[Question #5166] HSV2 / Nerve Pain

24 months ago
Recently had 3x unprotected sex with new partner.  Realize transmission odds are low. She is unaware of her status. 

Now, 3-4 days after contact,  I am suffering from very painful neuralgia in lower back and thighs/upper leg. Would chalk it up to anxiety — BUT I am concerned bc I felt similar pain once before, prior to a case of shingles (classic presentation / mid trunk).  

Handsfield says prodrome / nerve pain prior to initial HSV2 outbreak does not happen. However literature seems to be mixed. I am historically HSV2 negative (tested)  but now concerned and waiting for other symptoms / pustules given my current pain state. 

-Have you seen this type of nerve pain leading up to primary HSV2 outbreaks?
-Is the neuralgia / prodrome people describe similar to herpes zoster pain? 
-Perhaps nerve pain prior to initial outbreak simply goes unreported, as most people don’t know what it is? 

Thanks in advance. I will keep you posted. 
24 months ago
When you address this, I do tend to think it may be mechanical. The pain, while real, is bilateral and not as aggressively “electric” compared to shingles. No development of other sxs yet either, going on day 4. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
24 months ago
I have seen neurologic pain with a primary infection yes, but usually it present after lesions do.  Just continue to be on the look out for any skin changes.  This kind of pain alone would not suggest herpes to me.  It would be most useful if she would agree to be tested if you are concerned about this contact.  Have you asked her about this possibility?  Did you do something to lead you to think this was mechanical?

Terri
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24 months ago
One quick clarification. Initial lesions / outbreak would be at the point of contact, correct? 

I’ve had itching / irritation on my perenium for a day or so, and this morning it’s worsened. I investigated and noticed redness and very minor skin breaks (hard to see). I have zero other symptoms...the nerve pain resolved shortly after my message. Think this is related at all? I would presume not but wanted to check. Thanks. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
24 months ago
It's difficult to say about any particular symptoms.  It could be a fungal infection or a herpes outbreak - having it swab tested and/or examined would be the best way to know for sure.  I'm glad the nerve pain has resolved.

Terri
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24 months ago
I followed up w my GP today and he didn’t think it was HSV related to this contact, if at all. I will IGG test in a few weeks, but to sum. 
-no acute viral symptoms 
-no penile / point of contact ulcers
-perineal scabbing already taking place (noticed in a 10x mirror), in a mostly symmetrical / linear fashion, not diffuse. 
-no true blistering was ever observed, just minor skin breaks
-very flaky dry skin at base of the remaining skin break (seen in 10x mirror) 

All in, I think this would be an unusual primary outbreak. Would you agree? 

If this was a recurrent outbreak, then I’m one of the few w/out initial symptoms bc I’m way too OCD to have missed that. 

Thx again for your counsel and for putting up with the internet’s hypochondria. This is a helpful tool. Hopefully all tests neg. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
24 months ago
All in all, I do tend to agree with your GP about this, given what you have said.    If you have questions about your IgG results, be sure to let us help you.

Terri
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