[Question #1937] what are my chances

Catherine
49 months ago

I, (F) spent the night with this man. We didn’t have intercourse but we were naked and we rolled around all night. We had unprotected oral sex, him on me / me on him. He also came unexpectedly in my mouth. 9 days later I notice tiny red bumps on my upper hips and outer thighs (about 4 or 5) and they looked like chicken pox (spread out, round, red, small, slightly raised not sensitive or itchy or painful though). One was definitely a blister. It was about the size of a common tick and it had clear fluid that drained when streched it. I went to the doctor the day after and she said she couldn’t test me because the spots were dried up but she thought I was fine. I’m not convinced and furthermore, 3 days after I initially noticed the spots I developed a chest congestion and a cough. I think i was also feverish and maybe had a soar throat but I also had a lot of anxiety so hard to say. Not sure if this matters but I was also on my period when I noticed the spots.


My friends who have herpes seem to think I’m fine but I keep reading online that you can have very mild symptoms even during an initial outbreak and I even read about something called sacral herpes that can occur on the thigh area… 


So what do you think my chances are? Please be honest, I feel like everyone is trying to calm me down instead of admit how common herpes is and thus how likely it is that I got it.


Also in a worst case, assuming this is the first outbreak, what is the probability that this came from my encounter 9 days before? I know that you can never know for sure where it came from but surely, there must be data on what percent of outbreaks occur within 2 weeks of exposure?


Finally, I went back to the doctor and got a blood test 2 week later, it was IGG and IGM and both were negative but maybe it’s too soon to know.

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
49 months ago
Here is my honest opinion (based on 33 years of dealing mostly with herpes).  I think this is most certainly not herpes - it simply does not present in this way plus you didn't do anything that would result in a genital herpes infection.
If you do test again, please - don't do the IgM test.  It results in many false positives and cannot distinguish old from new infection, or HSV 1 from HSV 2.  If you were my patient, I wouldn't even retest you, given the very low risk of acquiring herpes in your situation.

Terri
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Catherine
49 months ago
Don't you think there is a possibility that people who have a mild initial outbreak outside the genital area don't go see a doctor because they don't think they have a problem? And therefor, the medical community would have a skewed view of how herpes presents since only the people with obvious symptoms come to see a doctor? I think that's my biggest concern. Also on another note, can you see my photo attached to this question or is it empty?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
49 months ago
Yes, that is certainly possible.  But from mass testing of large populations, we know how many people are infected with HSV 2.  They were all asked if they had ever had genital herpes.  Of those who tested positive by antibody test, 80% denied having herpes.  This is likely true because 1) people mixed up their herpes symptoms with other conditions (yeast, UTI, friction burns, zipper catches, etc and 2) people were having outbreaks outside the specific genital area (buttocks, belly, thighs) and so they didn't think of herpes being a possibility.  Those are the big reasons people don't think they have herpes.  Also people aren't tested as part of their STI screens. 

I'm so sorry, this website doesn't allow pictures - there are dermatology websites that do allow the posting of skin pictures - you might want to try that.
You could certainly get an IgG test is you continue to worry about this.

You have one more question - feel free to ask more.

Terri
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Catherine
48 months ago

I understand that just because 80% of people test positive for HSV antibodies, that does not mean that those people will necessarily ever have an outbreak or infect other partners. But if so many people have herpes, it seems your previous responses to my questions contradict just a little bit?

 

If I google “blisters on outer thigh” I get herpes results and any related rash is less common than herpes. Yet it stumps me that you and 2 other doctors seem so certain that’s not what it is despite how common herpes is.

 

Overall I find it hard to research this virus. I’ve tried to look at reputable sites like the CDC but I think there is a lot of misinformation out there. For example, I’ve read repeatedly that herpes can be contracted skin to skin through viral shedding with no lesion visible and using a condom. But from reading answers in this forum you don’t seem to think that’s possible. What is a good source of information on this virus?

 

On another note, I’m wondering about my test results. In a worst-case scenario, if I did get it I’m wondering where it came from. I tested negative after 2-3 week from unprotected oral sex. You said I didn’t do anything with this man that would result in an infection but he did go down on me so that could have transmitted HSV1. I also had sex with someone 8.5 weeks before testing. We used a condom but I saw afterwards that it had broken! I had no reason to believe this person had herpes. Could an IGG test still be negative 9 weeks after exposure if they transmitted it to me?

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
48 months ago
If a person has an accurate positive on an antibody test, yes, they can infect their sex partners, whether they have had symptoms or not - they shed virus too, just like those who have symptoms only less frequently. 
Since your last contact within 3 months, then it is possible that you were infected by a different partner and it just hasn't shown up yet in an IgG test.  We like 12 weeks from the contact for the most accurate (92%) antibody test.
I don't think the CDC website has misinformation on it.  Herpes can be spread from person to person but skin to skin contact is used quite broadly - as I mentioned, the skin of the thigh, belly and buttocks is too thick for virus to be "shed" from there nor enter there without broken skin

And you're right - he could have given you HSV 1 genitally, but if this was new infection, the symptoms would be genital, not on the thigh, for the first outbreak.  But the p[roblem is, if you get an antibody test and you are positive for HSV 1, it cannot tell you where it is (oral or genital) and the IgG test misses 30% of infections, so that's a bit of a difficult call to make.

You can certainly go to PubMed and search for genital herpes and find all sorts of peer reviewed articles - you can search my names, Warren, T and find 30 articles I have had published as a contributing author.

Terri
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