[Question #471] Worried about herpes

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109 months ago
Hello,
I had an unprotected encounter 8 weeks ago, deceloped some urinary symptoms(frequency, urgency, pelvic pain) followed by a rash on my right thigh that was painful and spread outward. Was diagnosed with prostatitis after negative std tests including herpes at 3 weeks post encounter.  All the symptoms are ongoing , and I've developed what white fluid filled spots on the lips, which look like cold sores, but haven't ulcered (about 2.5 weeks) . I have gotten cold sores before , but usually limited to one place . These new "sores" are in completely new locations.  I did test positive for hsv-1 , but have always gotten cold sores so it isn't surprising. Could this collection of symptoms be an exposure to hsv-2?
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Terri Warren, RN, Nurse Practitioner
109 months ago
Good morning Vicente,
Can you tell me a bit more about the rash on your thigh?  Can you describe it more fully please?  How long after the encounter did it show up?  Have you had any lesions or sores on the penis itself?  Were you the giver of oral sex to this partner as well as unprotected intercourse?  You mention testing positive for HSV 1 - when did you do herpes testing in relationship to the encounter?  Thanks so much for additional details so that I can help you best.

Terri
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109 months ago
The rash was on the right inner thigh, was raised red, and painful when touched. No visible blisters or ulceration, and did not itch. It was aggravated when I went jogging, and following the friction, it spread outwardly. It It appeared 3-4 weeks after the potential exposure. No visible llesions on the genitals, but did have "pubic bone" pain on the tight side as well. My std testing was done 3 weeks following the encounter and repeated at 5 weeks. Bit showed negative for hsv-2 and >5 for hsv-1. I was the giver of oral sex , as well as the intercourse with this person. 
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Terri Warren, RN, Nurse Practitioner
109 months ago
Three to four weeks after the exposure doesn't fit with new herpes plus I would expect that the first infection would be on the genitals themselves or the mouth.  The rash does not sound herpetic to me.  While 5 weeks is too early for accurate testing for herpes, nothing sounds consistent with herpes to me at this point, Vicente. 

Terri
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109 months ago
would the lesions on the lips that are in "new" locations represent a new herpes infection, or can herpes manifest in new locations over time? 
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109 months ago
And as a last question, would it be worth repeating a blood test at 8 weeks post encounter ? 
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Terri Warren, RN, Nurse Practitioner
109 months ago
No, Vicente, the location of lesions is not relevant as the virus can just travel along a different nerve and show up anywhere on the face. 
At 6 weeks past infection, 70% of people who are going to be positive will be positive so at 8 weeks, even more.  I like 12 weeks from possible exposure to take the final test.

Terri
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