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Herpes Culture Vs. Blood Test

I recently developed one small bump in the genital area, with no additional symptoms (such as fever, body aches, etc.)  I was given a herpes culture and blood test (IGM?) The blood test came back negative for both type 1 and 2, but the culture came back positive.  This raises several questions for me.

What is the false positive rate for herpes culture?  I read on a CDC webpage that it is as high as 15%.  What is the false negative rate for this type of blood test?

Is there a period of time after exposure when one could test positive on a culture but antibodies not be present to show on a blood test? (I am researching the availability of the more reliable Western Blot or Pockit tests in my area).

Can any test show if an infection is recent versus being a reactivation?  (I have never shown any symptoms in the past, neither oral nor genital).

How likely is a first outbreak to present as a single, relatively mild sore that never looked like a blister?

And finally, on a more political note, if 25% of women and 20% o men are infected with HSV and most do not know it, why is testing not an automatic part of checkups and annual gynecological visits?  This seems to me to be complicity by the medical community in a viral epidemic.

Thank you for your help,

M123

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242489 tn?1210497213
MEDICAL PROFESSIONAL
Something is wrong with this picture.  On the face of it, negative antibodies with a positive culture mean that you have a new infection, since the culture shows virus, but you have no antibodies, which take time (weeks to months) to develop.

The reason I'm a bit skeptical is that herpes presents as a cluster of blisters, not a "bump."  Moreover, those who are infected but have no previous exposure get very high fever, terrible erosions, and severe swollen glands.

I guess all you can do is repeat the antibody tests in a couple fo months.  If they're still negative, then I think a fair presumption is that the culture was false positive.  Then, unless the condition recurred, in which case it should be re-evaluated, there wouldn't be anything to do.

As to your political remarks, the problem with herpes is that there's nothing to examine, and little to do if you find something.  If there are no blisters or erosions --  which would be evident on any routine checkup or GYN exam -- then trsting for antibodies would not be helpful, since the presence of antibodies only indicates prior exposure, not active infection.  No conspiracy here, just an uncooperative and ubiquitous virus.

Best.

Dr. Rockoff
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Avatar universal
Update: I was told by my healthcare provider that I was exposed too recently for antibodies to show on the blood test.  As I have been in a monogamous relationship, I am told it is therefore all but certain that my partner is an asymptomatic viral shedder.  

M123
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Avatar universal
I've got lots of thoughts on this myself!

One thing that seems apparent to me is the vigilance with which the herpes community encourages inspection and testing. I've seen posts by worried people saying that they are *itchy*, only to be told that "25% of the population has it, so you'd better get checked, just in case!", yet the very same people go on about how it sucks to have to deal with the stigma of herpes and how it's really no more than a cold sore in a lousy place.

Well, these two attitudes are not congruent as far as I can see. Either it's a minor skin condition that really doesn't deserve that much worry, or it's a horrible skin disease that should be avoided at all costs, in which case the stigma fits, doesn't it?

Three months ago, I had red spots show up on my penis head and a variety of other redness and bumps that continue to come and go every few days. I've seen 5 different doctors, who after looking at it, have told me that it's not herpes. They said that it's maybe an allergic reaction to something, or friction, or eczema, or folliculitis, or scabies, and one even said "I don't know what it is, but it doesn't look anything like herpes, so just wait and see if it goes away". I've also posted here and even called my dermatologist in my home country for advice. Again, I was told that what I was describing didn't sound anything like herpes. That's a total of 7 doctors!

None of these possibilities explains the symptoms though, but then, neither does herpes. I have slept with several women in the last few months, but another thing that happened was that my penis was injured during intercouse just a few days before all of this began. I *still* get an occasional pain that feels exactly like the one that I had for a few days after injuring my penis. I'm thinking that if this isn't herpes, or a yeast infection, then the trauma must have set off some kind of hypersensitivity thing in my groin area. I get redness and irritation on the head that get worse every time I have sex or masturbate (vascular problem?), occasionally small red bumps over the head of my penis that go away within 2 or 3 days (usually after unprotected sex with my girlfriend, but once when we hadn't been together for quite a while anyway), red irritated blotches on the head around the urethra, a couple of red spots that formed in hair follicles that have left a sort of scar-type looking skin (light pink and a bit scaly/shiny looking) near the base of my penis (over a month ago), a red spot on my penis about an inch below the mucous membrane of the foreskin that lasted a month, a rash wherever semen comes into contact with my skin that fades within a few hours and goes away completely after a day or two, and today I noticed a very very small white bump on the side of my penis, about half way up, that popped something just like it was a miniscule zit.

