Likelihood this is herpes?

Hi--

Two years ago, I had oral sex several times and began intercourse unprotected a couple of times with my boyfriend at the time. I tested negative for all the STDs they test you for if you are asymptomatic. I haven't been sexually active at all since. I just had a negative PAP smear a week ago.

Over the past week, I have experienced a little bit of constipation, which I attributed to eating a lot of fiber while drinking very little fluid. This seems to be getting better as I've been drinking a lot more water.

On Wednesday (four days ago), I started feeling like there were secretions in the back of my throat that I couldn't cough up, but I had no runny nose or anything else. Thursday, the feeling of congestion in my chest got a little worse, and by the end of the day, I had a moderately high fever and chills. Still no stuffy/runny nose. I had to stay up really late Thursday night and wake up really early Friday morning and walk twenty minutes in the cold (unavoidable), feeling terrible the whole time. I wondered if I had a pneumonia. At three in the afternoon, I took a nap and ended up staying in bed until 9:30 pm. When I got up, I had a high fever, a  feeling of congestion in my chest, and a headache when I would cough. I took Advil, made dinner, and then went to bed at midnight.

This morning, I woke up at noon, still with some degree of a fever. I took Advil, ate breakfast, and went to the bathroom--getting better, as I said--although I had to strain a lot.  I was feeling better, the same symptoms, but milder, and sometimes my cough was productive. (I never have to cough; I cough to clear my throat.)

Let in the day, I took a shower and discovered to my horror small "pimples" on my vulva: one on one side and two close together on the labia majora and one on the edge of one of the labia minora. They are purplish-red with a bit of white in the center, as if there's a little pus. It hadn't hurt when I wiped myself before getting into the shower, but the pimples were a little bit sore.

So I'm wondering what the chances are of this being herpes?--especially combined with my othere symptoms. I'm wondering if they are three unrelated issues or connected...

I know that in order to know about this for sure, I will have to go to the doctor, but I wanted to hear some thoughts. Thank to anyone who responds!

[gracefromHHP]

pap tests do not look for std's.  you need separate testing for std's to know if you have any or not. most clinics do not include hrpes testing as part of their routine std testing either so  you have to ask if you are getting tested for it or not.

At this point it's best to be seen and get a repeat genital exam done. they could be due to herpes but more likely something else is going on down yonder.

grace

[Violet733]

Thanks for your reply, Grace. I know that the pap test only checks for abnormal cells on the cervix and that I wasn't tested for herpes. I was tested (negative) for several STDs but not herpes. (I was under the impression that they test for that only if you have symptoms.)

Would you mind telling me why you say the little sores I have are "more likely something else" (as opposed to *more likely* herpes)?

Again, thank you so much for your time.

[Violet733]

BTW, today the sores are a little bigger and firmer. There's swollenish/reddish color surrounding a small purple middle that is kind of flat. In the very center, there's a tiny white part that looks a little bit indented. They still don't hurt when I pee. They hurt when they're pressed against, but not when if I touch them.

I also started my period today...don't know if that's relevant. It hurt when I put my tampon in, I think because I had to press against one of the sores.

[gracefromHHP]

It just sounds more like a bacterial infection or even irritation than herpes from your description of things.  follow up today with your provider. they can see you even while you are menstruating. waiting to follow up on things isn't the best idea.

grace

[Violet733]

I just made an appointment, but unfortunately I couldn't get it until Wednesday. Today the sores do hurt when I pee, and they aren't purplish anymore, just round flesh-colored sores with kind of an open place in the center, I think.

[Violet733]

I was able to get my appointment moved up to today, and it turns out I do have herpes. The results should be back in a week to say whether it's HSV 1 or 2.

Thanks for your time, Grace.

