[Question #9460] Follow up concern

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32 months ago

Hello doctors, thank you for providing people with your expertise it is truly appreciated. Reading your responses and insights provides great relief. I had posted here before as I was concerned about HIV or Herpes. I am still very much concerned about potentially having hsv2. I have posted on Terri warrens site and had a video consult, but have been unable to renew my subscription to ask my follow up questions. Brief summary: I have had hsv1 for a few years but never had a cold sore. About 7 weeks ago had an exposure. Unprotected oral sex and protected vaginal sex but the condom broke at some point. Noticed that the sex worker had bled a little bit. Since then my main symptoms have been clear thin discharge after urination, doesn’t happen every single time, but noticeable and has been going on for 7 weeks. Stream seems weak and not smooth at times. I have a lot of urine that remains in the urethra after urination and a lot of post urination dribble. Something has just seemed off in my genital area for 7 weeks now. No pain at all during urination or ejaculation. Post ejaculation I notice tip of my penis gets red and seems dry. I have had sporadic pain that lasts a few seconds and then goes away in my pelvic region, lower abdomen, testicles and rarely my groin. I can’t tell if the lymph nodes in my groin or swollen or not, they are not tender to touch they aren’t red or noticeably raised. I haven’t had any lesions or sores develop but I feel like Over the past week and a half I have noticed more sporadic pain in pelvic area lower abdomen and sometimes groin. I have tested 3 times from exposure. 

4 days from exposure : hsv1 - 1.8 hsv2-  .1

4 weeks from exposure hsv1 - 1.8 hsv2- .1

6 weeks from exposure Hsv1- 1.4 hsv2- .2

The woman I had sex with was tested about 3.5 weeks from our encounter and she sent me her results. She told me her doctor said she was negative for everything but when I looked her igg for hsv1 and hsv2 were both .9. I understand that this could be equivocal but it didn’t say negative or equivocal on the test. She is not even concerned in the slightest she has anything and believes she’s negative as her dr has told her so. Teri warren thinks my whole situation and symptoms have nothing to do w herpes. I’ve seen 2 doctors at urgent care who don’t seem concerned and I’ve seen a urologist who doesn’t seem concerned either. 


I have been losing my mind with anxiety and depression. My questions are as follows: should I be concerned about the .1 increase in hsv2 from 4 weeks to 6 weeks? Can you explain lymph nodes and it’s association with a herpes infection like should sores be present if I’ve had sporadic pain? Would it be weird to be having my urinary symptoms for 7 weeks if it was herpes related? I am trying everything to believe I am negative and that maybe this has to do with my prostate but I am unable to believe anything until I have definitive proof. 


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Terri Warren, RN, Nurse Practitioner
32 months ago
It's Terri again. I answer the questions on this board as well.  Your post was initially viewed by Dr. Hook, but he referred it to me as it is about herpes.   I'm sorry that you continue to struggle with this.
It is likely on your partner's HSV test that there is a "<" sign in front of the 0.9 value.  That is how negatives are reported out on the IgG test by many labs.  Some labs give an actual negative value, but most often, it will be reported as "<0.9.  So the partner tests negative for HSV 2.  Her doctor is correct - she is negative.

You are also negative, and the change between 0.1 and 0.2 is in no way significant.  That is completely normal to vary slightly in the negative range, but you are solidly negative at 6 weeks out.  By 6 weeks out, 70% of those who will be positive on the IgG will be so.

Lymph nodes in the groin area can increase in size and/or be tender for any number of reasons - a hang-nail on a toe, a bad batch of mosquito bites, or anything that is troubling in the legs or feet or groin.  As I think I told you before, herpes symptoms would not last for seven weeks.

You have had no sores consistent with herpes, your partner tests solidly negative, you test negative, and yes you seem to still not believe that whatever is going on with you in not related to herpes.  The only other thing I can suggest to help you get past this is to obtain a herpes western blot antibody test.  I don't know what other "definitive proof" will help you settle this in your mind.

Terri
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32 months ago
Hi Terri, 

Thank you for the response. I tried to follow up on your site initially. I sent an email I renewed but when I went to respond it said I needed to renew again.   I definitely plan on doing the western blot. Do I have to wait until week 12 to do it or am I able to do it Sooner? I understand that lesions would typically appear 2-12 days after exposure, would it still be possible for lesions to appear after 7 weeks? I have been getting random like discomfort (not burning or tingling) but it lasts less than a few seconds and isn’t in just one particular spot, would any itching or discomfort associated with incoming lesions be sporadic like that?
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Terri Warren, RN, Nurse Practitioner
32 months ago
You can do it whenever you want to do it, but it is most accurate if you wait 12 weeks after a concerning encounter.  You can also do it now and repeat it - whatever works best for you.  It would be possible for lesions to appear 7 weeks later, yes, though unusual.  if you want to reach me, do info@westoverheights.com and we'll get it going.

Terri
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32 months ago
Good evening and happy holidays. 

I noticed I had a reply left so just wanted to update with a few questions. I got tested again a day shy of 9 weeks. It remained at .2 igg same as the test at 6 weeks. I am concerned because I woke up today with 4 different red spots - 2 in the same area on the back of the tip of the penis and another on the tip of penis as well as one on the backside of the shaft. None have caused me itching burning or tingling. I went to urgent care to see if I could get it swabbed but they said there is nothing to be swabbed. Should I take  my igg being the same from 6 weeks and 9 weeks as it being negative? Would I be higher if it were to ultimately turn positive at 12 weeks? This has been a living nightmare for
Me. I plan on my next test being the western blot at 12 weeks. 
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Terri Warren, RN, Nurse Practitioner
32 months ago
I think there is no point in testing further with the IgG test.  Just wait until the 12 weeks and do the western blot for the most definitive answer.  The red spots do not sound concerning to me

Terri
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