[Question #3699] Asymptomatic HSV2

35 months ago

Dear Doctor,

I am 30 years old Male. I had intercourse with prostitute massager on September 3, 2017. The condom breaks off during sex which I didn’t notice till maybe 10 minutes later and stopped immediately. After that, she did hand job for me till I come, and this was another 5 to 7 minutes.


I am expecting to have asymptomatic HSV2 due to the following symptoms.

1-      3rd day from the exposure I got fever and sore throat which last for 2 weeks

2-      4th day from the exposure one white not painful blister (1cm diameter) showed on shaft and last for almost a week.

3-      Black blister showed inside my mouth.  (I am not sure if its due teeth biting thing as mention in the net)

4-      Two separate wounds showed on my shaft which remain for like 4 days. After couple months another 2 wounds show in different place on the shaft and remain for 3-4 days. The dermatologist said it might be from the soap that I used during the musterbation

5-      Superfine and sticky skin on shaft

6-      After masturbating I can clearly notice red spot (2 cm dia) on the penise head

7-      Two Super small (1mm dia) separate pimple on the penis head remained for a long time. The Dermatology said it might be folliculitis. But there is no hair on the penis head which doesn’t make any since for me. He prescribes cream, but nothing changed.

Lately and till now I experience:

8-      Very Strong Headache. I did the brain CT Scan, nothing wrong with it

9-      Heart Pain (80% of the day), doctor echo report conclusion: Could be early dilated cardiomyopathy

10-   Burning sensation on Penis and itching from anus. All urologist test was clean and nothing wrong including the prostate ultrasound


Here is the confusing part, all HSV1 & 2 tests (IGG, IGM, Blood and Urine PCR) showed negative after six months from the exposure. All other STD test showed negative except UU which I took doxycycline hyclate for it and turned to negative for the next test.

Please note that I was under very high stress for all that time.

My Questions:

1-      Do you think my issue related to asymptomatic HSV2? Or is it a psychological thing?

2-      Do you recommend me to do the Western Blot in Washington University?

3-      Does it have anything related to HPV?

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
35 months ago
I don't believe that this sounds like a herpes infection.  The risk of getting herpes from a single encounter is statistically very low and it sounds like at least part of the time, you had condom protection.  I think your mind is worrying over time, yes.  If you cannot put this behind you and have peace of mind, you could work on obtaining a western blot, yes.  It is good news that your herpes testing so far is negative.  Very good news. 
I do not think anything you have described here is related to HPV either.
Have you been seen by a professional when you had at the blister on your penis and was any swab testing done?

35 months ago

Thank you for your response.
Yes, I have been seen by a professional, he did not take swab test. But, he asks for the urine and blood PCR test and both was negative.
1- With your experience which one is more reliable for Asymptomatic HSV2 PCR (Urine, Blood, or Semen)?
2- I live in the middle east, as far I know the western blot test exist at Washington University United State only? Is their anywhere else that I can get the test from!?
3- Since I still have the symptoms 8 months after the exposure (burning sensation on penis, anus itching, heart pain and very strong headache). What else other than asymptomatic HSV2 can that be!?

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
35 months ago
A blood PCR test is a mistake.  Herpes is almost never in someone's blood.  The PCR should be a swab test from a lesion, not a urine or blood  or semen test.  Did they do an antibody test for herpes?
We have done western blots for people who live far away from the US if you want to pursue that at westoverheights.com
Asymptomatic means no symptoms - you are having symptoms.  but herpes doesn't cause heart pain and only very rarely a headache. 

35 months ago
They did the Igg and Igm test for hsv 1 and 2 = I am not sure if these are the one you are asking for (antibody test)

Test done after the exposure: month, 3 months, 6 months and all show negative result for 1 and 2

4 Follow up questions.

Q1. These days with mobile light I can clearly notice 3 red spots (2 cm dia) on my penis head and it seems different than the normal skin, I know it sound weird? any relation to hsv?
Q2. Can hsv1 (genital) transfer through intercourse without oral sex?
Q3. How late can the HSV severe symptoms show after the exposure?
Q4. I read some people results changed from negative to positive after one year? is that possible with the IGG test? 

Thank you 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
35 months ago
Generally speaking, if you have to use an extra light or magnifying glass, these are not herpes lesions.  They are easily seen.
I have yet to see a case of intercourse transmitted HSV 1 in my career but they have been documented in the literature
If someone is going to have symptoms of herpes when they acquire it, that happens within 2-10 days normally
The IgG test has many false positives and some false negatives.  Changes in this test over time means nothing really.  The western blot does not change over time UNLESS someone tested too soon after exposure OR they have taken antiviral medicine for a long time.