[Question #6639] Acquiring HSV-2 through cut in finger

12 months ago
I have OCD and a history of worrying about catching HSV2. I have HSV1 orally. You may remember me from last summer where I was having recurrent perianal ulcerations. This turned out after multiple tests not to be HSV2 and likely perianal dermatitis. 

Regardless, I have avoided sexual contact since then due to these fears but recently have had some casual unplanned encounters.

Last night I met a girl at a bar and went home with her. I fingered her (can't remember if inserted or not), but regardless my hand was very exposed to fluids. Then she used her hands on me. I stopped it there.

I forgot that I had gotten a papercut halfway up the side of my middle finger from an envelope earlier that morning. This was the hand I used.

I have read a lot of conflicting info about this online. I have read anything from exceedingly rare to accounts of people becoming HSV2 positive only through fingering without any other sexual contact. It seems to make sense that if the skin barrier isn't there, then it's definitely possible, and logically likely, right?

I do not know what her status is. She was reluctant to let me touch her at first, so that worries me.

My questions:
1. How likely is it that I could become HSV-2 seropositive from this?
2. Will a primary herpes infection of the finger always develop into a Whitlow? Or can you acquire it asymptomatically through a cut in the finger. For instance, if I don't develop a Whitlow in the next 10 days, can I be confident I did not get HSV-2 from her?
3. Should I abstain from sexual contact with anyone else for the time being? There's someone else I am talking to and hoping to go out with and would hate to transfer something from my finger from this stupid one time encounter. At the same time I want to live a normal life.
4. Would you recommend serologic testing in 3 months if I never get any symptoms?
5. If worst comes to worst and I do get a Whitlow, is it possible to prevent this from infecting me genitally or is that just inevitable?

Thanks

12 months ago
I'll also add that I had two hangnails (index and middle finger) on the left hand. I pulled at one and it bled instantly. The papercut is halfway down and about 1cm (kind of sliced the skin at an angle so there's a flap of skin still covering the cut. It's relatively painful today, typical of a day old papercut. But I have no reason to believe the membrane wasn't intact last night as it surely had clotted by then.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
12 months ago
1. How likely is it that I could become HSV-2 seropositive from this?

I think extremely unlikely indeed!  I personally have not seen someone with whitlow who didn't have the infection either orally or genitally in addition to the hand.  That doesn't mean that it can't happen but it does mean it is extremely unlikely.

2. Will a primary herpes infection of the finger always develop into a Whitlow? Or can you acquire it asymptomatically through a cut in the finger. For instance, if I don't develop a Whitlow in the next 10 days, can I be confident I did not get HSV-2 from her?

Yes, I believe that you can.

3. Should I abstain from sexual contact with anyone else for the time being? There's someone else I am talking to and hoping to go out with and would hate to transfer something from my finger from this stupid one time encounter. At the same time I want to live a normal life.

That's your call but I think that whitlow in your situation is staggeringly low risk.

4. Would you recommend serologic testing in 3 months if I never get any symptoms?
No, I wouldn't.

5. If worst comes to worst and I do get a Whitlow, is it possible to prevent this from infecting me genitally or is that just inevitable?

If you only get it on your hand, you definitely may not get it genitally!

Terri


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12 months ago
Thank you. I realized I was being a little silly worrying about that one. However, I did have one more encounter with her two nights ago I am slightly worried about. We engaged in some dry humping, and she pulled my underwear off at some point and I fell asleep next to her with what I guess was my penis against her butt I believe she still had her underwear/shorts on but I could be wrong) and woke up naked. There was alcohol involved so my memory is not good. So I'm not sure if my penis came through the hole in my boxers at some point (I think it might have briefly). So there might have been some skin on skin contact but if it was it was very brief. There was definitely no penetration. She asked me why I didn't want to have sex the next morning and I said I was worried about herpes, and she said that was gross and she is very paranoid about that too and had been tested. She then performed unprotected oral on me briefly and a handjob.

Anyway, today I have noticed probably about a dozen brief stings coming from the top of my penis. No tingling, just like a random shock that lasts a split second. I have been checking the skin constantly and I see no cracks, redness, or blisters.

How concerning is all of this to you? If I don't get any blisters in the next week am I good or should I get tested?

Finally, immediately after I left her I came down with the flu and have been taking Tamiflu. Anyway Tamiflu could prevent herpes from showing up?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
12 months ago
The only risk here is the unprotected oral sex.  And the risk there is HSV 1.  Have you ever in your life had a cold sore on your lip or in your nose?  If yes, then it would be extremely unlikely for you to acquire HSV in a new location. 
Tamiflu would have no impact on the acquisition of herpes, no.
I would say that with this single episode of oral sex from someone who says they test negative, the risk of you getting herpes is very very low indeed.  If you have had  no sores with 10 days, you should feel quite reassured.

Terri
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