Concerned about having contracted Herpes from being rimmed

[Bikal82]

37 yr old gay male here. Back in late January 2020, I (stupidly) received a rimjob from someone I met online. The rimming lasted for probably a few minutes. Flash-forward about a month later and I notice a sore spot up from my anus (closer to the actual butt cheek as opposed to right near the anus) which was only really visible under close inspection (a miniscule open sore but no blister or ulcer). I have suffered from pruritis ani and prostatitis/CPPS for many years so I at first put it down to this (I have a tendency to scratch that whole area).
The patch of skin involved is reddish in the surrounding area but does not present in the same way as a lot of the pictures of herpes I've seen online - it is more like tiny tears that are weeping a clear/yellow fluid occasionally.
It seemed to go away/clear up (the first episode), but then it feels like every 2-3 weeks it pops up again. I realise that it's come back as it's a sharp stinging sensation with the affected area quite raw and reddish. It reappear always (thus far) in the same spot. My questions are:

1. If I have HSV1 orally already (I must, as on rare occasions get cold sores and have for many years - I presume it's HSV1 but do not know with certainty) is it possible for me to have possibly still contracted another strain of HSV1 from the rimming episode? Or possibly HSV2? I would presume that the guy that rimmed me, given his age (late 50s) was also positive for HSV1, meaning it'd be unlikely for him to have HSV2 orally and therefore to have given me HSV2 from oral-genital contact. Would this be a logical conclusion? My fear is that I've developed *some* immunity from having already acquired HSV1 orally many years ago, but that I still managed to on top of that also acquire HSV1 genitally via another strain. And this other strain is (perhaps) manifesting via minor outbreak/s that's relatively asymptomatic (presumably as I have antibodies to prevent a full blown outbreak).

2. I have had a doctor do a swap of the area but am yet to get my results (and am fretting in the meantime). If the swab was taken whilst the sore was active (which it was), and it comes back negative, would this mean 100% it's not HSV?

3. I am not sure if this is coincidental but worryingly, I also seem to have gotten a headache at the onset of the symptoms (symptoms being: sore patch, seeping/weeping fluid, some leg soreness). I also had major leg pain (dull aching) one night (only the once) that lasted for a few hours. Would the fact I've had headaches at around the same time as the onset of the tears/stinging/pain not bode well for it being something other than herpes?

4. If the spot/tears appear to come and go every 2 or so weeks (which is what has been occurring - it seemingly heals only to pop back up again), is this typical behaviour of the herpes virus? Or would it appear, clear up, and then lie dormant again for a few months before rearing its (ugly) head again?

5. Are there any other conditions you can think of that could possibly give similar symptoms as the ones I've experienced, but which are not herpes-related? Could it be some sort of infection? I just find it odd that the symptoms appearing about a month after the sexual encounter link up with it, which is what leads me to suspect it might be herpes.

Any advice/help would be appreciated.

[auntiejessi]

You are overthinking this.

1 - If you have hsv1 orally already, even if you got another strain of it, your antibodies would protect you from getting it in a different location. It would be very rare for you to get it genitally. The only exception might be is if the person rimming you had an active outbreak at the time, which you don't mention.

Oral hsv2 is rare, and when it happens, it rarely recurs and rarely sheds, meaning it rarely transmits to others.

2 - How old was the sore? The cultures are most accurate within the first 48-72 hours. If this was a PCR swab, that's far more sensitive than a regular culture, and can be done on sores far older.

3 - Headaches can be caused by so many things, including stress and anxiety. I wouldn't worry about that as related to herpes. It could also be related to something else that is causing these sores. I don't know what the major leg pain was, but if it only happened once, and you've had these sores recurring, I wouldn't relate that, either.

4 - Recurring this often is very frequent for herpes, even with a new infection. I'd expect by now that even if it was hsv2, you'd have antibodies to help keep it in check.

5 - I'm not a derm expert, but maybe MRSA or staph, hemorrhoids, skin ulcers. When you say it opens - does it bleed? Herpes doesn't bleed, but hemorrhoids can. Also, you said this started a month after the encounter - that's a long time for herpes symptoms to appear. Typically, they appear within 2-12 days, with 4 days being the average. Obviously, that's not a hard rule, but appearing at a month would be atypical.

When do you get your culture results back?

[Bikal82]

Thanks so much for your detailed responses.

It has put me at ease although I'm again (as we speak), a mere x2 weeks since the last lot of symptoms, experiencing another "breakout" where the skin around my anus is broken/split and tiny ulcerations of red (only visible when I shine a torch/light right on) are present. They glisten and seem to weep ever so slightly.

I got a call from the clinic to advise me that they used the wrong swap when they took the culture. They said if I'm still having issues I'll need to make another appointment and go back to get it done again, which I will do.

The fact that the last bout cropped up x2 weeks ago, and went and is now back, makes me think it's some type of psoriasis perhaps. I'm really not sure but it definite is uncomfortable and I always seems to get a massive migraine prior to the onset of the sores which I find suspicious.

Thanks again for liking at my individual case and responding so comprehensively. I really appreciate it. I will keep you updated as to the result of the swab when I get it re-done.

Many thanks!

[auntiejessi]

I'm so sorry about the testing. How frustrating.

Can you go now and get it re-tested? Ask them to do a PCR swab on it, if they can. Those are far more sensitive than a regular culture, and aren't as time sensitive.

Good luck, and keep me posted. I hope you feel better soon!