[Question #986] Follow up to Question #927

50 months ago
Hello Terri,

Yes, I see a NP nearby. When she gave me the swap test, I asked if is it a PCR.  She wasn't so sure about it, but from the report I obtained it looks like cultural. I might have to find another provider for this, and consider about the urgent care option you suggested.

This is day 20 since I found out the rash. About a week ago, I completed my 10-day treatment. I initially thought the lower abdomen pain is the side effect of the drug. But I recently notice it is more like a bladder pain and I also started to feel discomfort at the tip of my penis (I had theses symptoms before but not as server as this). 

Upon further inspection yesterday, I found new rashes and a flat white spot (more like a discoloration) at different locations on the glans from the last outbreak. I consider myself have a good personal hygiene, but it didn't smell pleasant down there.

I understand it can take about 3 weeks for the virus to go into dormant. I am not sure are these symptoms related to other problems, and I don't know shall I go back to see my NP or go to see an urologist. Do you have any suggestions? 

Thank you. I look forward to hearing from you soon.


Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
50 months ago
If the new rashes are significant and worrisome, I would suggest that you see a dermatologist for evaluation.  The odor is also concerning and you may wish to evaluated for trich while you are being seen.  The urologist might be helpful for that issue.  Remind me - was the swab test positive or negative?

Terri
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50 months ago
The swab test came back negative. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
50 months ago
OK, so if you are concerned about this rash, go be seen again.  Herpes lesions don't have an odor.

Terri

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50 months ago
Hello Terri,

Thank you for your help so far.  I went to see my regular provider, and she said my penis looked fine. I am clear for UTI, and was told to wait to be evaluated for trich if the bladder pain and irritation at the end of the urethra persist. I understand I might need to wait for new lesions to get a PCR swap test. My questions are,

1. If my symptoms are related to GHSV1 infection, how long does it take for them to go away? The physical pain causes emotional pain for me.
2. Continued from Q1, will Valtrex alleviate the bladder pain and irritation?
3. Based on my sexual history and you said I did not acquire HSV1 from the mutual masturbation, do you think shall I disclose about my conditions for sexual activities like kissing, mutual masturbation, frottage and massage before it gets confirmed genitally?
4. If I would like to lower the possible risk to infect someone else, do you recommend taking suppressive therapy?
5. Continued from Q4, will it also reduced OHSV1 shedding, if I have it orally?
5. Are there any other medical conditions (e.g. allergies to bacitracin and Neosporin I applied or yeast infection) can be misdiagnosed as herpes? Do you think any of it shall also be ruled out for my case?

I appreciate your feedback a lot, and I look forward to hearing from you soon.
 


Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
50 months ago
1.  Most HSV 1 outbreaks resolve in a couple of weeks.
2.  Herpes doesn't cause bladder pain so no, it won't
3.  no, I don't think that is necessary
4.  If you had herpes, suppressive therapy would reduce the risk of transmission,yes
5.  yes
6. Yeast can be misdiagnosed as herpes, yes.

Terri
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49 months ago
Hello Terri,

The pain persists for another week, so I went to see an urologist for my bladder pain and rashes. The doctor's diagnoses are bladder spasms and yeast infection (He said it's common for uncircumcised men). I was prescribed Flomax and asked to use Clotrimazole cream for my rashes. 

We talked about my concerns about herpes. He also agrees the mutual masturbation contact is minimal, and given high prevalence of HSV1 in Asian population and the symptoms/sexual history I described, he thinks the blisters I had experienced are folliculitis. 

Since I don't have a baseline test to compare and no symptoms of cold sores as far as I can remember, if I really picked up HSV1 from the mutual masturbation, are 10 days enough for antibodies to be detected from an IgG test? 

I'm a little confused now. First the autoinoculation and now folliculitis. I know I will have to live with uncertainty without another outbreak. I feel obligated to tell my potential sexual partner if it's GHSV1, but as for now, I don't know what shall I say. What's your view on this?

Thank you for all your feedbacks so far. They help me to navigate around this topic a lot. I look forward to hearing from you again.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
49 months ago
I think you are under no obligation to tell partner you have genital HSV 1 - you have no idea if that's true! 
10 days is not enough time for an accurate antibody IgG test, but the IgG test is also not a great test for HSV 1. 

Terri
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