I haven't had a "normal" penis for over 3 months now. None of my diagnoses can account for the variety of symptoms that I've had. Although I have never spent so much attention on myself before, I do know that what's going on is not normal. Still, this sounds nothing like classic herpes symptoms. There's no blistering, no ulceration of the skin, no pain, no itch, and it's gone on for way too long, or so it seems. But there've been a bunch of spots or bumps that just get replaced by something new when I think it's about to go away.

Some of the herpes activists will tell me that "anything strange can be herpes, so better get checked," and because of that, I'm living with the paranoia that 7 doctors may be wrong. What the activists never bothered to do is to tell me about the OTHER 101 things that could cause a variety of symptoms. No one except ME seems to be all that concerned with what I've got. They've done a very good job of making me extremely paranoid. But what am I supposed to do? I keep telling myself that I've put in the time and money to get it checked out way beyond my social reponsibility. I'm not going to go out and see an 8th doc and spend 2-300 dollars for a blood test for something that, even if it IS herpes, I can't do anything about.

And like you said, 80% don't even know they have it anyway, and no one's telling THEM to get tested, so why should *I* go to such extremes because I have something "strange" yet sounds nothing like the dreaded H virus?

Still, I can't get the idea out of my head that all these docs are wrong, and I continue to worry that it *might* be herpes or that I may have unknowingly transmitted it to other people... Sigh. No one ever felt guilty about transmitting a cold sore on the lips, why am I mad to feel to guilty about the *possibility* of H? Maybe I *should* pay the couple of hundred bucks for the Western Blot, if for nothing else, peace of mind. If I had blisters or sypmtoms that were "classic", then I'd definitely get it done, but how far is one supposed to go for atypical symptoms? Shouldn't I take comfort in the fact that this is much MORE likely to be something else entirely?

I know that these comments don't get answered, but if Dr. Rockoff is so inclined, I'd love to hear what he thinks of this.

Thanks,
Bumper
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Avatar universal
I happen to have the same symptoms. They started sometime in dec 2000 and have been haunting me ever since. Numerous tests, Doctors and pills have failed to help me.

IMMEDIATELY after the act I felt a searing pain in my Scrotum (immediately after the ejaculation). Ever since I am experiencing burning pain in my scrotum and around my buttocks. The same tingling/tearing sensation is also felt between my legs just below the scrotum. The skin surrounding my testicles feels thick and sweaty. The scrotum always feels full. Infact one of the testicles always feels as if it is clinging on to the other one.

Earlier after ejaculation them the bag surrounding the testicles always feels empty. Now it always feels full.

Rashes have developed on my penis and it has also enlarged round the glands. It is red when it is erect. Does not itch.

I had visited numerous Doctors and underwent a number of tests including:

1. HIV (non-reactive)
2. VDRL (   "       )

I visited several Doctors and they keep on saying this is nothing
*One of them said that it is just my mental frame of mind

* I conducted 3 vdrl test but all were
  Non-Reactive
*Several drugs have been prescribed but I am yet to get any relief
* the drugs are
(a)
1. Penidure Injection LA24- One dose
2. Tab Resticlin 500 mg x 40
   (1x4 daily for 10 days)
3. Polybion x10
(b)
1. Azithral 500 x10
   (1 cap daily)
2. Beecosule 10
   (1 cap daily)

(c)
1. Pyredirium x30
   (1 x 2 daily)
2. Cystone x30
   (1 Daily)

(d)
1. Aziwok 500 X 3
   (1 cap daily)
2. Meftal spas x 10
   (1 tab if there is pain)

(e)
1. Minicycline X 20
   (1 X 2 Daily)
2. Cobadex Z X 10
   (1 Cap Daily)
(f)
1. Powercef 1g

(g)
1. Powercef 1g

Recently again I visited another Doctor (may 21- 2001) who diagnosed me as suffering form ORCHITIS. He gave me an Injection which he did not disclose the name (but simply said it is from the USA) and told me that it will help cure my problem within 6 Months. He also prescribed DOXYPAL for my rashes.

