[Question #1968] Confused about possible HSV-2 exposure

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84 months ago
I had a one time unprotected vaginal exposure with a female of unknown history or status.  I have been on "high alert" since the exposure, inspecting the genital area multiple times per day.  I noticed no signs whatsoever of anything for three weeks.  On the night of the 21st day post-event, I noticed two small red bumps, one on the scrotum and one on the penis shaft.  Both were painless, with no blister-like appearance or whitehead.  There is no redness, dryness, itch, or cluster.  My questions is this: is the 21 day period too long to suggest HSV?  Most sites, including the CDC, state 14 days as the longest it would take, however, I have seen it may be possible to take three weeks.  Secondly, is it possible to have two individual bumps in different locations that have no other symptoms be HSV?  This was a one time exposure with no other possible exposures.  Thank you for your help.
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Terri Warren, RN, Nurse Practitioner
84 months ago
Yes, I would totally agree that three weeks is well out of the normal range for a new herpes outbreak with a first infection.  In addition, the bumps that you describe sound nothing like herpes to me.  Herpes lesions would normally start with a blister - please observe these and if something changes, and it looks like a blister, get it swab tested right away but I would be very surprised if this was a herpes outbreak this late in the game.  Plus a single exposure, while not 100% safe, is unlikely, statistically, to result in a herpes infection.  Please feel free to ask me whatever other questions you might have.

Terri
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84 months ago
Thank you for the reply.  To clarify, a "blister" indicative of HSV would be a clear, fluid filled growth as opposed to a more traditional pimple that may or may not develop a white head.  And assuming that these two spots either remain a bump only, or only develop a traditional small white head, would you advise against blood testing ?
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Terri Warren, RN, Nurse Practitioner
84 months ago
You've got it exactly right. 
Whether to test or not depends upon how much you can let this go or are worried.  I think herpes is very unlikely to have happened here.  If you do decide to test, use only IgG testing and if positive and your index value is between 1.1 and 3.5, you would need confirmatory testing by western blot. 

You have one more question here if you would like to ask more.  Thanks for using our forum for reliable herpes information.

Terri
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84 months ago
Thank you for your advice.  I am not too concerned given all of the information to suggest something other than HSV.  In addition, the bumps have just about disappeared after 3 days which seems like another indication that it is not HSV.  Since I have one more question available, I suppose I would like to know if the first outbreak is always the most severe compared to potential recurrent outbreaks.  Thank you again.
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Terri Warren, RN, Nurse Practitioner
84 months ago
Yes, most often the first outbreak is the most severe compare to future recurrences.

Terri
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