 weeks; if you already had a syphilis test 6 weeks or more after a potential exposure, no need to repeat.

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