[Question #997] suspect herpes and testing

52 months ago
Hello, I noticed 2-4 pimple like lesions (red, flesh) things in Sunday morning. I am confident that it was not there Saturday.  Went to see the dr on Monday.  Doc took swab and said suspicious for Herpes, but was not sure. Almost no  pain, except  vague, infrequent discomfort. Doc touched the lesions and no pain at all and no puss/liquid. 
Also went for a 10 panel blood work on Tuesday morning. After the blood work, stared taking antiviral. 

Both culture test and igg bloodwork (hav 1/2, all other STIs) came back negative (results came back in a week). After 3-4 days, no pimples .. Just a red bump with some yellowish tail in the middle and healing.. It has been 10 days and it has not completely healed, but looks better...still no specific pain, no fever. Lymphnodes do feel little sensitive once in a while...

No sexual contact with anyone for at least 5-6 weeks before this situation..all sexual acts have been with condom...

What are your thoughts and recommendation for next step? Should I consider hsv negative and not worry or ???????

Thank you.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
52 months ago
Red fleshed colored bumps that don't hurt with pressure and no fluid are unlikely to be herpes but clearly I can't say for sure.  If the IgG blood tests were negative, that's good thing - more accurate for HSV 2 than HSV 1 but still a good thing.  However, we like 12 weeks for the final blood antibody test for herpes from the date of any concerning encounters.  If you continue to take medicine, it may impact the results of the antibody test.  A negative IgG at 6 weeks has a 70% chance of staying that way.  But your odds are likely even better than that because your sex acts were condom protected.  I would say that the chance you became infected with herpes at this encounter are low.

Terri
---
52 months ago
Thank you. It is appreciated. Some follow ups just to clear my head:

A. After reading your answers, I remembered a brief oral without condom sometime in March when female was on her periods..... Does that pose risk for hsv 1? Also since it was that long ago, should I not develop antibodies? 

B. You said  blood test in not accurate for HSV1? What is recommended? Culture test was also negative and it was taken about 30-40 hours after the first sign of lesions..

C.  I am not an expert on the type of lesion..Dic  pressed it pretty hard with th swab.... Did not hurt... He said it did not look like fluid but in his word does look suspicious.. But also could be molliscum? I have had some pain (more discomfort) when the wound rubber against my underwear.. .. May be 1 on scale of 10.

D. I rechecked the timelines.. It actually was close to 8 weeks (1 day short) from the last exposure - which was just intercourse with condom..

Based on the above, is your recommendation to get the igg blood work done at 12 weeks?  Is this confirm  both types? How can I make sure it is/is-not HSV 1 or 2? 

E. Also, culture test  was useless then?

My biggest question is What do I tell my regular partner?
 Thank you. 

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
52 months ago
1.  so you were the giver of oral sex to someone else when she had her period or she was the giver to you?  If she was the giver to you, there is a small risk of HSV 1 but if you were the giver to her, the risk would be lower for HSV 1 acquisition.
2.  The western blot is more accurate for HSV 1 than the ELISA test
3.  I wondered about molluscum also,  possible, though those bumps are normally flesh colored and are in my opinion pretty distinctive.
The IgG at 12 weeks is the most accurate though this sounds little like herpes - your call, depending upon how much certainty you want.  If your doctor hadn't said "suspicious" about herpes, I would feel more reassured, wouldn't you?

Terri
---
52 months ago
Thank you.

So, it does NOT sound like Herpes to you?
I will ask my Doc for the HSV1 western blot test? Should that also be done at 12 weeks?
Doc said it was suspicious .. But, after culture test..He said not to worry.. It probably is not!! 
If it is Herpes is it more likely that it is HSV1 vs 2? 

In your opinion, should I abstain from any sexual activity until all these tests are done at 12 weeks?

Thank you very much.

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
52 months ago
The western blot is a specialty test that comes only from the University of Washington and you can order a kit from them to have your doc draw your blood and ship it to them.  It is NOT a test that can be ordered routinely through your doc.  I couldn't say about the type if it might be herpes at this point, sorry.  The WB should be 16 weeks out from a risky encounter, another IgG 12 weeks out.

Terri
---