Possible Herpes ?

[verynervous565]

Hi Dr.

I was on Vacation in Thailand where I was in a situation where I drank a bit too much and had a one night stand.  I performed manual stimulation on him first where he ejaculated.  We then proceded to have intercourse and a condom was used.  This incident happened on Nov 24.    The day after the incident I experienced an upset stomach with diarrhea and a sensation of urgency to urinate.  These symptoms only lasted about a day.  Since travelling home on Friday (24 hrs of travelling). I have have been experiencing extreme fatigue, nausea, diarrhea ... and on Sunday Dec 2  I stared having a strange burning sensation in my right inner labia close to the opening of the vagina and upon my own examination it appeared red and a bit inflammed on the right side only.  I also have a fissure like cut between the skin on my anus and the vagina (perhaps from the diarrhea).  When I pee it burns a little when the urine hits the fissure and the lower par t of the vagina.

I am scared to death that I have Genital Herpes as I have been reading so much on the internet that points my symptoms towards this.

I went to a sexual health clinic yesterday (mon dec 3) where a nurse practioner did a vaginal exam. She stated that she did not see any lesions or sores but that the labia, but that it appeared red and a bit inflammed.  She decided to do a HSV 2 swab just in case ... and because I was so petrified I basically made her test for it.   She also swabbed for BV and tricamonis (which she said didnt think it was ).    

She was not able to tell me one way or another whether it was herpes or not. She said she has seen cases where herpes were evident before swabs were even done. But in my case she said its inconclusive until the swab results come back in a week to two weeks! So i guess its a 50/50 shot.  What do you think ?

I am very scared and in my gut believe herpes is what this is... as my symptoms seem to point towards this

Any advice or support is appreciated

[Edward W Hook, MD]

If the inflamed area was due to HSV, I would anticipate a high probability that the test would be positive.  

I would not recommend a HSV blood test at this time. the antibody tests are not typically reliable enough to count on their results in situations such as yours and the rates of false positve tests are rather high.  

Take care. EWH

[verynervous565]

Dr Hook,

Thank you so much for your reply! I am definitely someone who can over react especially when it comes to something like this. And yes I am in total regret and guilt of such a terrible decision. I was in a serious 7 year relationship which ended a while ago and I guess i just used this incident to get over it perhaps. Big mistake. However,  I do blame the internet for almost sending me to the nut house.  I believe the internet could probably convince you that you were dying if you believe everything it says. I have since refrained from googling every herpes symptom and have just focused on this forum that is providing me much better advice and is calming my nerves.

Just one more question though... if there were no bumps to swab and the nurse just swabbed to inflamed labia could this still provide accurate result of hsv 2 exposure ? or should i look into the blood work antibody test? Although ive heard that test can reveal some false positives at times.


this will be a tough week of waiting for results

thanks so much Dr.

[Edward W Hook, MD]

Welcome to the Forum. Become replying I read through your earlier interactions with Grace on the HSV Community site and I agree with the counsel she has provided.  From reading your posts both above and there, my sense is that you are over reacting a bit- perhaps from some combination of guilt over what, in retrospect, may not have been one of your best decisions.    That said- please know that you are doing everything ( well, almost everything- I would urge you to stay off the internet) right- you used a condom and have been checked by a trained professional who sounds as though she did a good and thorough evaluation.   I anticipate that you will find that you were not infected.  Having said this, let me now provide a bit of perspective.

This was a low risk encounter.  You do not know that your partner had HSV or, for that matter, any other STD and even if you did- even most unprotected exposures do not lead to infection and you used a condom (again- good job).  The symptoms you had the day following your exposure were not due to any STD, including HSV- there are no STDs that cause symptoms within 24 hours of an exposure.  As for your subsequent symptoms, they are more likely to be due to a combination of the rigors of your travel and perhaps local irritation from your diarrhea and self-examination than form HSV. Had it been HSV, while inspection is not perfect, that the clinician who saw you saw nothing of the concern moves things further in your favor.

I urge you not to worry. At this point you have done everything right and things are out of your hands.  Try to stay off the internet, stop what Grace sometimes calls "the crotch watch" and wait for your test result, knowing that your risk is low and you have done things correctly.

I hope my comments are helpful to you. EWH