[Question #5210] STD/HSV2

26 months ago

Hello Doc (DR  H. Hunter Handsfield, M.D),

Thank you for your great contribution and support.

Before I would just like to emphasize I have not googled anything  with respect to symptoms.

Story line:

Was invited to a party and it was a swingers party wasn’t fully expecting it.
Was exactly 5 days ago on Saturday, I had intercourse with 4 different ladies, I used protection most of the time however there were instances of penetration without any protection but not very long 5min, this was about 5min with 2 of the ladies. There was also oral without any protection.

  Symptoms Started on Monday.

·            -Very odd light headache for last 3 days the back of the head (I never get headaches, never take pain killers).

·           - Stiff Neck

·          -Sore throat back right, seems red. Not intense pain but can feel it when swallow.

·            -Odd throbbing pain in glands near groin area but not inflamed.

·            -There are some red spots In groin area there are two very close to each other and another two about 1 inch away the other are not close to each about 0.5inch apart. No puss just red.

·          -The two spots do have a odd tingling feeling.. Could be my mind…

·          -I had done a clean shave that Saturday so may be due to shave but usually don’t get lots of spots.

·         -Red irritated foreskin (This is common when I wear latex and in general foreskin is red I have checked this its no issue.                                              

-        Not had any fever, just some joint pains.

1)Based on the above information and facts could you please advise what my symptoms could be related to, STD?

2)What tests should I do and when?

3) Main Concern I would say probably HSV2.?

 I am generally in good health and very conscious about my health so I can tell when I get aches pains. 

Appreciate your feedback and guidance.


H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
26 months ago
Welcome back to the forum. Thanks for your question. Herpes related questions usually are answered by Terri Warren, but she referred it to me because of your concerns about STDs in general.

Your symptoms are not those of any STD. Sore throat rarely is due to STD; there are no STDs that cause headache, joint pains, or "throbbing pain" in the groin (except with obviously enlarged and tender lymph nodes); and red spots in a shaved area of the skin also doesn't sound like herpes or any other STD. Redness or irritation of the foreskin also is generally not due to STD, especially since you have experioenced it previously in association with latex condoms. (In retrospect, this -- and not Ureaplasma -- probably was the cause of the symptoms addressed by Dr. Hook in response to your question two years ago.) All things considered, if you have any infection at all, almost certainly it's a garden variety upper respiratory virus. And of course any party, and especially one with multiple sexual contacts, is a high risk situation in regard to the common cold, influenza, etc. Also, onset about 2 days after the party is typical for such infections, but too soon for most STDs. You might check with others who were at the party. If you find others also have developed colds, sore throat, etc, that would tend to confirm this theory.

Nevertheless, this could well have been a pretty high risk exposure. It's difficult to judge, since you don't say anything about how careful these various couples are in their sexual safety. Some swingers of course are at high STD risk, but many are not. But if you caught any STD, so far it is asymptomatic. To be maximally safe, consider having a urine gonorrhea/chlamydia test (valid any time more than 4-5 days after exposure), and blood tests for HIV and syphilis after about 6 weeks. And of course see a doctor or clinic if you develop any symptoms typical of STDs:  discharge from the penis, penile blisters/sores, etc. These recommendations are common sense based on your exposure, but not because of your symptoms.

Those comments directly address questions 1 and 2. As for HSV2, your symptoms do not suggest it. I cannot say the risk is zero, but it's very low. Even if one or more of your partners had genital herpes due to HSV2, your risk was low because of mostly consistent condom use; and because the average HSV2 transmission risk from vaginal sex, if one partner is infected, is roughly 1 in a thousand. Oral sex can risk genital HSV1 infection, but almost never HSV2. Certainly you describe no symptoms that suggest herpes, and I recommend against testing for it. The HSV blood tests are not perfect, and generally are recommended only when symptoms or other factors suggest a much higher chance of infection.

I hope this information is helpful. Let me know if anything isn't clear.

HHH, MD
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26 months ago
Hello Doctor,

Thank you for your reply and information.

In response to your question/comment regarding the exposure of the ladies, I have asked The ladies that had less than 5 min unprotected intercourse and they said they had done their tests and all clear and that they never had any unprotected sex.

I have done my first set of test and that came all clear. I just have to do my other tests at 6 weeks as suggested.

I was hoping you could provide some insight from an STD point of view.

The last 5 days my right neck lymph nodes is very tender that side of my throat hurts similar to a stiff neck but the pain d9esnt seem to go away.
The gland hurts when I touch but doesn't seem swollen the whole area is sensitive.
I've had no fever at all just a mild sore throat but not a typical sore throat lasted 2 days and a chesty cough with phlem. 
The other symptoms are joint paints light head ache.
As mentioned before I am genetally in good healthy and in this instance I have never experienced a pain in my throat external as if it is the lymph nodes. Pain starts from lymph. So it's only one side right side. When move my head the area from the gland to colar bone hurt and is tender when I touch the higher up under the jaw bone more it hurts.
Just to also note I have had my tonsils removed from a young age.

What's your opinion of these symptoms relating to STD.
Thanks for your contribution and time.


H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
26 months ago
Given your partners' sexual histories, it's up to you whether to have additional testing (e.g., HIV) at 6 weeks. There seems little chance you were infected, but you are free to be tested if the negative results will be reassuring.

No STD is a likely cause of the symptoms you describe. Even though you have never experienced a pain quite like this, that doesn't mean it's an STD or that it has anything to do with the sexual exposures you have mentioned. It is much more likely that you have a common respiratory viral infection. If the symptoms continue or become severe, or if you develop other symptoms (e.g. sores in the mouth), see a doctor. But whatever the cause, I'm confident it's not an STD.
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25 months ago
Hello Doctor,

Just to update and get your final thoughts.

At day 7 I tested for chlamydia and gonorrhea via urine test and it was clear.

At day 27 did HIV 4th Generation test was negative.

At day 28 did blood test for Syphilis , Herpes 1/2, Hep A and Hep B.

All came back clear.

You mention below 6 weeks does that make the above tests not accurate more so about HIV?( I know this is a common questions however you mentioned 6weeks.)
Any other testing or suggestions? 
Or the above are conclusive ?

Thanks for support and suggestions.


Regards

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
25 months ago
The urine (or urethral swab) gonorrhea/chlamydia results are conclusive. The blood test results are highly accurate at 4 weeks, but not quite conclusive. For trulyl conclusive results, testing is necessary at 6+ weeks for HIV and syphilis and 3+ months for herpes. However, there is no realstic possiblity that herpes explains your symptoms and I see no need for repeat testing. In addition, viral hepatitis is no chance for practical purposes, and really no need for retesting.

That concludes the two follow-up comments and replies included with each question. This thread will be closed shortly. I hope the discussion has been helpful.
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