Unfortunately the symptoms have prevailed and I am no nearer from being cured.

However the worst is that I think I may have infected my wife who recently gave birth to a son on 14/6/2001. Although it is too early to tell the baby is having some discharge from his eyes and some rashes are on his body. (YOU DON'T KNOW HOW TERRIFIED AND SHAMEFUL I FEEL).

2 days ago since I felt that the drugs were not working on me so I took another dose of Penidure Injection LA24- Three doses ( I thought that my symptoms may be Syphillis) However I feel worse. Going to the Hospital to visit my wife and child is an ordeal for me.

Again a week earlier I was advised by another doctor to undergo an HIV test and some Urinal test. Non-reactive reports were recieved. However he again prescribed some pills for me,

1. Flagyl 400mg daily X 3
2. Azithromicyn 250mg daily X 2
3. Disodium Hydrogen Citrate Syrup daily X 2
4. An ointment to apply ofor my rashes

After this course the pain on my scrotum seems to have subsided however the rashes on my penis have continued in full force. During erection especially the Penis is crimson red and swollen in the glands.


1. Is this Herpes?
2. Is there anyhope for a cure?
3. Should I take any further tests?
4. What were the results of your tests?


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Avatar universal
Well, there you go. Another one who is so terrified that he can't relax. Banjop, your symptoms are a bit different than mine. I don't have anything going on with my scrotum. But here's the deal...

You've gone to the doctor's several times and have repeatedly been told that it's nothing to worry about. You've had tests done and everything comes back ok.

This is exactly what I'm talking about. Are you in any real discomfort? It sounds to me as if your symptoms themselves are not something you can't deal with, but your statement that you "feel ashamed that you may have infected your wife", even after repeatedly being reasssured that you don't have any communicable disease, tells me that what's got you is the same as what's got me. The paralyzing fear of herpes.

Well, you've done pretty much what you can, haven't you? Really, if the symptoms themselves (discomfort, pain, etc.) aren't bothering you that much, then just forget about it and move on. That's what you SHOULD be doing, anyway.

As for me, it's the same thing. Ihaven't had any blood tests and no cultures have been taken, but then all of the doctors I've seen say it's not necessary. And really, I'm not suffering from that much discomfort (mentally yes, but not physically) from this. It is a little sensitive at times, but that's about it. If I knew for a fact that this wasn't herpes, but that I would still have these symptoms, I wouldn't care all that much. Aside from the fact that it might be a bit embarrassing or difficult to explain to new partners, they don't bother me much. No pain, no itch, no blisters, no weeping, etc. Just assorted spotting, and that's about it. Who cares?

And yet, I myself can't seem to stop worrying and thinking that I may have infected others with herpes!!! It's crazy, and it's all because of the herpes community's agenda. That is how bad the stigma has gotten. It's stupid. Sure I don't want to pass it on. If I knew that I had herpes for sure, then it would be different, but for now, until I get some kind of breakout that is more evident, or until someone comes up to me saying that they've got funny spots identified as herpes, I'm gonna do my best to stop worrying about it and get on with my life. Anyway, the stress of worry alone is probably the biggest part of the problem now!

Take care, and if it don't hurt that much, then stop worrying about it and get on with your life. That's what I'm trying to do.

Bumper
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Avatar universal
Hi Bumper,
Thanks for the reassuarance. However I have never been tested for Herpes. I am wondering if I should do the test?
You seem to be much saner so Please advise me on how to go about it.

You don't know how glad I am to actually hear from someone who shares my grief.

