HSV sypmtoms

[Worriedman81]

I had a sexual encounter on or around Jan 5, 2008. It was protected but I am now led to believe that it was a goat skin condom. About 17 days later, I felt my left testicle pop inside as I lean down to put on a sock. Immediately I felt a sharp shooting pain. As I look, I see what appeared to be my left testicle not in my sac but up in my groin. So, I push it back down and the pain stops. About a day later I notice that the left side of my scrotom is swollen and mildly tender. A couple days later this progresses to a sore pain on both sides of my pubic area. Then I start to feel mild burning on my penis. I went to see  a doctor who seemed to think it is a hernia.  When I told him my concern for an STD, he gave me Rocephin with some azyhtromax. Then he ruled out herpes by visual inspection (I have no blisters or sores) and the fact that I am not having any difficulty urinating. The day after that, I start to feel more burning and tingling on my penis shaft with malaise, so, I go to Quest to get the IgG and IgM blood work. The test were ran on Wed the 30th of Jan. So, about 25 days later, my blood test for HSV IgG type 1&2 were both negative and so was my IgM. After reading many forum posts on this blood test, I get the impression that the IgM is a poor test. It is now Feb 2, and I still feel malaise with some fatigue and burning in my groin. And, I am worried because I though these test were accurate.

Questions:
1: Can hernias cause these symptoms?
2: I do not have any blisters, ulcers or discharge, but just burning and tingling in/on my penis shaft. I haven’t taken my temperature but feel warm, malaise with dry eyes. Does this sound like herpes?    
3: I know that the IgM test is hard to interpret, but what if I am testing negative for everything…even HSV type 1?
4: Could my hernia have catalyzed my initial outbreak of HSV or am I just worrying too much?

Thank you so much, this forum is extremely helpful.

[Edward W Hook, MD]

I do not doubt that you are experiencing the discomfort you describe.  At the same time, there is nothing, including your most recent test results that suggests that this is herpes (or, for that matter, any other STD).  My advice is to work on this with your doctor.  If he/she is not sure as to what is going on the proper thing to do might be to have you evaluated by a urologist (could this be kidney stones) or a neurologist (some sort of neuropathy?)  either way, once again, the problem is not herpes.  Hope this helps and good luck with other clinicians.  EWH

[Worriedman81]

Hello Dr.
I took your advice and consulted my family practitioner about my ongoing concerns of herpes. He said basically the same thing as you did, that this does not sound like herpes. He then sent me to get and ultrasound to check for any obstruction. It all came back negative. Now I am at eight weeks, the burning sensation on my entire penis shaft has come back (it subsided for about two weeks). I've noticed that I now have inguinal lymphadenopathy with pelvic and lower back pain that radiates to my buttocks and lower legs. I still have no blisters or ulcers anywhere, no trouble urinating or no discharge. Right at about eight weeks I got another Igg type specific test which came out pan negative again (<0.9) for HSV 1 and 2. I can honestly say that these symptoms are not psychological because they really do hurt.  I understand that my first description did not sound like herpes, but what about now? I am worried because since I tested negative and was told I didn’t have herpes, I began to have sex with my girlfriend. It was protected vaginal, however, unprotected oral.

[Edward W Hook, MD]

This is not herpes.  It does not conform to the way herpes begins.  You have  had negative tests for other STDs.  Anxiety over such things however may cause such symptoms.  I would work on this with your helath care provider. It is not an STD!  EWH  

[Worriedman81]

Days later and I still have burning and tingling in just my penis. Is there anything else besides herpes that can cause this?

[Edward W Hook, MD]

It sounds as though your main concern should be the testicle and problems associated with this rather than STDs, including herpes.  Your initial symptoms do not in any way suggest STD and are quite suggestive of a mechanical problem such as a hernia.  This needs to be attended to.  My suggestion would be to go back to your doctor, discuss the continuing concerns and see if he feels that you should see a surgeon or urologist.  As for your STD concerns, even a non-latex condom offers protection, just not quite what is achieved with latex or polyurethane, thus you had a single exposure with at least partial protection- the odds are hugely in your favor that you would not acquire an STD, even if exposed.  You then had treatment which is highly effective for bacterial STD, further guaranteeing that these are no longer a concern and a blood test which effectively rules out herpes (well over half of blood tests would have been positive by 21 days and your test was beyond this, thus when considered in context- HSV is effectively ruled out).  As for your questions:

1.  Absolutely
2.  No, there is nothing to suggest you have herpes
3.  The test suggests that you have neither HSV-1 or -2 infection
4.  You're worrying too much- go see your doctor and get your hernia taken care of.  EWH