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Urology (Expert Forum)
Blood test reults
Answered by
Kevin Pho, MD - Internal Medicine
Kevin, M.D.
Boston - MA
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
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Blood test reults
by AdviceSeeker06, May 15, 2007 12:00AM
Hi,
This is a follow-up question from a while ago...
Please refer to this link if you have time:
http://www.medhelp.org/forums/urology/messages/32110.html
Accidentally paid twice for this ? So I will go ahead and ask a few if that is ok with you :)
***
Since last question, got bactrim subscribed for pain in penis and was pain free after four days of taking it however...
Urine Analysis came back negative.
***
Fast forward 1-2 months and pain is back in penis, no other symptoms in that area. Urine Analysis came back negative.
Had a Cystoscopy done with no results.
Had a negative HIV result, negative Chlamydia result, negative Gonorrhea result, negative Reiters Arthritis result (at least I think that was the test...it was Arthritis something)
The red flag on the test was the Herpes portion. Herpes Antibodies came back 1.0 which is inconclusive. Apparently < .9 is negative and > 1.10 is positive but I am sure you already knew that.
I have no visible indications except for possibly a rash on my stomach that has been around for three days now while I have had pain in my penis. Looked at a lot of pictures online and it really doesnt look like anything I have seen.
My question(s) are:
#1
How likely is it that my symptoms could be explained by Herpes. Doesnt the 1.0 test result prove, without a doubt, that at some point in time I had herpes? Even though the test itself is inconclusive, I cannot think of any other reason why I would have antibodies at all. The last OB would have been two months ago and I would have had a few before that if indeed it has been herpes all along. Why wouldnt the result come back positive with a high number given the fact that I have had a potential recent outbreak (1-2 months and another 4-5 months ago). Maybe you can help me understand what the results really mean.
#2
How likely is it for me to have severe pain in the penis yet have no visible signs except for the possible rash on my stomach? Is it possible for it to have spread to there?
#3
If I do infact have herpes and the lesions are inside my penis I guess, how likely am I to spread this to other people? Could I spread it by touching my penis and then touching someone else or another part of my body? Would I have to literally touch the sore that is deep down in my penis in order to pass the virus?
#4
Could I eventually develop sores on the outside of my penis even though I have never had them the last ~6 possible OBs? Could I eventually develop sores anywhere on the outside of my body for that matter? I really do not understand the virus even after reading about it online for 10-20 hours.
#5
Can I get herpes Type 2 from oral sex? Seems like the only solution I can come up with as to how I got it but then I really do not understand how the virus managed to get inside my penis then. When I open up the hole and look in with a flashlight I dont see anything though but then again I am not a doctor and I am guessing it could be deeper down than the human eye can see.
#6
Do antibiotics help treat herpes temporarily? Is it possible that the antibiotics have helped in the past or was it always just a coincidence or "in my head" no pun intended?
#7
What antivirals would you suggest?
These test results and my symptoms are difficult for me to understand...maybe a Western Blot test would be a good next move...what do you think doctor?
Maybe I should go back and get the test that allows you to figure out if it is Type 1 or Type 2.
I am going to follow-up with my Urologist tomorrow and see what he thinks; however, I value a second opinion and yours seems to be better than most :)
Thank you for your time and any additional information and comments would be useful....
- AdviceSeeker06
This is a follow-up question from a while ago...
Please refer to this link if you have time:
http://www.medhelp.org/forums/urology/messages/32110.html
Accidentally paid twice for this ? So I will go ahead and ask a few if that is ok with you :)
***
Since last question, got bactrim subscribed for pain in penis and was pain free after four days of taking it however...
Urine Analysis came back negative.
***
Fast forward 1-2 months and pain is back in penis, no other symptoms in that area. Urine Analysis came back negative.
Had a Cystoscopy done with no results.
Had a negative HIV result, negative Chlamydia result, negative Gonorrhea result, negative Reiters Arthritis result (at least I think that was the test...it was Arthritis something)
The red flag on the test was the Herpes portion. Herpes Antibodies came back 1.0 which is inconclusive. Apparently < .9 is negative and > 1.10 is positive but I am sure you already knew that.