Thanks anyway and hoping to hear from you soon.

Banjop
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Avatar universal
Sorry Banjop, I have no idea how you would go about it. I've heard that the only reliable blood test, the Herpes Specific Western Blot, is only available in two labs. One in Canada and one in the US. I don't know about other countries. (I'm not in North America.)

Although, as I've said, I myself may need to get the test done before I can get any relief from my anxiety, but I'm trying to calm myself down and not worry about it.

Here's why:

- (They say) 25% of the population has herpes.
- Only 20% of those know it.
- That means that only 5% of the population have it and know it, while 20% have it and don't know it. That's 1 out of 5!
- I have odd things going on down there, but not all odd things mean it's herpes. In fact, it sounds like there are a LOT of odd things that can happen that are not herpes. Still, these odd things must mean *something*, so it probably increases the likelihood that I have herpes. But, by how much? I can only guess, but with all the other things it could be, let's say that I have a 25% chance, (if it's even this high), of carrying the virus.

So, my point is this... If everyone who has ever had sex has a 20% of carrying and are NOT encourage to get tested, and if my odds sit at about 25%, is that enough to make me jump through all these hoops and spend so much money trying to figure out if that's why I have? Is that extra 5% enough to justify all of the extra effort and stress for me?

The answer is clearly no. I would tell a friend exactly that. Especially since there nothing that can be done about it anyway. If these symptoms meant that I had a 70% chance of having it, then maybe yeah, just so that I could prevent transmission to other people.

Here's a question for Dr. Rockoff:

Of the people that show symptoms that are NOT typical herpes symptoms, how many end up testing positive for herpes?

The H community is doing a very good job of making anyone with the slightest little abnormality paranoid. My friend said it best when he asked me, "you've seen 5 doctors and consulted another 2. What are you going to do? Keep going to different doctors until you find one that says it's herpes?"

What's the point of that?

Just relax, and if it's not hurting you, stop worrying about it. It's probably not H, and even if it IS, you can't cure it. Especially since you're married, it probably won't affect your lifestyle much at all. It's not like you're out spreading it around, right? And if your wife has no symptoms, she's not likely to have any problems giving birth.

I'm worried only because I'm NOT married. I'd hate to think that I've given or will give it to others unknowingly, but then, given the information I have, I just slightly more likely to do so that the average person out there. I'm not gonna knock myself out worrying about that possibility any longer.

When you tell someone "hey did you know that 20% have it and don't know it? You should get tested," they don't. Should I really feel any more guilt about not getting the blood test? No, not really. At least I don't think so. Not after 7 doctors saying it's not necessary!

Let's make a deal to both stop worrying, ok? ;-)

Take care,
Bumper.
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Avatar universal
Is it possible that perhaps a previous exposure to Herpes Zoster or Type I would lessen the severity of a type II outbreak?

I empthasize with the concerns of the writers.  It is difficult for us to discern the symptom of one condition from another.  If you have a red bump, any herpes site can persuade you it is herpes.  However, other sites will do the same.  You could make yourself believe it's syphillis, folliculitis, etc.  I have had two red bumps in the area - a few inches apart.  On the face of it they should not be herpes but the paranoia sets in and you wonder how they couldn't be.  M123 seems to have a handle and perspective on things.  I envy her for that.  The key thing is that doctors have been involved with everyone here and ultimately that is as good as its gonna get.  Stigma or not you can live a long time with this condition.  Too many people would trade what they have for it.  

