[Question #860] HSV2 as yet undiagnosed-pd for 2 ques.

52 months ago
Next day after unprotected sex-gave oral & had vaginal-tingling began in outer labia x 4 days. Saw Dr on day 4-exam & testing-all STDs. Tingling stopped after 1 wk, but mild stinging began (inner & outer labia & vaginal opening) & has continued daily. Today is day 15. No sores,blisters,lesions, or odor. Discharge from thick white to thin white. Day 4 tests all neg. Assume HSV2 testing premature & positive result still possible after 6 weeks. (3 neg STD panels til now over past 8 mo). Until retest, abstinence is best.  If I have sex,1)  can kissing & giving oral(no condom)or receiving oral infect partner with HSV2?  I'm assuming HSV2 is my main concern; But 2) Wondering if any other STDs have these same/similar symptoms?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
52 months ago
Wow, I don't have an exact answer for you.  Do you know anything about the sexual history of the partner with whom you had unprotected intercourse? I would be very unusual for herpes to present with symptoms the very next day.  It's a good thing that you have a baseline herpes antibody test (were you negative for both HSV 1 and 2?) to know that you were negative at the time you had sex with this person.  You are correct that you were very early to determine your HSV 2 status from this encounter, but a one time encounter is unlikely to result in herpes though it is not impossible.  Can you have sex?  If you have no genital contact, it would be safer, yes.  Have you been evaluated for things like trich and yeast infections?

Terri
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52 months ago
Have tested pos for HSV1 w/NO history of cold sores. Again, neg HSV2 tests so far, but will retest at 6 wks post exposure. Partner claimed to clean, recent test results. Vaginitis panel done w/STD panel, including Trich, all negative. Losing my mind & not sure what to do while I wait for HSV2 retest in 4 wks. Very mild stinging comes & goes throughout the day, but daily since tingling stopped after week 1 (1 week ago-2wks since sex). Currently, NO other symptoms. Do you have ANY specific recommendations prior to the retest?  (Including going back to Dr for further testing, and for what? Specific test recommended for retest? I understand there are different 'types' of tests for HSV2). I'm sorry- your response wasn't terribly clear- I assume oral sex (giving & receiving) holds risk of passing on virus if indeed present, but are kissing & protected vaginal sex relatively safe, tho not without risk, at this point?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
52 months ago
You only want IgG testing - never IgM testing - it can be falsely positive and really mess with your head. 
I think we are talking about the possibility of genital infection, correct?  Giving oral sex is not an issue if you are infected genitally - receiving oral sex may be present some small risk.  Kissing is not a risk and protected intercourse is relatively safe, correct. 
There is really nothing that takes the place of the time required to seroconvert.  I know it is very hard to wait.  You could test at 3 weeks and see if you are still negative, as an intermediate step.  I do think your risk is quite low.

Terri
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52 months ago
I think I will see Dr again at 3 wks for IgG testing. Not sure what else she might test me for, as far as genital infections go, any suggestions? I've no idea what's going on, so genital infection seems preferable to HSV2. Still fuzzy on how spreading virus happens when no symptoms present/shedding, but prior to submitting questions here, I  had scheduled a 1 on 1 call w/rep from this same site, but couldn't schedule til tomorrow. So grateful for the quick response here, though,  THANK YOU! I will see what further info I can get from that call tomorrow. Again, any thoughts for my Dr. on further testing for infections would be great.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
52 months ago
well, aren't we talking about genital infection WITH HSV 2?  I am.  What I said in the response above had to do with possible genital infection with herpes type 2.  Since you have no odor, I think trich and BV are unlikely.  Perhaps the provider that you see will have more ideas when you are seen.  The odds of acquiring HSV at a single encounter are really low - not impossible, but really low.  I think the odds are on your side, particularly since you've had no sores or lesions.  We'll hope for the best!  If you are negative at 6 weeks, there is a 70% chance it will stay that way.

Terri
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52 months ago
I see now. I thought you meant there could be another explanation for my symptoms with a genital infection other than  HSV2.  Will retest at 3 & 6 wks. During the wait time, I just wanted to fully understand my risk of transmitting the virus (if indeed present), and you addressed that. But during my 1 on 1 call today,  I was told that though unlikely, HSV2 can possibly be transmitted via kissing & giving oral sex & the recommendation was that during this waiting period, & while the mild stinging is still present (and it is), even protected sex was discouraged.  My last question is what are your thoughts about that advice? (I am assuming it was full disclosure, and erring on the side of extreme caution against spreading virus. Do you agree & stand by your risk assessment for each type of intimate contact in your previous reply? Trying to better understand any gray areas here). Thank you, again!
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
52 months ago
So the risks that you are talking about involved having HSV 2 orally.  That just doesn't happen often and when people do get infected orally with HSV 2, shedding is very uncommon - about 3 days out of a year.  So though no one can tell you it is impossible to transmit from your mouth, it is extremely unlikely.  We can't say it is zero.

Terri
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