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I have a 5 year old little girl who has bumps/blisters on her butt. She had bloodwork done and it came back positive for both hsv1 and hsv2. The pediatrician prescribed an antiviral but it didn't touch the "rash" and she said I shouldn't be too concerned. However, nothing was making the bumps go away, so I took her to the dermatologist. He did cultures, bacterial and viral. The bacterial one came back positive for staph, but the viral has not come in yet. The dermatologist did suggest that since we know she is hsv2 positive (and that's what the "rash" looks like) that we probably need to start asking questions about who is spending time with our daughter. Here is where my question comes in:
1. Is sexual abuse the ONLY way that hsv2 is spread?
I am positive that she didn't get it from me or my husband so I just need to know where to go from here. I don't want to open "a can of worms", so to speak, with the extended family if there is no need for concern.
First, you gotta be careful with IgG testing with children (was her testing IgG or IgM?). Grace would advise you better on the matter, but unfortunately she's dropping by once a week or so. I guess IgG testing is not fully reliable with children, it's mostly indicated in an adult population. But I'm not 100% sure, to be honest.
It would be good if you could post her results here (ex.: Hsv1 IGG 1.45, hsv2 Igm 4.5, etc)
Second, if the swab was done in a timely matter, it will tell the story. If her symptoms were due to hsv2, the viral swab will most likely be positive. However, if your child was already taking antivirals, the swab will most likely be negative - maybe a false-negative.
Assuming her outbreak was, indeed, due to hsv2 - yes, sexual abuse is strong possibility.
Just to clarify - if a child has genital hsv2 (hsv2 in the vaginal or anal area), it means someone rubbed against her down there, had genital contact at least. So, yes, sexual abuse is the most probable cause.
well, autoinnoculation of hsv1 to the buttock is a possibility. she could've transmitted her oral infection to her buttock. still, you need to know (a) if her buttock sores are indeed herpetic; (b) what type is it.
again, waiting for the swab results is the way to go.
blood testing in children her age is highly inaccurate and shouldn't be done :( We don't have tests approved for use in her age group since she is under the age of 12. The false positive issues with testing under that age are even higher than with adults due to less blood volume. It's quite likely her testing was erroneous for hsv2 and honestly we have no way to confirm otherwise for her at her age.
You can't actually determine if these were herpes related from blood testing either. A lesion culture done early into the episode would've been helpful. Odds are the lesion culture done after she was on antivirals will come back negative regardless.
It's highly unlikely she transmitted her own oral herpes to her buttocks especially with a well established oral infection.
Staph infections, especially MRSA infections, are very common in children in that area. She should continue to follow up with the dermatologist as needed at this point since it's not unusual for staph infections of the skin to come back repeatedly.
Well, I got the results for my daughter's test and it came back negative. However, the nurse said we should probably re-culture though because the bumps aren't gone yet. :( Made an appointment, hopefully will get answers someday!
We got good news! Seeing the bumps after all of the staph was cleared up and the dermatologist said that the rash could possible be molluscum. I asked for a biopsy and we got the results yesterday and it was positive for molluscum and negative for HSV 2! Praise the Lord!! I wish she didn't have either but out of the two, that's way better. Thanks for all of the information and well wishes!
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