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Avatar universal

Disseminated herpes?

I am 39 yo male. In early Jan, right after a high risk sexual encounter, I started feeling itching, stinging and burning mainly in the anogentital area. One month later I had several episodes of mild burning and pain on urination, and developed low grade fever (99.5~100.5F) everyday mostly in the afternoon, associated with fatigue and night sweating. My PCP ordered a series of test, including blood and urine culture, STD panel (syphilis, GC, chlamydia, HIV, but not herpes), all came back negative. He prescribed antibiotics (Levaquin and doxycycline) for around 2 weeks, which did not help. In the end of Feb, I got herpes test: HSV1 IgG (+)>5.0, HSV2 negative. I never saw obvious blister, so never got swabbed. I was started on Acyclovir for 10 days and then switched to Valtrex 1 gm twice a day. The fever stopped. But the itching and burning remained, and spread to all over the body. In March, my eyes started itching and pain. My eye MD did not see any lesion in the cornea, and prescribed artificial tear and anti-allergic drops, which were of little help.  About one month ago, I noticed some red pimples in my scalp which are very itching and sometimes very painful. Shortly afterwards I started feeling dizziness and headache, located mainly around my eyes and the temporal areas. In the past 3 months, I saw several doctors including ID, dermatologist and ophthalmologist, none of them could give me a definitive diagnosis, which is really frustrating. But I am 100% sure I got herpes. I tried to stop valtrex for a couple to days, then the fever came back. After resuming valtrex, the fever and diarrhea resolved the next day. I also tried increasing valtrex to 2gm twice a day, and was feeling almost completely well. I am really worrying that I have contracted disseminated, drug-resistant herpes, including ocular herpes and herpes encephalitis, and don’t know what to do. I am currently still taking Valtrex 1g twice a day, but feeling that it’s not working. I am considering increasing it to 2g twice a day again, which seems the only way that helps. Meanwhile, I am concerned that this may cause further drug resistant. What should I do now? Please advice and help!!!
3 Responses
Avatar universal
You have had HSV1 since your youth, almost no doubt. Do you remember having oral cold sores?

Hence the only risk is HSV2. A negative at around 7-8 weeks is close to 90% sure you are negative.

Further when you have already HSV antibodies in your body, guess what the symptoms are if then infected with the other type? Pretty much nothing. So much so that 75% of people infected this way cannot remember any symptoms.

So good news here, there is now only a minimal chance that you'll discover you are infected with HSV2, I'd be comfortable enough to call it negative.

Your symptoms are not related to a herpes infection. Stop the Valtrex, no need for it.
Avatar universal
Thank you so much for your reply.

I don't worry about HSV2, but HSV1. I am not sure if I ever had cold blisters when I was a kid. But I am quite sure it's HSV1 this time. Because of  the high titre to IgG in blood, the symptoms. I cannot find an alternative explanation for all what I have been suffering (itching, burning, low fever, eye inflammation, papules all over including scalp, dizziness, headache, etc. ). Anti-viral seems working partially at least, while antibiotics did not help at all.

I am currently mostly concerned about my persistent dizziness, headache around the eyes and the temporal region, which is worse at night. I thought I did not have full-blown encephalitis just due to the suppression effect of valtrex. I am worrying that if I stop it, I will experience an catastrophic progression of the disease.

I  started 2g valtrex twice yesterday, feeling better during the daytime , esp. the eye pain. But the headache was still bad last night. Now I really freak out.  




Avatar universal
Then please seek medical assistance for persistent headaches. Most likely if this is an issue, it will be something other than HSV1. Viruses such as CMV are much more common at causing problems such as what you describe.
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