Violet

[gracefromHHP]

so you've had a visual diagnosis of herpes so far?  what testing did they do? Did they do any testing for anything non-herpes too?

grace

[Violet733]

Yes, visual diagnosis so far. When I described everything to the doctor, she said said my description sounded like a primary herpes outbreak but that that would be unusual if I got the virus two years ago. So she said nothing was jumping out at her as the obvious problem. She asked me about whether there was anything else new in my life, new detergent, etc., and I said no. She examined my ears, throat, etc., too. She was definitely open to it being something other than herpes at that point. But then after she examined the sores, she came back and said did look like herpes. (She didn't sound like she had any doubts anymore.)

I forget the name of the test they're doing, but I think it was three letters and started with a C. I wasn't tested for anything else.

[gracefromHHP]

well certainly when they call with the test results, you need to ask what testing you had done.

grace

[Violet733]

Well, I actually got an *email* with the results today (I'm a graduate student and have been going to the student health center at my universtiy), and they were negative for HSV 1 and 2. The doctor wrote:

"I am surprised [that the test was negative] as your sores looked just like herpes. Sometimes if the sores are healed too much the test can be negative. At this point I hope you are feeling better. We could retest them if they occur again (maybe earlier just after you get them). Let me know if you have any questions. There are other viruses that can cause sores though they usually do not present the way yours did."

I replied asking what the test was, and she said it was "Herpes Simplex virus, direct specimen, PCR (this is a DNA test) for types 1 and 2 HSV."

She also said she could do a blood test in about three months to see if I have HSV antibodies if I haven't gotten any new sores by then.

Do you have any thoughts on this? I really appreciate your time, Grace. Thank you.

Violet

[gracefromHHP]

so they did a pcr swab of your actual lesions and it was negative.

did they also test you for yeast and bacterial infections vaginally or just do the herpes testing?

follow up with the blood test in a few months just to err on the side of caution. Should you get a return of symptoms before then, return to be seen again.

Not quick answers I know but sometimes it's the best you can do.

grace

[gracefromHHP]

Actually since you haven't had sex in awhile, you can get the blood test done at any time. Forgot your last encounter wasn't recent.

grace

[Violet733]

Hi, Grace,

Sorry to post again after over a week. I did ask the doctor if I might have the antibodies already, since it's been two years since I was sexually active, but she said, "No, not necessarily. The virus sits within a nerve and may not come out for months/years. So you could have gotten this 2 years ago but it did not come out with lesions until now." So I guess it makes sense for me to wait three months to have the blood test, correct?

I'm a little confused by the likelihood/certainty that I have herpes as I wait these three months to have the blood test. The PA who talked with me most when I visited basically told me that, if the PCR tests came back negative, I *shouldn't* take that to mean I *didn't* have herpes because it could be a false negative and because the sores clearly looked like herpes. But then when the test *did* come back negative, the doctor, who also looked at my sores, said she was "surprised" because my "sores looked just like herpes," a statement that made it sound like the visual diagnosis was less certain.

I was not tested for yeast or bacteria. But I have had yeast infections and bacterial vaginosis before, and those infections weren't anything like this. Can they cause isolated sores on the labia like I had?

My sores are completely cleared up now, and everything feels back to normal down there now, so it's easy to forget about it. But it's still weird not knowing for sure whether I have herpes and having to wait until the middle of April for the antibodies test. I'm not dating anyone, but I can't help wondering if I were to start dating someone and have the possibility for a relationship what I would tell them. I suppose I would just have to say that I *probably* have herpes and explain the whole situation...

Thanks so much for your time, Grace.

Violet

[LeapofFaith]

As Grace said, since your last sexual encounter was years ago, you can easily get tested now.  You should get an IgG type specific blood test for HSV-1 and HSV-2.  The doctor you spoke with about antibodies isn't necessarily correct.  Just because you haven't had an outbreak in the past two years does not mean that your body does not have antibodies.  It is also quite possible that you have had an OB before without recognizing it/noticing it, since your sores weren't necessarily an active discomfort.  Again, get a blood test done soon to confirm.

