[Question #2394] Is this herpes? What next?

43 months ago
I have a herpes diagnosis, but I’m not so sure, and I’m not sure what to do next.  Here’s a timeline:
Week 1 - 2:  
Pain in the glans penis right at the corona, and in the valley below it.  No visible rash blisters or swelling, a tiny bit of redness but substantial pain.
Minor sore throat
Dr has me use hydrocortisone (no impact)
Week 2 – 3 ½
Pain in penis recedes almost gone.  Never any blisters or visible rash
Low grade sore throat on and off
Week 3 ½ -  4
Pain in glans no blisters
Some pain in lips small pimple-like thing on mouth for 2-3 days
Dr. diagnoses herpes  prescribes 1000mg Valtrex once per day
Week 4 - 8 (present)
Ongoing pain in penis the glans penis and valley below it a little on the meatus
Week 5: 2 small blisters on penis, heal in 3-4 days
Week 7
I took a STD test that included Herpes, Hepatitis, Syphilis, HIV, gonorrhea, and chlamydia (negative for all)
sore throat increases in intensity
Sharp pain in tongue (I can see some spots)
Pain in throat/tongue comes and goes.  Is worst at night near bed time.
(pain in penis present through all of this, some days worse than others)
Week 8
Sore throat is bad, and I can see some small pinpoints that may be sores
Penis still hurts, and if I shine a bright light on it, I can maybe just barely make out a reddish rash on the glans
Lower part of glans feels rough to the touch, and on the corona there are tiny white bumps (not blisters).  
I’ve been in pain for almost 9 weeks – 4 week “outbreak”. What should I do next?  What could this be?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
43 months ago
How did your doctor diagnose you with herpes?  Swab test?  Blood antibody test?  Visual inspection?  If visual inspection only, that is not an adequate diagnosis, according to the CDC - you need a lab test.  And was the diagnosis made from your mouth or from your genital area?  Were the blisters that appeared in week 5 swab tested?  You took a blood test when you did the full STD screen for herpes antibody?  Was it an IgG or IgM blood test?  Has anyone done a swab test of your throat?  Herpes would not cause pain for 9 weeks and outbreaks would extremely rarely last for 4 weeks. 
You need a swab test of lesions and an IgG antibody test 12 weeks after any possible concerning exposure to confirm your doctor's diagnosis unless one was done by a swab test of lesions.

43 months ago
Hi Terri, thanks for your response 
The initial diagnosis was visual only
I was on Valtrex for 2-3 weeks before I used and online service to get the STD test (Igc at 7 weeks)
I returned to my dr at 9 weeks, and he told me (based on visual inspection) that this isn't herpes and that he doesn't know what it is, and that I should go to a dermatologist.  He took me off of the valtrex

They swabbed the back of my throat for strep (negative), but never my tongue

I'm entering week 10 now (week 5 of outbreak, if thats what it is). Penis pain comes and goes. Pain in mouth is pretty consistent -- tongue and roof of mouth. 

In all this time, the only blisters or lesions I've seen are the ones from week 5. I have to say, the pain is starting to wear me down. Not sure what to do. 

BTW, from my other question, I was on Valtrex for 2 weeks exactly when I took my blood test. 

Is a dermatologist the right call?  ENT?
What tests/swabs should I ask for if there are no lesions when I go?

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
43 months ago
A dermatologist is probably a good call.  And if you get more swabs, I would ask for PCR swabs, not culture - far more sensitive.  But there isn't a lot of point in doing swabs if there is nothing there to swab.  Two weeks of antiviral therapy is not going to make a huge difference but you might want to wait just one week longer to do a final test - perhaps 13 weeks instead of 12. 
Herpes simply does not cause pain continually for weeks - it just doesnt.

43 months ago
Thank you Terri. I've been going crazy, between being convinced that this is herpes, and convinced that it can't be. 

The Valtrex did not seem to impact my condition at all (in fact, one of my worst days was on day 6 of the medication, right after a 5 day course of 1 gram twice a day). 

One more question:
I have tried to figure out whether this could be thrush. I read online about the spit test (where you spit in a glass of water and wait to see if tendrils form)
I tried it -- first thing in the morning, just like they say, and I got very obvious tendril formation. 
But I don't have any discharge. My tongue is coated a little, but it doesn't look nearly as bad as pictures I've seen on the web. 

Is there any veracity to that spit test, and is there any chance I could have thrush?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
43 months ago
I have never heard about the tendrils test and have to think it is just BS honestly.
If the Valtrex did nothing to help you symptoms then I think it is highly unlikely that this was herpes, don't you?

43 months ago
Thanks  Terri. I agree -- the tendril thing does sound like BS!  

And thank you for being a sounding board for my hopes that this is not herpes. It probably sounds a bit ridiculous on your end. On my end, I've been afraid that I both have it, and that for some reason, my symptoms would never

One last question:. I have also been taking L-Lysine (1500mg every morning). Will  that have any impact on the Igc test?  (I'd like to keep taking it until I test at 14 weeks, unless you think that I shouldn't)

And by the way, a huge thank you to the 3 of you for operating this forum. I have had a really hard time finding a local doctor who has experience with STDs. You are doing us all a great service, and I'm sure that everyone who uses the forum deeply appreciates your dedication. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
43 months ago

Lysine will not impact the IgG test, no.  You're good test while taking it. 
You are most welcome, Jeremy