[Question #4007] HERPES

33 months ago

Hello. In May 19th I went to a frat party and kissed some people. I’ve drinked a lot and I don’t remember so much about it(I can’t recall if I’ve received or have given oral sex, but I think I haven’t). I’ve never had any herpetic lesion before.

In May 23th a lesion appeared in my lips. It evolved typically: with blisters, then ulcers and cicatrization. I did the treatment correctly and it was cured(I’ve been to some doctors after, showed the pictures and they confirmed it as herpes).

One week after(May 30th) a lesion appeared on the tip of my penis, but differently it wasn’t typical: no blisters nor ulceration. Rather, the skin around my meatus started looking wrinkled. There were some really tiny bumps in the area but they didn’t evolve to blisters or ulcers. I had NO pain, itching, tingling, burging, or discharge at all. Just the wrinkles and tiny bumps.

It’s been almost 2 months since this lesion appeared and it didn’t go away. In the beginning I started taking acyclovir again because I thought it was herpes, either because I had autoinauculated it during the masturbation(I kept masturbating during the outbreak on my lips, although I was always careful and washed my hands before) or because I’ve received or given oral sex on that party.

The antiviral didn’t work so I stopped taking it. I consulted with an infectologist and an urologist, both said the lesion didn’t look like an STI, nor herpetic at all. I asked the infecto about doing some PCR but he didn’t recommend that since I had no blisters or ulcers where we could colect the material.

Could it be an atypicall manifestation of herpes(considering the symptoms, time and non-response to antivirals)? And if not, what could it be?

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
33 months ago
The situation on your penis sounds absolutely nothing like herpes to me and it is excellent that you saw a clinician in person about your concern.  Do you think it is possible that your penis might have looked like this previously and that you are just noticing it more now since you have acquired HSV orally?  Your description sounds pretty normal to me.  What do you think?

Terri
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33 months ago
Thank you for the answer. 
And no, I'm pretty sure my penis never looked like this before. The skin around meatus used to be smooth, now, like I've said earlier, it's kinda wrinkled and overgrown, with these really tiny bumps, even when erected. And it's been like this for almost 2 months. I'm just afraid it can be something infectious and I might spread it, so I've not had sex during this time. I colected some exams on July 20th(2 months after ''exposure''), HIV, HEPB, HEPC, SYPHILIS, all came back negative. HSV I and II positive(IgG 12,2). Like I said, this never happened to me before, my penis skin was always smooth and then 1 week after labial herpes this happens... it seems related to me. By the way, there are some eritematous patches on my oropharynx, they look like some red nodules aswell, but they don't ache or anything, they're just there. I realized it and it's has been more than a month. So I think these pharyngeal lesions and the penis lesion couldn't be related? couldn't they be an abnormal manifestation of herpes? 
And one more question... since I have no blisters with fluid, ulcers etc. and the IgG I have had done couldn't tell me if it was HSV-1 or HSV-2, just told me I am HSV positive, isn't there any exam I could do, considering my symptoms, to know if that's indeed herpes? PCR or swab and culture wouldn't work?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
33 months ago
OK, so it definitely looks different to you now. 
But herpes would not cause wrinkling of the meatus. 
So you tested positive for HSV 2 at an index value of 2.0, is that correct?  That is considered a low positive and should be confirmed by a second test, preferably the herpes western blot, per the CDC STD treatment guidelines. 
You could see a clinician to evaluated the red patches on your throat and if appropriate and warranted, they could swab them for HSV.  You are not describing anything on your penis that I think warrants a swab test.

Terri
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33 months ago
I tested positive for HSV, but it didn't say if I or II. I'll be looking forward to get to know. And one last question. Since I'm 21 and I've been to a lot of frat parties and kissed lots of people... It's probably HSV2, right? Cause almost 100% sure I was already infected with HSV-1.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
33 months ago
If you had a test that showed you are infected with HSV but not the type, and you know you have HSV 1, I'm not clear why you think it is HSV 2.  What you want is a type specific antibody IgG test - that will tell you if this is HSV 1 or HSV 2 or both

Terri
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