Also keep in mind that although a visual diagnosis by a doctor is reliable, it is the most unreliable of all the methods of diagnosis for Herpes.  It is always wise to confirm a diagnosis, whether positive or negative, with a blood test.  Also, some studies have shown that only 1 in 5 patients who present with typical GH symptoms, such as yourself, actually have GH.  So just because your sores look typical of GH does not by any means say that you definitively have herpes.  Keep us posted.

[Violet733]

Thanks, LeapofFaith. I suppose I should call and find out how much a blood test for antibodies would cost because I'm pretty certain that the insurance I have through my university will not cover it. I'm worried that I could have the blood test now and that it could come back negative, leaving me with no more conclusive an answer than I have right now. If the blood test came back negative now, I would just have to get it again in three months, right? Would a blood test three months from now be more conclusive?

I'm wondering if I should just plan to get the test in April unless it looks like I am going to be dating someone before then and, in that case, get the test at that point. Does that make sense? I would really like to know for sure now, but I'm worried that I'll pay for the test and just end up having to get it again in three months.

[LeapofFaith]

I suppose it all depends on how concerned you are, as well as how sexually active you are.  If you aren't particularly concerned about knowing your status for the next three months, by all means hold off from testing until then.  If you plan on being sexually active, its best to get tested soon.  And to answer your question, since your last sexual encounter was years ago, it makes little difference if you test now or later.  The reason your doctor told you to wait three months was probably because they assumed this was your first OB, and you encounter with HSV was recent.  Generally, those of us who have a suspicious encounter for the first time need to wait 3 months.  Since you have a good two years under your belt, if you have GH you would certainly have antibodies by now.  I would say the test results from a present blood test would be just as conclusive as three months from now.  And ask your health services at your university whether Herpes blood tests are covered by your plan.  Its quite possible, since STD checks are one of the most common reasons college students visit their health centers.  I would know :-p.

[gracefromHHP]

you do not need to get the blood test in a few months. You haven't had sex in a long time now so if you really did have herpes, you would be positive now. Yes you can have herpes symptoms that you don't realize are herpes and then at some point get an obvious ob that sends you to be seen but your blood test would still be positive regardless. No need to repeat your blood test later on if the igg blood test is negative now since you haven't had any sex recently.

grace

[Violet733]

So it's just plain not true that the virus can "sit within a nerve and may not come out for months/years" *without* causing antibodies? I would *definitely* have begun to develop antibodies when I was initially infected, even though I didn't have symptoms? What you are saying makes a lot more sense than what the doctor told me, Grace and LeapofFaith. I'm just trying to make sure I understand this.

When the PA was telling me that the PCR might come back negative (a PA and a doctor both examined me), I asked her about a blood test, and she said, "The problem is that the virus isn't in your blood. It might have been in your blood when your outbreak first started, but by now it definitely wouldn't be in your blood anymore." She didn't mention a test for antibodies at all, which I find pretty strange and annoying.

The PA also said several times that I could have gotten genital HSV *recently* if I have herpes in my mouth and then transferred it down there somehow... (I don't get cold sores, but I suppose I could still have the virus in my mouth, right?) That seems pretty far-fetched to me. And if this were actually what happened--if I had HSV in my mouth and somehow infected myself genitally--wouldn't I have antibodies already from the oral infection anyway??? I'm just trying to make sense of what the doctor told me. So far what you've said seems a lot more logical.

This is just a general question about antibodies: Suppose a person with no symptoms wants to find out if they have the virus genitally and so they get the blood test for antibodies. If the test came back positive, would there be any way of knowing whether that person has the virus orally or genitally if they never had symptoms in either location?

It makes sense to me that, if I was infected two years ago but did not notice symptoms, now would be the time when I finally had a noticeable outbreak because I think my immune system must have been unusually low. I don't normally get sick very often, but I think I had H1N1 when I got the sores. (I still haven't completely shaken the cough even now.) So (if I do have herpes) does the fact that I've finally had a noticeable outbreak mean that I should expect to get them more often now? Or does the fact that symptoms didn't show up for two years mean that my outbreaks will probably never be very frequent or severe?

