Hello doctors. I initially asked a question about 10 days ago and Terri answered my questions. Not sure if Terri will be assigned this question again so I will give a little bit of details. 18 days ago I had protected vaginal sex at a massage parlor which lasted about 5-7 minutes. The condom slipped a little during sex. This was my first sex partner besides my wife in almost 20 years. Initially I thought condom sex was safe for all stds as long as the condom doesn’t break. I now realize that is false. I was mostly worried about herpes as condoms don’t provide complete protection. As time went on and two weeks passed I thought I was in the clear for herpes. However, 2 days ago I started having bad headaches and significant neck pain and stiffness. And then last night I started having body aches, fever, and chills. My wife and I haven’t left the house in a week so I doubt it is some other infection like flu causing my symptoms. I also have no runny nose, no sore throat, and no cough. Just the body aches, fever, stiff neck, and headaches.  I am now worried this could be the precursor to a herpes outbreak. As of now I have no obvious lesions. My questions are as follows:

Hello again. I am providing a quick update. Please also answer my questions in my above post. I saw my doctor today who thinks I have a mild case of meningitis. He came to this conclusion based on my symptoms along with the stiff neck. He also thinks that because I do not have typical ‘sick’ symptoms that it is very possible this is herpes meningitis. He says it fits my timeline. He also said that he has seen herpes meningitis without genital lesions. I tested negative for flu and covid-19. He said I could get a spinal tap but I really do not want to do that. Today is day 19 and still no obvious lesions. However, I still have the body aches, stiff neck, headaches, and fever. I feel like the severity has decreased slightly. Neck pain and headaches started on day 16. Fever and body aches on day 17. What do you make of all this?

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I’ll briefly add to the comments Terri has already made. I agree entirely with her assessment. I also respectfully disagree with your doctor that this is suggestive of HSV meningitis. On the other hand, it may well be a so-called “aseptic meningitis” which is most often caused by a wide variety of viral illnesses of which HSV is one. The likelihood however that you have HSV is very low for all the reasons that Terri’ has told you. ---

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Thank you both for your replies. I ended up going to an STI testing clinic on day 21 and my results just came back. I am negative for all stds except IGG positive for both HSV1 and HSV2. The numbers were 1.2 for HSV1 and 2.96 for HSV2. I still don’t have any obvious herpes lesions, but there are some small red bumps at the base of my penis that have popped up. They don’t look like typical outbreaks tho. Obviously this horrible news and very distressing. I just had unprotected sex with my wife last night.  I literally can’t believe this has happened to me after just one condom protected mistake.

I would be extremely reluctant to believe these results at this point.  While it is possible that you had herpes in the past and this test reflects an old infection, I know that both of us don't feel you acquired HSV from this encounter.  You need a herpes western blot to confirm these test results.  You are in what we call the low positive range and the CDC definitely recommends a confirmatory test for anyone in your test result range (1.1 to 3.0).  I suggest that you keep a close eye on your wife and any symptoms that she might have during the next 10 days.  I can help you with the western blot at westoverheights.com.  Please don't panic yet, OK?  And by any chance, are you a first or second generation immigrant to the US?  We are seeing many more false positive in this population.---

Thank you for your reply. I am not a first or second generation immigrant. I am Caucasian and 43 yrs old. I have a few additional questions as I process this and decide how to move forward:

Oh and I should add that this testing was done through quest diagnostics. Not sure if that makes a difference.

Quest labs have a 57% false positive rate if your index value falls between 1.1 and 3.0. that's HUGE---