[Question #5529] Potential HSV symptoms?

22 months ago
Hello and thank you for this service, very useful and informative.
I would like to have your feedback about potential HSV risks following unprotected oral sex.
At the end of May I received unprotected breast massage on my penis and unprotected oral sex for 1 min from a CSW.
Here is the timeline of the symptoms after the exposure.
3 days after exposure: light tingling on my scrotum, I would have probably never paid attention to it if it wasn't for the sexual encounter
4 days after exposure: scrotum and penis shaft were full of irritated hair follicles probably from the breast massage and lubricant used. I also came down with fever and chills but it all subsided a few hours after I took tylenol
5 days after exposure: started having tingling, itching and burning in my entire boxer area. The sunburn feeling was more pronounced on the front of my thighs (nothing on the back) and the itching was very noticeable around my genital area, specifically anus, perineum, scrotum, shaft.
I also experienced intermittent pain every now and then at the base of the urethra, where the urethra meets the scrotum
Symptoms lasted 5 days and werent unbearable (I was able to normally continue my day-to-day life at work, gym) but they were uncomfortable enough to cause worry
I had no pain at all urinating not ejaculating and absolutely no sign of lesions or blisters anywhere on my body. Checking with a flashlight several times per day but penis looks absolutely normal in terms of color an without lesions
10 days after exposure I got tested negative for trich, gonorrhea and chlamydia, doc prescribed Cipro for 2 weeks
Symptoms have mostly subsided 11 days after exposure, but on 12th day I started having a painful backache that has however not affected my buttocks or nerves (pain concentrated on the back.
Do you think the timeline and correlation between these symptoms suggest an HSV infection?
Thanks!

22 months ago
I actually have an update on the backache... It seems to be expanding down the thigh calf nerves to the point that I have a pinching and uncomfortable sensation.

I really don't know what to think... On one hand all from what I have read here all the burning and itching do no seem to suggest herpes directly... But on the other hand the fever after 4 days of exposure and this back/nerve pain have me worried.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
22 months ago
These symptoms do NOT suggest a herpes infection to me, not even a little bit.  The breast contact was zero risk and the oral sex was so brief one night think there was no real risk there either.  And the risk from the oral sex for herpes would be HSV 1, the virus that causes cold sores.  Have you ever in your life had a cold sore on your lip?  If yes, then you already have HSV 1 and it would be extremely unlikely that you would then acquire HSV 1 genitally.   Let me know

Terri
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22 months ago
Hello Ms Warren,

Thanks for your reassuring answer about the symptoms.
I never had a cold sore and I have no history of cold sores in my family either.

I am now not overly concerned since I am now completely symptoms-free (save for the backache) but I have a few follow up questions:

1. One concern is the timing of the symptoms, they appeared after 3 days after exposure and lasted about a week... Which seems to coincide with the duration of an herpes outbreak.
Symptoms stopped once I started taking Cipro. Do you see this as a sign that they were caused by bacteria or could it be a coincidence?

2. I had fever and chills for a day at the beginning of the symptoms but it went away with Tylenol. The doctor who visited me said that when fever is STD-related it doesn't go away with things such as Tylenol... Do you agree with that?

3. After all the burning/itching has subsided (14 days after exposure) I started having backache and nerve pain in my legs, 3 straight days now.
In your experience when this is caused by the herpes virus, does the nerve pain appear this early in the infection? I am trying to think of reason to exclude herpes as the reason for this.

4. Is it common in your experience to have people experience that many symptoms (pain, itching, burning, tingling, backache) and not present a single blister?

Thanks again for your time.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
22 months ago
1. One concern is the timing of the symptoms, they appeared after 3 days after exposure and lasted about a week... Which seems to coincide with the duration of an herpes outbreak.
Symptoms stopped once I started taking Cipro. Do you see this as a sign that they were caused by bacteria or could it be a coincidence?

While the timing does fit with a herpes outbreak, it could also fit with a bacterial infection and the fact that the symptoms stopped while taking cipro does suggest that it is bacterial

2. I had fever and chills for a day at the beginning of the symptoms but it went away with Tylenol. The doctor who visited me said that when fever is STD-related it doesn't go away with things such as Tylenol... Do you agree with that?

Not necessarily, no

3. After all the burning/itching has subsided (14 days after exposure) I started having backache and nerve pain in my legs, 3 straight days now.
In your experience when this is caused by the herpes virus, does the nerve pain appear this early in the infection? I am trying to think of reason to exclude herpes as the reason for this.

No, I do not believe that the backache is related to a herpes infection

4. Is it common in your experience to have people experience that many symptoms (pain, itching, burning, tingling, backache) and not present a single blister?

NO!  It is not common.  I think the diagnosis of a bacterial infection is probably right now

Terri
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22 months ago
Hello Ms Warren,

Thanks again for your answers.
I have a couple of final follow up questions before I move on from this experience.

1. I know it's a remote possibility now, but in the unlikely scenario that I am infected, will I still be highly contagious using a condom 4 weeks past exposure? (I have started dating a girl and we will probably have protected sex in the upcoming weeks)

2. You mentioned that the infection is probably a bacterial one. I tested negative for gonorrhea and chlamydia, is there any other bacterial infection that I could have contracted based on the exposure described?
Is it common for bacterial infections to cause fever?

Thank you very much for your help and for your involvement on forums and websites.



Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
22 months ago
Condoms reduce transmission by 96% so if you are infected, condoms will reduce the risk of transmission greatly.
Skin infections are not caused by gonorrhea or chlamydia, there are other bacteria (many) that infect the skin.  Staph, strep, etc.  And no, they normally don't cause a fever.

Terri
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