Peace of mind to you all.
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Avatar universal
Only 6 doctors?  Well I have consulted 7 so it is VERY reassuring to learn this is not a conspiracy waged by the local medical community to make just MY life a living hell.  I was expecting something like, "so you think you may have contracted genital HSV?  Oh my gosh! We better run some tests and contact the Mayo Clinic and The CDC!"  Instead I get "hmmm, does'nt look much like a herpes" or as one exasperated GP stated, "Sometimes alota little things are alota little things!".  So now I got every genital skin condition known to man and a really sore PP but I at least I don't have THAT!
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Avatar universal
Should you get tested?  In my opinion, yes.  Not knowing (as shown by the other comments posted here) is as bad or worse than knowing you're infected.  That being said, BE SURE you get an ACCURATE blood test -- there are ONLY THREE and your doctor probably does not know what they are!  They are: POCkit Test (see website pockit.com for location near you -- the test takes about 10 minutes, has an accuracy rate of about 97%.  It is expensive, about $100, and may not be covered by your insurance plan); the Western Blot, or the Herpes Select. (See the CDC.gov webpage). Even if your healthcare provider is a gynecologist, dermatologist, or other who you would expect to be knowledgable about herpes, you may be in for a rude surprise.  Like you, I have been apalled at the lack of knowledge on the disease itself, and of the callous attitude that herpes is "no big deal."  It IS a big deal, if you have it.  

I recommend that you check this Tulane University webpage -- it has links to other pages that have good, accurate information:

http://www.tulane.edu/~dmsander/garryfavweb12.html#Herpe

There is a lot of misinformation and quackery out there -- please don't rely on "information" that is not from reputable sources!  

Also, check out the Centers for Disease Control webpage at www.cdc.gov for the most accurate information available.

If you find that you are infected, here are some things to keep in mind (this is based on personal, recent experience.  I hope it helps you.)

You will be hysterical at first.  Don't think that this feeling will last forever -- it won't.  Don't give up.

This is serious and life changing, but don't lose sight of the bigger picture.  While you are dealing with the news of herpes, others are dealing with news of cancer, MS, HIV, and so on.  Keep in mind that this is not life threatening, and that you CAN deal with it.

You now have two choices:  Deal with this situation well, or deal with it poorly.  I don't see many advantages to dealing with it poorly.  There are drugs that can help minimize outbreaks and viral shedding.  Get the facts and see a doctor who has the facts.

You are the same person you were before you were infected.  Do not allow this virus to define you.  Live your life in a way that others will not define you by this virus.  Be honest, and if you meet someone you want a relationship with, give them the information they need to make an informed decison, allow them to deal with their feelings.  If you feel someone will reject you despite the facts that this virus can be managed (though not yet cured), then that person does not deserve you.  

Find a group, either social or support oriented or both, in your area, or find a counselor who is familiar with the issues surrounding sexually transmitted diseases.  What you are feeling is normal and you are not alone.  Remember, 20% of the population has herpes.

Best wishes to all of you.  I hope you get tested, and I hope that you test negative and take the steps to stay that way.  But if you ARE infected, I hope you get the information and emotional support you need.

M123
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Avatar universal
Comment to Bumper:  I hope that I am misreading your intentions. If you think you may have herpes and are resisting getting tested (based on the most likely uninformed opinions of the 7 doctors you have talked to)  and are continuing to have unprotected sex, you are in my opinion being irresponsible at best and predatory at worst.  This isn't about percentages of likelihood, Bumper, it's about a virus that can't be cured and changes people's lives! Herpes infection in women is linked to cancer, can be passed on to babies during birth, and can cause serious, painful, disfiguring outbreaks.  I hope your human decency will override your need to get laid.  Please get tested.  Please don't put others through hell just because you want to get your **** wet.
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Avatar universal
Gentlemen,

I've read your passages and I empathize. However, we must keep in mind that science has a limited scope eventhough we've made tremendous advancements. I would kindly suggest that you protect yourself and your lovers by using protection. Keep in mind that viruses are tough for scientist to completely understand. We've classified them as dead until they have a host; which helps them live.

However, your symptoms are not indicative of the virus being in its full blown state. I would gamble and say out of shear speculation that the reason it looks like a herpes culture is because the virus is in the herpes family. My reasoning:

-many of you have taken countless drugs to no avail
-intermittant moments of irritation
meaning there is something acting as a stimulus for the flare-ups
-the culture came back positive for herpes
-the symptoms are recurrent
-the flare-ups are genital area prone

-Logically, I know why the physicians are not prescribing the herpes protocol medication; but I will gamble that it will help.

Good Luck in your quest to find relief. My prayers are with you.
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