I have no visible indications except for possibly a rash on my stomach that has been around for three days now while I have had pain in my penis. Looked at a lot of pictures online and it really doesnt look like anything I have seen.
My question(s) are:
#1
How likely is it that my symptoms could be explained by Herpes. Doesnt the 1.0 test result prove, without a doubt, that at some point in time I had herpes? Even though the test itself is inconclusive, I cannot think of any other reason why I would have antibodies at all. The last OB would have been two months ago and I would have had a few before that if indeed it has been herpes all along. Why wouldnt the result come back positive with a high number given the fact that I have had a potential recent outbreak (1-2 months and another 4-5 months ago). Maybe you can help me understand what the results really mean.
#2
How likely is it for me to have severe pain in the penis yet have no visible signs except for the possible rash on my stomach? Is it possible for it to have spread to there?
#3
If I do infact have herpes and the lesions are inside my penis I guess, how likely am I to spread this to other people? Could I spread it by touching my penis and then touching someone else or another part of my body? Would I have to literally touch the sore that is deep down in my penis in order to pass the virus?
#4
Could I eventually develop sores on the outside of my penis even though I have never had them the last ~6 possible OBs? Could I eventually develop sores anywhere on the outside of my body for that matter? I really do not understand the virus even after reading about it online for 10-20 hours.
#5
Can I get herpes Type 2 from oral sex? Seems like the only solution I can come up with as to how I got it but then I really do not understand how the virus managed to get inside my penis then. When I open up the hole and look in with a flashlight I dont see anything though but then again I am not a doctor and I am guessing it could be deeper down than the human eye can see.
#6
Do antibiotics help treat herpes temporarily? Is it possible that the antibiotics have helped in the past or was it always just a coincidence or "in my head" no pun intended?
#7
What antivirals would you suggest?
These test results and my symptoms are difficult for me to understand...maybe a Western Blot test would be a good next move...what do you think doctor?
Maybe I should go back and get the test that allows you to figure out if it is Type 1 or Type 2.
I am going to follow-up with my Urologist tomorrow and see what he thinks; however, I value a second opinion and yours seems to be better than most :)
Thank you for your time and any additional information and comments would be useful....
- AdviceSeeker06
Doctor's Answer
by Kevin Pho, MD, May 16, 2007 12:00AM
, May 16, 2007 12:00AM
To answer your questions:
1) Herpes is possible, and the blood test is not 100% accurate. Obtaining a Tzanck smear can be considered for more clarity.
2) It would depend on the cause. If there are anatomical abnormalities - such as a urethral stricture or polyp for instance, it can lead to that scenario.
3) Herpes is normally transmitted via open sores, however can be spread during other times as well. More information can be found here:
http://www.herpes.com/Transmission.shtml
4) Yes, the sores can spread outside the penis. Herpes can manifest in different ways and lesions, which is why it may be confusing.
5) Yes, type 2 herpes can be spread orally. Antibiotics will not help herpes. Antivirals are normally needed to prevent outbreaks.
6) As mentioned, antibiotics do not help. You need antivirals. A Tzanck smear would be a reasonable step to diagnose this.
These options can be discussed with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_
1) Herpes is possible, and the blood test is not 100% accurate. Obtaining a Tzanck smear can be considered for more clarity.
2) It would depend on the cause. If there are anatomical abnormalities - such as a urethral stricture or polyp for instance, it can lead to that scenario.
3) Herpes is normally transmitted via open sores, however can be spread during other times as well. More information can be found here:
http://www.herpes.com/Transmission.shtml
4) Yes, the sores can spread outside the penis. Herpes can manifest in different ways and lesions, which is why it may be confusing.
5) Yes, type 2 herpes can be spread orally. Antibiotics will not help herpes. Antivirals are normally needed to prevent outbreaks.
6) As mentioned, antibiotics do not help. You need antivirals. A Tzanck smear would be a reasonable step to diagnose this.
These options can be discussed with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_
