[Question #4917] HSV2 Questions

25 months ago
I received protected anal from a trans escort.  There was very little body contact as she was standing on the floor and I was kneeling on the bed.  I’m 16 days post exposure.  I have had no classic HSV2 symptoms.  However, I have felt sick, aches, heavy chest, very mild sore throat(pushing 2 weeks) poor sleep.  (Tend to feel worse at night and in the morning better during the day)No fever or obviously swollen lymph nodes, for at least 7 days.  I have one red spot on my upper buttocks, just above the sacroiliac joint that showed up yesterday.  Hurts every now and then but doesn’t look like a blister, possibly follicitis.  Also, I had stopped a 3 week course of Tramadol on Sunday for a back injury, I know once before after taking it that long I felt sick for about 8 or 9 days after.  Possibly that.   

Questions
1.  Does the initial HSV2 infection only show up where it entered the body?  So if something shows up where there was no contact it is not HSV?
2.  Is it common to have the flu like symptoms with no fever and no rash?  Trust me I’m looking closely!  Too much really with magnified cell pictures everything looks odd.
3.  Is the first noticeable sign at 15-16 days after rather late?
4.  If this is HSV2 (which I don’t think it is, to many exceptions) when is the earliest normal time a second outbreak would occur?
5.  I tested negative for HSV2 about 3 months ago (IGg), the test was a full year and a half from the last risky exposure. 
25 months ago
2 questions I forgot.  

6. The pain in the area of the one spot is diffuse, feels under the skin like the pressure after getting a large shot.  Not pin point like a bee sting. Is this typical?
7.  Do sores hurt when touched (like a canker sore) or just hurt (like a bee sting).  
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
25 months ago
The chance of you acquiring HSV-2 from receiving oral sex is incredibly low. The type of herpes most often transmitted via oral sex is HSV one, the most common cause of cold sores. If you have ever had a cold sore on your lip or in your nose in your lifetime, it is extremely unlikely you would ever require that genitally.  The normal incubation time from an infection to symptoms is 2 to 10 days. Herpes lesions can have pain or no pain so the presence of local or diffuse is not diagnostic in terms of whether this could be herpes or not. And yes, new herpes shows up and the location where it into the body. Recurrences can show up anywhere in the area innervated by that nerve group so for example with genital herpes, recurrences can show up around anus, buttocks, belly for pubic hair in addition to the genital area specifically.

Terri
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25 months ago
As noted there was receptive protected anal.  However, there was extremely limited body contact.  Just slight thigh to buttocks  The main question was around the one spot which is at least 4-6” away from where there was contact.  If that can’t be HSV2, which it sounds like, then I’m not too worried.  There really wasn’t much skin contact, condoms were used and the provider said she was tested regularly, has nothing and no symptoms.   Not a guarantee but seems like odds in my favor.  I’ve been sleeping very little due to stress, largely unfounded I know, but the off switch on it has been elusive.  So a good chance stress, anxiety, lack of sleep and exercise are just making me feel sick. 


25 months ago
I’ve also been looking way to carefully, builds anxiety.  Haven’t found anything except normal small spots that look identical, location to location, like folliculitis.
25 months ago
So, how soon after an infection is the earliest you would expect a second outbreak might occur.    I know this can’t be predicted but wondering if there might be a “second outbreaks rarely occurs sooner than x weeks after the initial infection”

Second and last question
Based on condom use and very limited contact legs to buttocks I assume it is a fairly low likelyhood of infection?  (Again, I know no guarantees).   
24 months ago
Hello?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
24 months ago
A second outbreak can occur anytime after the first, or it can be months.  It varies greatly between people
And I do believe that an infection, given all you have told me, is incredibly unlikely.  Just so so unlikely.  I promise.

Terri
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24 months ago
Terri,

Thank you very much.


Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
24 months ago
You are most welcome

Terri
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