Herpes Symptoms

[Nick2013]

Hello HHH,
Please help me in evaulating my problem .
I'am a male 32 yrs old .
Exposures :7-8 times had been to a Strip club .
1) The stripper fingering herself  and then giving me HJ .
2) Blowing on the penis with me wearing Clothes .
3) She also used Saliva for HJ
4) Using towels to clean penis  which may have been used by others.

My last exposure was 2 yrs back

Symptoms :
1) 3 days after the last exposure i found there was a  wound .I'am not sure if it healed with a scab .Probably
it took around 2 weeks to heal.
2) 2 months after this wound    there was a small nodule inside the skin and after 7-10 days
i saw there was white bump above the skin . My school's Dr had a look at it and she said it's not herpes .
2 days after that there was small hole on the dome of the bump and 2 days after this bump was gone .
The area  had now become red in color.
3) In past 2 yrs i had around 3  anal fissures in the midline .There was a gap of 6months to 1 yr for every fissure appearance.
This normally lasts for 2-3 weeks .
I had Dermatologist look at this once but they said it's not herpes .
4) Also i have intense itching sometimes in the scrotum or sometimes in the anal region .This normally lasts
for 2-3 weeks . I had this kind of symptom 3-4 times in the last 2 yrs .
I visited the Dermatologist once but they could'nt find anything as the skin
was normal .
5) Regularly i have started having tingling/itcthing in anal/scrotum/penis region but occasionly
it becomes extreme as mentioned above .

The last HSV test was after 1.5 yrs of exposure with HSV-1 & HSV-2 -ve

what are the chances that i have genital HSV-1/HSV-2  as i have read most of the times
they are asymptomatic ?  Also i have read there could be microscopic lesions in herpes .
Should i go for Western Blot ?
Can this be any other STD's ?
Was there any risk for any other STD'S with this exposure ?  

Since the tests are only 75% reliable  will i never know if it is herpes until i see lesions /sores  ?

[Edward W Hook, MD]

You can't give it up, can you.  Final answers:

1. autoinoculation rarely spreads HSV and when it does it occurs in person's expereincing intial outbreaks.

2.  No, this would be a worthless experiment in animals.  The FACT is, it is not a concern for those of us who have taken care of thousands of PEOPLE with genital herpes.

This in no way changes my advice or assessment.

There will be no further answers. EWH

[Nick2013]

Thanks for all the replies Dr .
This would be  my final questions in this  thread  .

1) what is the difference between autoinoculation which happens mostly during intial outbreak where HSV Persons are advised not to touch the lesions and then touch eyes or mouth which might lead to spread of infection

and
in this scenario where CSW has an outbreak and she touches the vagina and immediately penis  for masturbation.
The reason why i say it i saw three bumps on her vagina but i'am not sure if it was herpes .

2) Are there any studies done on animals to prove that such spreading of infection don't happen

3) Does  this change you advice .

Thanks for all the help again .
Take care  

[Edward W Hook, MD]

More "what if's" - you can't leave it alone can you.  Still no evidence or experience to suggest this is a realistic scenario.  No change in my assessment or recommendation.  EWH

[Nick2013]

Thanks for the reply Dr .

I have read number of your's and Dr HHH's replies about hand-genital contact that you both have never seen such a case  and it's a safe sex .
But in the scenario the stripper has an outbreak in vagina and she touches the lesions and then touches the penis  will it not lead to Herpes in the recipient  ?
or is it that only in the primary outbreak the lesions  have virus and all subsequent outbreaks the amount of virus in the lesions will be comparatively less   which can cause herpes to the recipient .

[Edward W Hook, MD]

No, these symptoms are not suggestive of HSV. They could be due to any number of things, including increased attention to sensations as you looked for signs of infection.  Asking "if it is herpes" questions makes no sense since it is so unlikely to be HSV. "What if" questions are of little help.  

No change in my assessment or advice. EWH

[Nick2013]

Thanks for the reply Dr . But looking at the symptoms like itching or a single bump or fissures that i have explained in my comment earlier does it show the symptoms  of Herpes . If  regular itching is not a symptom of Herpes is there any  other reason i can have such symptoms  ?
Even if it is herpes is it more likely to be HSV-2 or HSV-1 ?
Should the itching  always be at the same spot can it be anal , scrotum or penis or it's surrounding regions . I was off the impression it's more concentrated but i get itching at all the above  places  listed .

[Edward W Hook, MD]

Welcome to the Forum.  Your post suggests to me that you have been worried about herpes for several years, at least, that you have sought professional attention on several occasions about the possibility of herpes and been told that the concerns that took you to the doctor were not suggestive of herpes, and have tested for herpes with blood tests which were negative.  Since you are so worried, I should ask, why? and what would you do if your tests were positive?   If you had been found to have herpes, it should not meaningfully change you or your life with others.  

None of the activities you describe as occurring during your 7-8 exposures to commercial sex workers carry any meaningful risk for acquisition of herpes.  Not masturbation, not saliva exposure during masturbation, not having possibly (but probably not) used towels used to clean you up.  

Finally, I would advise you that further testing for herpes is a waste of time.  While, as you point out, the diagnosis of herpes is not precise, when you have multiple sources of information which all lead you to the same conclusion, the power of the combined observations become enormous and should be considered reliable.  Further testing for herpes, based on the information you have provided is a waste of time.  

I hope you find this comment helpful and that it will let you move forward without concern. EWH