[Question #7420] Burning after urination - Blood + STD screen & IgG normal/negative
 |
57 months ago
|
Hello, hope you're well. I think it might help to provide a brief timeline before my questions:-
~2010 diagnosed with oral HSV (by inspection, I had a cold sore). Have had them intermittently since. Around that same time, had a small bump on the penis shaft, that would ache/burn for a day or so and disappear (after scabbing over) within a week. This happened every couple of years or so - most recently back in 2018. I didn't think much of them and they went away without much fuss - I once popped one (bad move, I realize), and it had a clear fluid in it, and while that was particularly painful, it just scabbed and went away like normal. I unfortunately, didn't think to get it tested or swabbed at the time.
- Between 2010-2015 multiple sexual partners, with multiple occasions of unprotected oral sex, but no unprotected PIV sex. In a monogamous relationship since 2015
- In September, I began experiencing some pain after urinating - a few minutes after and it would last for maybe 20-30mins later. The pain is sharp enough to be distracting, but not too intense. Around this time, I started getting a pain in the left buttock area (like right in the flesh, not on the skin) and down my left thigh and calf. There was a weekend where I ended up getting a low grade fever (37.5-38C) and was generally under the weather for a couple of days. Around this time, the bump from above presented itself, and resolved. Soon after, I had painful lession in a new location - on the underside of the penis. It burned fairly consistently and painfully for a good 5-6 days, but it never scabbed over. It just sort of got smaller and receded and eventually the burning stopped.
-Since then, the burning after urination has not ceased. Sometimes the burning returns even long after I've urinated. In that time period, I've done a full blood + STD + HSV screen - negative on all of them. My main concern here is HSV2, but my IgG was negative for both HSV1 & HSV2.
|
57 months ago
|
Ah, sorry I forgot my questions - and missed one potentially important detail. The blood test noted a vitamin B & D deficiency, but I've since rectified them
Questions:
- If I do a second IgG and it's negative for HSV2, can I safely rule out HSV2?
- I have wondered whether I have HSV1 both genitally and orally - I didn't mention above, but I've been getting more cold sores this year than before. I'm able to catch them before a full duration outbreak, and sometimes they recede before the blister forms. Do my symptoms seem consistent with that possibility? My igg was negative for HSV1, but I understand that it could be a false negative?
- I have no idea if the small bump I had in the past was herpes, much less an 'outbreak' but none of them caused the urination or left leg issues. Is it likely that the left leg issue is related or is it more likely a coincidence
- I understand a Western Blot would give me a more definite answer - though it would not be location specific. Could I have your opinion on whether herpes (HSV2, more specifically) seems plausible here? If it's unlikely, I'd rather not go through the cost and trouble of the Blot.
Thank you!
 |
Terri Warren, RN, Nurse Practitioner
57 months ago
|
If what you are actually having are cold sores, then you have HSV 1 infection. The IgG test misses 30% of HSV 1 infections, compared to the gold standard western blot. Remember that cold sores are outside the mouth, on the edge of the lip, rather than inside the mouth which is canker sores. The IgG test only misses 8% of HSV 2 so that is far less likely. It is possible that you acquired HSV 1 orally and genitally at the same time, I suppose. if you get these bumps again I would strongly suggest that you get them swab tested right away to try to sort out what is causing them. It's unknown if the leg pain is related or not, I'm afraid.
Having repeated IgG tests does not mean you are not infected. In my experience, if the IgG test misses an infection once, it will miss it repeatedly.
Terri
--- |
57 months ago
|
> Having repeated IgG tests does not mean you are not infected. In my experience, if the IgG test misses an infection once, it will miss it repeatedly.
I assume this applies to both HSV1 and 2? Are you aware of why this is the case? Is particular to the person or to the type of infection (e.g. oral infections are missed more often than genital ones?)
Could herpes have been causing the burning while urinating? I'm not sure if I could see any lesions on the penis head or the urethra opening.
|
Terri Warren, RN, Nurse Practitioner
56 months ago
|
It applies to both, yes, though HSV 2 is missed only 8% of the time while HSV 1 is missed 30% of the time, as I described above. It's a function of the test, not something about the person, I think.
Herpes can cause pain with urination when lesions are inside the urethra - that pain is usually quite remarkable indeed!
Terri
---