[Question #857] Risk assessment STDs / HSV1

51 months ago

Dear Experts - I’m a 36year old male and need your advise. 3 month ago my wife told me she fell in love with another guy. Now she quit and told me, there where not more than kissing. Now she came back to me. 17 days before she came back, I received oral for about 5min from a girl I know. I didnt spot any sores and she told me she never had cold sores (HSV1). Now my wife is back and last wednesday (before 6 days) we had again unprotected vaginal sex as we do for years. After this i felt some discomfort in the genital area like red areas, hot and cold tingle, but no discharge, no pain while urinating, or blisters. But today i spotted some white skin areas on my penis shaft when you pull the foreskin back. You have to look really closely - it looks like 2-3 cold sores. No fluid (so no chance for a swab), no ulcer but i dont think they where there before. So to my question. I went to the lab yesterday for a chlamydia/gonorrhea PCR (5 days after exp) - just to check it. NGU is possible but tests are not possible i know. What do you think 1)is there a chance i got genital HSV1 from my oral happening that late in my life? I had a long single life–with over 50 sexual contacts i guess. ONS genital where protected-oral almost never. With longterm partner i always had unprotected after testing. I know 2-3 girlfriends had HSV1 for sure but i never had a cold sore or HSV outbreak in my life. 2)Do you think I 100% already got it? Does it sounds like herpes? 3) Is there a bigger chance, that my wife dont tell me the whole truth and i get something from her? 4) perhaps i’m overreacting because i can’t trust her anymore. Last 6 month we had 3 times unprotected vaginal sex. Perhaps those are just irritations because im not used to it anymore, or other bacterias? 5) would you resume to have unprotected sex or should I tell her to go to a Doc?

Kind regards and thanks

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
51 months ago
Wow, complicated situation.  I"m a little confused by the presentation of the white areas on your penis.  Are they open skin?  You mention no ulcers but you think they look like cold sores.  Are they tender?  If you touch them, are they tender?  Have you ever had a herpes antibody test in the past?  It is certainly possible that you have had either oral or genital herpes for years, statistically you probably do have one or the other.  Has your wife ever had a cold sore in her lifetime?

Terri
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51 months ago
Hey Terri
Thanks for your answer! PCR tests went back negative. To your questions:
1. they are tender and not open! No fluid (till now). I can see them better if i strecht the skin. If i touch them i dont feel any level difference.
2. no - thats not common in europe to make antibodytests for hsv1. They say that almost everybody has this virus.
3. no my wife never had cold sores. But i know that her brother and i guess her father has it.

Kind regards

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
51 months ago
So you had the areas PCR tested and they were negative?  That's actually great news as the PCR test is quite sensitive. Obviously, if they will with fluid you would want to revisit that.
Without an antibody test, I'm not sure how to guide you here.  I don't think it is at all 100% that you have HSV 1 but it is likely that you do, regardless of this particular situation.  Unless you have sores that show up that are different, possibly tender or open, I'm not sure there is anything else for you to do here.

Terri
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51 months ago
No no sorry. The pcr tests were chlamydia / gonorrhea as i wrote in my first post.
So your advise: just keep an eye on it?! If i see some fluids and the spots geeting deeper i should visit an std clinic? How long does it takes till i'm out of the woods? And till i have no fluid i cant transmit it?
Kind regards

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
51 months ago
sorry, missed that the PCR was only for CT and GC.  Yes, absolutely if your spots develop fluid in them or if they get deeper or more painful, please, go in and be evaluated.  You don't absolutely need fluid in the lesions to transmit if indeed they are caused by herpes.  Most people who develop herpes will do so within 14 days of an infecting encounter, some slightly longer.

Terri
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51 months ago
Dear Terri
They are not deep, no fluid and not painful - so im looking forward and take your advise. Last question-
just to get sure: it could be that i had Herpes for over 6+ years and i never had an outbreak or never noticed one - right?
Last 4 months i had the biggest crisis in my life. No much sleep, food, mentally injured because of my whole situation. Could such a crisis
lead do an outbreak if its herpes - and this after years without any problems?
Kind regards
51 months ago
Edward W Hook wrote in this post from 2013:
I repeat "estimates are that if your partner had HSV-1 but did not have a lesion present at the time you received oral sex, your risk for getting HSV through orals sex is again less than 1 in 10,000."

http://www.medhelp.org/posts/STDs/hsv-1-unprotected-oral-sex/show/2010991

That was exact my situation - so if we break down the whole thing. If I get HSV its more likely 1. that I have it since years or 2. i got something from my wife (HSV 1 or 2).
Would you agree to this summary?
Kind regards
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
51 months ago
I was not thinking that you acquired herpes necessarily from the mouth of the person who gave you oral sex once - that seems very unlikely indeed as you can see from Dr. Hook's opinion - I'm just wondering if it is herpes if it could be an old infection, either from HSV 1 or HSV 2.  But the way you are describing this right now it does not sound herpetic.  Again, if these change and fill with fluid or become tender, these should be evaluated further.  It is so difficult when a person says they are having a skin change in the genital area - since we don't allow pictures and don't want pictures, we honestly have limited knowledge about what you are seeing. 

Terri
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