[Question #3210] New HSV2 infection
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92 months ago
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-----High characters but words well under 400 pls------
33yr old male. Pre-existing hsv1 (oral and genital) for 11 years. No recognisable genital outbreak for over 7 yrs.
Day 0; Protected ONS (vaginal and oral)
Day 3: Swollen nodes in left armpit. No where else. Lasts 10 days.
Day 5: onset of week-long Flu-like symptoms
Day 6: Dr. notices very low lymphocytes.
Day 9-10: single round 'pimple' seen in pubic hair. Pop it with a pin emitting yellowish fluid (not too thick) and little blood. No sore or scab observed.
Day 14: Tiny rash on 3/4 of left side of scrotum. Some with tiny whiteheads. I'm finding it difficult to describe this; pinhead rash maybe. Note that during the protected oral, my scrotum was exposed to quite an amount of vaginal fluid as a result of the lady touching herself and massaging my scrotum for quite a while.
Rash is only mildly itchy. I put fucidic ointment on it. Clears in about 4 days. No sores. I notice 2 hpv warts on that side of my scrotum. My first warts.
Around day 36: Throbbing pain in thighs, calves,feet, heels with periodic pins and needles. This more or less is present one way or another always.
Day 40; I notice a single raised ' big pimple/lump' on my left butt cheek. Possibly tingling sensation before it came. Unsure. Feels firm/semi hard and painful only when pressed. No fluid. Dismissive Derma says it's an inflamed follicle. Prescribes fucidic cream. It disappears in about 4 days, no sore or ulcer only to appear 7 days later; exact same spot to the last mm.
This has recurred 4 TIMES since mid December. It appears, raises, without forming a sore or blister becomes dry skin and recedes only to come back in 5 to 7 days. Same exact place. Taken 2 different antibiotics to no avail. I've taken 3 tests so far. Swabs are difficult in my country. Tests are not presented with numerical values;
Wk 4: +hsv1 igg, -hsv2 igg, -igm
Wk 6.5: +hsv1 igg, -hsv2 igg, -igm
Wk 9.5: +hsv1 igg, -hsv2 igg, -igm
Hiv, hep panel,urine culture all negative
What are your thoughts on the symptoms and my chances?
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92 months ago
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Title should have included a question mark. Sorry
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Terri Warren, RN, Nurse Practitioner
92 months ago
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I think HSV 2 infection is very unlikely here. Though your tests were done a bit early for my satisfaction, they are quite close to the 12 week mark we like best.
The IgM is totally useless and has many false positives so I would suggest that if you test again, you don't use that.
It intercourse that we worry about for HSV 2 and that was protected and though condoms don't offer 100% protection, particularly from infected females to males, they are very good. HSV 2 orally is rare and transmission via genital fluid on her hands I don't consider a reasonable risk at all.
Herpes lesions can happen on the buttocks so I would suggest that someone swab test that one, on the surface of the skin, just to be sure.
Terri
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The IgM is totally useless and has many false positives so I would suggest that if you test again, you don't use that.
It intercourse that we worry about for HSV 2 and that was protected and though condoms don't offer 100% protection, particularly from infected females to males, they are very good. HSV 2 orally is rare and transmission via genital fluid on her hands I don't consider a reasonable risk at all.
Herpes lesions can happen on the buttocks so I would suggest that someone swab test that one, on the surface of the skin, just to be sure.
Terri
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92 months ago
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Thanks for the response. Like I mentioned I don't have access to swabs in my country unfortunately. The tests were very much anxiety driven. I'll take another at week 12.
I was the receiving party for the oral and I had a condom on so I'm not concerned about that. However her fluid-covered hands were rubbing my scrotum as this went on. And i happened to have rashes on my scrotum on day 14. I have also had recurring pain and muscle twitches in my legs, calves, front and back of my thigh. Suspicious responses from this lady makes me think she has something. I was blocked when I suggested a test to her so that's not possible.
Can a buttock lesion present how I've described; similar to an isolated insect bite, raised but somewhat firm/hard under the skin and doesn't fully form a sore or discharge fluid. Can outbreaks recur at the exact same exact spot 4 times in about a month and a half?
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Terri Warren, RN, Nurse Practitioner
92 months ago
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In my experience with buttocks lesions, they start as a big blister and more often, several blisters - they are deeper because the buttocks skin is thicker. They break upon and form unpleasant scabbing. Your presentation sounds nothing like this.
And I still do not think that her touching your scrotum with vaginal secretions on her hands represents a realistic risk for transmission.
Terri
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And I still do not think that her touching your scrotum with vaginal secretions on her hands represents a realistic risk for transmission.
Terri
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92 months ago
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Thanks Terri. What of the frequency? Is that possible and at the same pinpoint spot for that matter? Would a buttock outbreak cause mascular pain on that cheek? My 12 week test would be taken on Friday with results delivered in about 4 days. If it's not against protocol I'll ask that you keep the thread open so I can update.
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Terri Warren, RN, Nurse Practitioner
92 months ago
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The frequency of buttocks lesions? Could range anywhere from 1-10 per year and the location could be the same or different each time. It usually wouldn't cause muscular pain in the buttocks, no. I will keep the post open for the posting of your lab values only - no more questions, please.
Terri
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Terri
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91 months ago
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Hi Terri,
Negative at 12 weeks. Would be glad if one final question is permitted. Still having constant neuropathic symptoms. Can I do a western blot at 12 weeks or I need to wait till the 16 week. Thanks for your consideration.
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Terri Warren, RN, Nurse Practitioner
91 months ago
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You can do the western blot at 12 weeks.
Terri
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Terri
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