[Question #6644] HSV Recurrence?

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66 months ago

Thank you in advance for your counsel and patience.  Please review my most recent question I submitted, also. 

Two weeks ago (and one month after my original symptoms), I experienced intermittent shocks or pulsing pains every few seconds at the head of my penis over about 10 minutes—it really got my attention.  I also briefly felt a few less intense pulses on my anus.  Later that day and part of the next, I had a few more of these sensations but widely spread out over time and much lower in intensity.  I have felt exactly one shock like this before in my life and it was at the same time of the original symptoms and at the same spot on my penis.  It came and went in a second, so I thought little of it.  Following these new sensations, I watched for blisters on my penis, urethral opening and anus.  After several days of seeing and feeling nothing unusual, I noticed the head of my penis vaguely sore to the touch.  After two more days of no blisters but with a vaguely sore penis head, I looked as deep into the urethral opening as I could.  Just past the easily visible area the tissue was more red (not pink) with uneven edges.  I have no idea what it is supposed to look like.  During all of this, my perineum became irritated and red like before, again no blisters, and I briefly felt unusual testicle sensations of a similar quality, like a pulse/throb.  I had previously treated the perineal irritation as a fungal infection by using Clotrimazole for one week, 2x/day.  That seemed to clear the issue, but since I had only quit using it three days prior, I entertained the idea the fungal infection was undertreated and returned, so I resumed the Clotrimazole.  Now, two weeks after the new symptoms began and seven weeks after this all started, I am symptom-free again.

Other info:  I tested negative for gonorrhea and chlamydia 6 days after sex.  I tested negative (<.9) for HSV 1&2 with igg (42 days after sex, ~36 days after first symptom).  No pain during urination, no discharge.

What do you think based on new symptoms?  If HSV, it seems mild.  Would that mean it takes longer to show on a blood test?  Does your previous advice that this is not HSV change?  My instinct is to test again with igg after 8 weeks and, if I have an obvious breakout, to get a PCR swab.  None of this strikes me as psychosomatic.

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Terri Warren, RN, Nurse Practitioner
66 months ago
A negative antibody test at 42 days out (almost 6 weeks) had a 70% chance of picking up herpes if you indeed did get infected at the encounter that you were worried about.
Symptoms do not determine whether an antibody test is correct or not.  That is unrelated.
Your view into the urethra revealed very normal tissue.  I've looking into thousands of male urethra over the years and yup, that's what it looks like deeper in.
This doesn't change my view of whether you have herpes or not, no.  The sensations that you describe are unlikely herpetic.
I think if you are still worried, you could repeat the IgG test again,but my recommendation would be to do it at 12 weeks, no 8, for greater clarity.

Terri
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66 months ago
Thanks for the feedback, Terri!  I'll have to test again to be convinced.  I have no additional questions now, but would appreciate you leaving this open for the very near future.  I'd like to be able to tell you what the results are.  It may be useful to other readers, too.
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Terri Warren, RN, Nurse Practitioner
66 months ago
Yup, I will leave this open - you have one more post available.

Terri
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