I think the likelihood of you contracting herpes in this way is so very very low - the situation present almost zero risk and your symptom are just not consistent with new herpes infection.  I would say that the majority of people I examined in practice have some kind of pimple or bumps on their bottom!  I do not think that you have ruined your life nor do I think that you are infectious to your wife.  You went to a doctor who also didn't think this looked like herpes.  I think you should feel reassured.

Terri

Thank you for the reply, I’d like to provide further update to see if your view remains the same given some new information.

So on top of the lesion that appeared (still red but no scab so looks like it’s almost gone) 8 days ago (18 days post possible risk)  I developed soreness between my bum cheeks just above the anus, this followed a day or so of a dull tingling sensation in my left buttock calf and foot. Again I thought this was highly suspicious especially given that despite trying e45 creams  it has persisted (usually I would have expected this to have cleared up in a day or so). On the day that the soreness appeared I also suffered very loose stools where ther may have been mucus present at least once. So my mind then jumped to the possibility of proctitis (that also has links to herpes).

Could a primary outbreak show as a single lesion on the buttock followed by persistent soreness (again I couldn’t see any blisters or classic sores) in between the buttocks?  Would I expect to see scabbing in the area if there were true herpes lesions?

Thanks in advance for your reply

The presentation that you describe COULD be herpes in a person who had an established infection and was having a recurrence, yes.  But it really isn't consistent with what I would expect from a new infection in a person with the sexual encounter that you describe, no.

Terri

Once again, thanks for the reply.

Although I am still really confused as to what’s going i wanted to try to use this post to clear up a few last queries before trying to move on and maybe stop stressing about this whole situation.

1) looking at your last reply, would I be correct in thinking that given the sexual encounter described, you do not think that I will have contracted herpes?

2) I am not really worried about HSV1 as my wife has this orally - she gets cold sores (I have never had a single one). Given the symptoms I described, what would be your advice as to what I should do, is testing for HSV2  warranted? (4 weeks post encounter so would have to wait at least another 6-8 weeks) and western blot is not available in this country, only serological Igg testing and at some cost  oh and pcr if sores / blister are present

3)  could HSV2 cause symptoms inside the anus given the encounter described?

4) Repeat trip to GUM (after a week of the sore bum) gave an answer of nothing that looked suggestive of herpes and no evidence of healing sores or skin breaks etc again could not confirm I don’t have herpes, would there be any evidence at this point during an initial outbreak?

5) given all of the above, should I continue to abstain from sex? Or would you think the risk sufficiently low / theoretical so as not to worry unless classic symptoms arise?

Lastly thank you to you and the other doctors for this service, it really does help to keep the anxiety in check.

1) looking at your last reply, would I be correct in thinking that given the sexual encounter described, you do not think that I will have contracted herpes?

Correct, I think it is almost impossible that you contracted herpes at this encounter.

2) I am not really worried about HSV1 as my wife has this orally - she gets cold sores (I have never had a single one). Given the symptoms I described, what would be your advice as to what I should do, is testing for HSV2  warranted? (4 weeks post encounter so would have to wait at least another 6-8 weeks) and western blot is not available in this country, only serological Igg testing and at some cost  oh and pcr if sores / blister are present

I do not feel that further testing is required here, no

3)  could HSV2 cause symptoms inside the anus given the encounter described?

No, as there was no genital to genital contact.

4) Repeat trip to GUM (after a week of the sore bum) gave an answer of nothing that looked suggestive of herpes and no evidence of healing sores or skin breaks etc again could not confirm I don’t have herpes, would there be any evidence at this point during an initial outbreak?

If you contracted herpes at this encounter, it is likely that you would have had some symptoms that you recognize since you were observing so carefully, I would imagine.  Plus the situation you describe just doesn't present any realistic risk of acquiring herpes.

5) given all of the above, should I continue to abstain from sex? Or would you think the risk sufficiently low / theoretical so as not to worry unless classic symptoms arise?

I don't tell people when to resume sex with partners after having had another partner.  What I can say is that if I were in your situation, I would not be concerned about resuming sex with my partner.  I hope that is helpful. 

Terri

Terri