I have been sexually intimate with one person, during one encounter. I am a male and I had reciprocal oral sex with another male about six months ago. Around six days after the encounter, I noticed a rash in my genital area and was visually diagnosed with herpes. They said there was not a lesion to swab. I had a herpes blood test about 6 weeks after this; the IGG results were negative and the IGM for type-1 was a weak positive. The doctor maintained that I had type-1 herpes in the genital area.

The partner I was with had the blood test done and it came back negative. He has never had any oral or genital symptoms, nor have any of his other partners.

My partner later told me he had tonsil stones at the time of our encounter. Could this have any connection to my rash? Also, an hour after the encounter, without showering first, I went on a very long, sweaty bike ride. I noticed itching in the genital area beginning 4-5 days after the encounter and noticed the rash about 6 days after the encounter.

Last week I got tested with the Herpes Select IGG Elisa type-specific blood test; both types came back negative.

I do not want to keep undergoing further tests. I understand that no test is completely accurate, but could the initial rash have been caused by something other than herpes? Could my first weak positive result have been a false-positive? How likely is it that my most recent test result is a false-negative? 

There is so much not right about this situation.  First, a visual diagnosis alone is never OK.  The CDC says a lab test should be done as well.  How could there be no lesion to swab but herpes was the diagnosis?  I'm very confused.  Herpes is characterized by lesions so what triggered the diagnosis?  And type 1 and HSV 2 don't look any different so how was typing decided upon?  This doesn't make much sense here - what am I missing? 
Of course the rash could have been caused by something else!  Many different things.  I like 12 weeks from the time of the encounter for the most accurate IgG test but if you are negative at 6 weeks, there is a 70% chance your result will remain negative.  If you dont' want to keep testing, this will let you know how accurate this one is.  Over all, compared to the gold standard western blot, the IgG for HSV 1 misses 30% of infections.

Terri
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Maybe some more information regarding the rash itself will benefit. It originated on the scrotum and backside of penis and spread gradually over upper thighs and anal area. It probably took about 3 weeks to go away completely. I do not remember any burning or tingling sensations; the itching was the only discomfort it caused. It did get irritated and a little painful when I would go for a run or take a hot shower. I do not remember seeing any large bumps with fluid. It was really just a large red, irritated area with small bumps. 

Your rash sounds classically like a fungal infection and nothing at all like a herpes infection, based on your description. I would suggest that you do some looking on the Internet at groin fungal infections and see if the pictures resemble what you had. This is not to say that the IgG could not have missed an infection because we know it does. But even if you do the Western blot and we're positive for HSV one, that would not indicate that this rash was herpes. It could for example indicate that you were infected orally as a child with a cold sore virus. If you are doing all of this testing to try to sort out if the rash was herpes or not I'm not sure that's worth doing. Your rash description sounds nothing like herpes to me. Nothing like herpes. Of course, I didn't see it and can't tell for sure. Your description of small bumps might be representative of herpes but the description of a large red area with itching fits far better with the fungal infection in my mind than herpes.  You are right, we can't diagnose over the Internet. In my experience, once the IgG tests misses an infection, it misses it every time.

Terri
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Because of my location, I do not think the Western Blot is really a viable option for me. I have found a test offered near me, a type-specific EIA IGG test, that claims to be 95-96% accurate compared to the Western Blot. Is this test a good idea or is it unnecessary after my most recent HerpeSelect ELISA test? 

That type specific IgG is exactly what you have done with the herpesselect and I do not see any benefit I'll be doing that again. And I would disagree with their statistics for people who are screening for herpes infection. I do not see other options for you if your are infected and for some reason, the IgG is not picking it up.

Terri
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