[Question #2055] HSV2

48 months ago

In early September, I engaged in frottage with a female who is HSV2 positive.  She kept her thong panties on, but rigorously grinded against my exposed penis.  She also performed oral sex on me.  I manually stimulated her clitoris & digitally penetrated her.   She has never experienced an outbreak since her initial diagnosis 8 years ago.  


I experienced discomfort (paresthesia/inflammation (felt warmth) at my glans & generally at my testicles, gluteal fold, & rectum in late September (09/20).  I noticed a small lesion (looked like ingrown hair-meets-cold sore) on dorsum of my penis, & small plaque-like formation just inside urethra that felt irritated with urination.  


IgG testing for HSV1 & 2 negative 09/24/16


We had similar encounters after.  While lesions resolved, I have experienced paresthesia & general discomfort since (sacral pain, particularly with pelvic floor contraction). In early November (11/02), I experienced significant eye irritation & esophagitis.  Eyes were very blood shot, felt mild burning sensation, with milia formed at the medial aspect of both lower eyelids.  I experienced mild dry skin on my forehead & nose, like light sunburn.  I also developed cold sore-type lesions at the lateral aspect of mouth and in both nostrils.  I worried that this was self-inoculation. These resolved.  For the first time ever, I developed terrible eczema on knuckles of both hands.   This continued for several months & only recently resolved.  Allergist said he doesn't think that my symptoms are related to allergies. 


IgG testing for HSV2 negative (0.13IV) 11/23/16. 


Symptoms continued. 


IgG testing for HSV2 negative (0.08IV) 01/04/17. 


Ophthalmologist noted severe dry eyes & decreased tear production.  Prescribed Erythromycin ointment & preservative-free drops, which took eye discomfort from 2-3/10 to 1/10. 


IgG testing for HSV1&2 negative (0.13IV & 0.06IV) 03/27/17. 


While I have had similar contact with her since, my last test well over 6 months from initial symptoms.  


The only explanation I've been given is psychosomatic symptoms from trauma psychotherapy, but I'm definitely not convinced.  Is there any chance that this is Herpes, given my exposure & symptoms, in spite of the test results?  

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
48 months ago
The only thing that worries me at all is the cold-sore like lesion on the penis on the 20th.  And I'm not worried it could be HSV 2 because your contact with her, with her underwear on, does not present a risk.  Many people wonder if the virus can penetrate clothing - it cannot.  So that means the only risk is the oral sex you received.  Do you know if she has HSV 1 infection?  The IgG test for HSV 1 misses about 30% (the HSV 2 test misses 8%) of infections so you could have HSV 1, especially since you are describing cold sore lesions on your mouth and in both nostrils.  Did a clinician see that and evaluated or swab test it?  That would be important.  I don't think that the knuckle symptoms have anything to do with herpes because 1) herpes wouldn't last that long and 2) it wouldn't be all over your knuckles.   And I think if the eye issues were related to herpes, the doc who saw you for that would immediately have recognized it.    If you are curious about the HSV 1 status (or need more reassurance about HSV 2) you could pursue the herpes western blot for clarification.  Does your partner take antiviral therapy?

Terri
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48 months ago
Terri, 

Thank you so much for your reply. 

My partner takes oral acyclovir for suppression.  

The various lesions had healed by the time I had appointments with my PCP, the allergist, the urologist, and the ophthalmologist.  

I'm just so troubled by the length of time that I've been experiencing symptoms. 

Any other insights would be greatly appreciated.  
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
48 months ago
I can understand that you are troubled - it's not fun and worrisome to have symptoms of anything a long time.
Get the western blot - if negative, you can at least take the herpes worry off your plate.  What do you think?
You've already had a diagnosis for your knuckles and your eyes, now we need to rule out herpes as a cause for genital and mouth and nose issues.
When you say you had cold sore like lesions on your mouth and in both nostrils can you be  bit more detailed in your description please?

Terri
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48 months ago
On the right side of my mouth I had a small vesicle-like lesion that was clear fluid filled (looked like an ingrown hair follicle). 

I've never had cold sores before, but it was definitely a scare.  

I had whitish circular lesions inside both nostrils at the inferior aspect that stayed relatively wet for just under a week before they dried and resolved.   
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
48 months ago
i think a western blot would be a good idea for you.  I also think that if you get these lesions again, either orally or genitally or in your nostril,  you should probably get  swab test right by going to an urgent care clinic - you almost always get in the same day.

Terri
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