[Question #6289] Exposure Risk/Symptom Check

15 months ago
I had unproteced sex with an escort. Approximatley 10 days later I felt a sligh ache in my testicles and a burn at the tip of my penis. 22 days later, 32 days after the encounter, a small red patch appeared where there was an intermittent burn on the head of the penis. After taking Valtrex for one day and an anti-fungal pill and cream, the red spot was mostly gone in 48 hours and completely gone in 60 hours. There has continued to be a slight sting in the tip of the urethra and a buring at the head on and off until now, day 55 from exposure. I have also been experincing body zings that I have never felt before. They started quite strong and were shocking, but have reduced in strength and now only happen ocassionally in places like the back of my knee, my chin, my shoulders, and a few other places. I have had a few instances of the same feeling starting at the bottom of my foot and radiating upard for a second or two. This foot feeling is stronger that the body zings and has caused involuntary movment of my leg. I have also experienced slight pinching at the scrotum. As I type this I have felt a few penis aches, but they dissapear as soon as they are noticed. I have been to multiple doctirs who looked at the rash and none were concerend enough to offer additional testing, however; I have completed 2 HSV IGG tests. One at 6.5 weeks and one at 7.5 weeks. Both tests have been negative for both HSV1 and HSV2. I submitted bloood for another IGG at the 8 week mark. I contacted the woman and asked her aout her HSV statsus and received no direct answer either way. I am operating under the assumption that she would test positive. I have had no distinct lesions. I have not seen such a small red rash on my penis before this encounter. I am concerend and would like your opinion on my exposure and if you would expect the test to remain negative. From what I understand, no lesions, 7.5 week negative IGG test despite no history of HSV1, no obvious first outbreak, observable symptoms startig at day 32 point to this not being HSV as all are outside of the typical presentations, however; I am still concerened. What do you think?

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
15 months ago
I don't think you have to assume that she is infected with herpes, but the majority of the population has either one of the other virus.  Given that, a single exposure is unlikely to result in infection.  HSV 1 would be more likely if you were given unprotected oral sex but you don't mention that.  If no oral sex, then HSV 1 is a very low risk from intercourse (possible but unlikely).  HSV 2 would be the concern then, and the IgG test picks up 92% of HSV 2 infections, compared to the gold standard western blot.  Some people do go from negative to positive after 8 weeks and before 12 weeks, but not too many.  Taking Valtrex for any extended period of time can influence the test results  - I define that as more than 2 weeks.  Given all of that, I think it is really unlikely that you became infected with either virus. You may wish to take a final test at 12 weeks and if you can't rest easily about this, you can obtain the herpes western blot from the University of Washington.

Terri
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