Member Comments are provided by individuals and reflect their personal opinions only. Under NO circumstances should you act on any advice or opinion posted in this forum. ALWAYS check with your personal physician before taking any action regarding your health! MedHelp International and our partners, sponsors and affiliates have no obligation to monitor any comments posted on this site, or the content and/or accuracy of such exchanges. MedHelp International does not endorse the views of any user.
STDs (Expert Forum)
HSV locality
Answered by
University of Washington
Seattle - WA
This forum is for questions and support regarding STD issues such as: Chlamydia, Crabs (pubic lice scabies), Gonorrhea, Hepatitis (viral), Herpes, HPV, Molluscum Contagiosum, PID, Rectal Infections, Syphilis, Trichomoniasis, Warts, Yeast Infection.All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.
 |
HSV locality
by tfe, May 08, 2005 12:00AM
Hi Doctor,
Thank you for your time answering questions. I was wondering if the specific site that a person contracted herpes (penis and surrounding area, rectum, etc) is where the virus will recur in the future?
Also, a lot of resources say that people experience a delay in primary infection (or don't experience it all) and some people get very severe flu-like symptoms. Have you noticed that one is more common? For example, do most people get a primary infection within the 2-3 week period?
And lastly, for a male, if he was to get herpes in an area other than the penis or its immediate surrounding, would it still have the potential to cause problems urinating, discharge, etc?
Thank you.
- F.
Thank you for your time answering questions. I was wondering if the specific site that a person contracted herpes (penis and surrounding area, rectum, etc) is where the virus will recur in the future?
Also, a lot of resources say that people experience a delay in primary infection (or don't experience it all) and some people get very severe flu-like symptoms. Have you noticed that one is more common? For example, do most people get a primary infection within the 2-3 week period?
And lastly, for a male, if he was to get herpes in an area other than the penis or its immediate surrounding, would it still have the potential to cause problems urinating, discharge, etc?
Thank you.
- F.
Doctor's Answer
by H. Hunter Handsfield, M.D., May 08, 2005 12:00AM
, May 08, 2005 12:00AM
Recurrent herpes emanates from persistent infection in a nerve ganglion. The nerve associated with each ganglion serves a modestly broad area, and recurrent herpes can be anywhere in the distribution of skin or mucous membranes served by that nerve. Therefore, it is common to acquire herpes, for example, in the vaginal area and have reucrrences, say, near the anus; or to acquire the infection on one part of the penis but have recurrences in a different spot. But once a pattern of recurrent outbreaks is established, all subsequent symptomatic outbreaks generally occur in more or less the same spot.
The severity of the initial infection, including whether or not there are flu-like symptoms, is highly variable and not all the reasons are known. One important factor is the presence of prior HSV infection. This usually involves someone who already has HSV-1 then gets genital HSV-2: they tend to have milder initial episodes, and less commonly have fever an flu-like symptoms, than those who have not had HSV-1. Another factor may be the inoculum (i.e. the "dose" of virus received from one's partner), with higher doses meaning more symptoms and severity. But most of the time there is no clear explanation; some people are just less lucky than others.
On the whole, out of every 100 people with newly acquired genital herpes due to HSV-2, about 20% will have fairly severe disease, with multiple painful lesions, swollen lymph glands, fever, and muscle aches; about 40% will have milder disease, without the flu-like symptoms; and 40% will have no symptoms. Of the latter, most nevertheless develop symptomatic recurrrent outbreaks in the future.
Herpes almost never causes the symptoms you describe. Once in a while, a male will first acquire herpes that involves the meatus (urethral opening) or the inside of the urethra itself. This is excrutiatingly painful, but happily does not generally occur with recurrent herpes. In other words, even with initial herpes that involves the penis, very few men would have recurrent symptoms of discharge or urinary pain; and it would be even more rare (virtually nonexistant) if the inital herpes were acquired some distance from the penis.
I hope that helps. Best wishes-- HHH, MD
The severity of the initial infection, including whether or not there are flu-like symptoms, is highly variable and not all the reasons are known. One important factor is the presence of prior HSV infection. This usually involves someone who already has HSV-1 then gets genital HSV-2: they tend to have milder initial episodes, and less commonly have fever an flu-like symptoms, than those who have not had HSV-1. Another factor may be the inoculum (i.e. the "dose" of virus received from one's partner), with higher doses meaning more symptoms and severity. But most of the time there is no clear explanation; some people are just less lucky than others.
On the whole, out of every 100 people with newly acquired genital herpes due to HSV-2, about 20% will have fairly severe disease, with multiple painful lesions, swollen lymph glands, fever, and muscle aches; about 40% will have milder disease, without the flu-like symptoms; and 40% will have no symptoms. Of the latter, most nevertheless develop symptomatic recurrrent outbreaks in the future.
Herpes almost never causes the symptoms you describe. Once in a while, a male will first acquire herpes that involves the meatus (urethral opening) or the inside of the urethra itself. This is excrutiatingly painful, but happily does not generally occur with recurrent herpes. In other words, even with initial herpes that involves the penis, very few men would have recurrent symptoms of discharge or urinary pain; and it would be even more rare (virtually nonexistant) if the inital herpes were acquired some distance from the penis.
I hope that helps. Best wishes-- HHH, MD
Thank you very much for your detailed response. I only asked the above post because I think I might have acquired something perenially. Would a case of rectal/perennial herpes manifest itself just inside the rectum and persist without pain (beyond an occasional mild 'itch') for many weeks unchanged?
Thank you again!
Best wishes-- HHH, MD
I had a urologist check me out, but he said because of the lack of any penile discharge/staining, discomfort urinating/ejaculating, swollen epidis, etc.., that I don't have anything. Since my last unprotected exposure was several months ago, he said anything would have manifested itself (and would have done so differently) by this point in the game. (I only asked about the symptoms of discharge, urination problems strictly rhetorically in my first post).
After my unprotected exposure around 10 weeks ago, I was checked out for lesions/STD symptoms by means of a digital exam within a few days of my exposure and was assured that there wasn't any sign of any lesions/openings, nor an STD infection (but this was visually and not via blood test, etc)
I had a protected (prolonged) anal exposure since my 10 week ago unprotected exposure, for the first time, without much lube (just spit) -- would a cut from that (or just hard stool) cause a tiny painless bump that won't go away? (I think you mentioned fissures in related posts)
I guess my only concern is herpes. I mentioned that I had rectal discomfort to my GP. He did a non-digital visual examination and said that there wasn't anything he could see as being wrong, and several people who are privy to STD knowledge said that based on the non-severity, persistent nature of the symptoms, plus the location of the bump, my stress