I'm sorry to ask so many questions. Thank you so much for your time!

Violet

[Mistakeguy789]

Hi Violet,

I read your post and wanted to hopefully share some of what I have learned!  :-)

Antibodies once present in the body don't leave you.  So getting tested now will yield a result if you have anitbodies in your blood.  Which is why people get tested to begin with.  The standard rule of testing is that if you get tested get a type specific IgG test.  Pretty easy to do.  The testing is most accurate 3-4 months from the last expsoure.  As Grace said you have not had sex in a long time (2 years).  This puts you beyond even the 6 month mark for which testing would be far more accurate.  So the point here is that to answer your question once those antibodies are there they will stay there.  You need to make sure the test is type specfic.  

Once you get the results if you post them here Grace would be HAPPY to interpert them for you as well.  She does it pretty much all the time when she asks people.  Plus shes been trained on it.  

As for which place your strain of HSV impacts is a little trickier.  Really what you would need to do is once you have symptoms of the blisters is get them swaped and then tested via PCR (a lot more accurate).  This test then will tell you if the blister is herpes and if so what type.  Since the blister is in that location (face or genital area) you will know which location is being impacted.  The igg test will not be able to tell you where you have the virus (oral or genital) just that you have the antibodies for it.  Commonly HSV-1 is oral and HSV-2 is genital.  However, you can get HSV-1 Genitial and vice-versa.  

The fact that you didn't notice them before could be they were not that sevre to begin with if you had them.  According to various resources the re-occuring version is less severe.  However, I am sure grace can answer that one better then I.  

Hope this helps.  

[gracefromHHP]

you won't infect yourself genitally with your own oral herpes.   You can knock that off your how could I have gotten this list!

yes you are understanding correctly - if you had contracted herpes 2 year ago, your igg blood test would reflect that.

the virus wouldn't be in your blood test at this point but you would test + to the igg antibodies that formed soon after you were initially infected if you had contracted it 2+ years ago and were just now getting obvious symptoms.

Honestly I don't think that the doctor or the PA are believing you that you haven't been sexually active lately either :(

so call next week and make arrangements for the igg blood test so you can get answers for once and for all about this!  ( and man I wish I could sit down the providers you saw and teach them a thing or two about herpes!!!! )

grace

[Violet733]

Thank you so much for the responses. Grace, I wish you could straighten out the providers I saw, too!

And maybe you're right that they might not believe it's really been two years since I was sexually active, although I can't imagine why I would lie to doctors about that, especially in this situation.

I've made an appointment for the blood test on Tuesday of next week.

Thank you again!

Violet

[gracefromHHP]

I know, most folks lie the other way - say they've been shagging someone regularly when they aren't....he he he

I can help you with your blood test results when you get them :)

grace

[Violet733]

The test came back negative! The results were:

HSV 1 IGG, HERPESELECT TYPE SPECIFIC AB <0.90 index
HSV 2 IGG, HERPESELECT TYPE SPECIFIC AB <0.90 index

So this should be conclusive, right? I'm really mystified now about what those sores were. They just went away on their own after a few days, which has definitely not been the case when I've had yeast infections and bacterial vaginosis in the past. Do you have any other ideas, Grace? I suppose I'll just stop worrying about this now, and if I get the sores again, I'll try to get in to have them swabbed as soon as they appear.

Thank you so much for all your help!

Sincerely,
Violet

[gracefromHHP]

correct, it wasn't herpes going on.  

if they reoccur, return to be seen, let them know that you ruled out herpes and make them test for other issues.

oh and congrats - you don't have herpes!

grace

[Violet733]

Thanks! I really appreciate all your time!

Violet

[Mistakeguy789]

Congrats!!! Violet!