Possible False Positive

I have had a positive herpes culture.  How reliable is a lesion culture?  I am wondering if it is possible that it is false positive?  I have been on Valtrex for a week now, and it hasn't helped at all.  Also my culture set at the lab for 5 days or so before testing because it was ordered wrong.  Could that affect the test?  Should I get a blood test?  

[gracefromHHP]

A positive lesion culture is most definitely an indicator that you have herpes.  Do you know if it was typed to know if it's hsv1 or hsv2?

grace

[Misty24]

I dont know if it was typed.  I am waiting on a call from my doc and I will ask.  Why hasnt the Valtrex helped any?

[Misty24]

It was typed and positive for hsv2.  

[gracefromHHP]

Did you also have any other testing done for vaginitis and such when you were there?

grace

[Misty24]

I was not tested for anything else.  It was supposed to be just a follow up pap because I had a procedure done for abnormal cells on my cervix (second one).  I had a sore spot come up close to the anus, and at the check up the doc said it was herpes and did a culture and put me on Valtrex.  A few days after I went on the Valtrex, my condition actually got worse.  Is that common?  I have read that the first outbreak is the worst, but how long can I expect it to last?  It has been two weeks, one week on Valtrex, with no improvement.  Also, is it possible to have herpes and carry it for months with no symptoms?  I am just trying to figure out where this came from.  

[gracefromHHP]

If you are getting worse instead of better then you need to return to your provider for further evaluation.

grace

[Misty24]

I talked to him today and he said to call him if it gets worse, but said nothing about coming back in.  He said I should feel better by this week end. He seems to think it is because it is its the initial outbreak.  I have been in pain for weeks now, and am just looking for something to help.  Is it possible that I just dont respond to antiviral meds?

[gracefromHHP]

No it's not likely that you aren't going to respond to antivirals. Further evaluation is in order - not a phone call.

grace

[Misty24]

Is there any possiblity that it is not herpes?  Could that be why I am not responding to the med?

[Misty24]

How long does the initial outbreak usually last?  Also, does my partner need to be tested even if he doesn't have any symptoms?  We even had sex when I had a sore, because I didn't know it was herpes.  I am so confused because I still have no idea where this came from.  I guess with a positive lesion culture, it would just be wishful thinking to think that it is not herpes.  

[gracefromHHP]

Yes your partner needs to get tested even though he can't recall any obvious symptoms of herpes.  Over 90% of those infected have no idea they are infected until tested. You can't make educated decisions about what precautions to take, if any, until you know who has what.

You had a + culture for herpes so yes you do have genital herpes. That doesn't mean however that you don't also have something else going on like another sort of infection to boot.

grace

[Misty24]

I just want to thank you for the time you take to do this... It is really a great thing.  Since my doctor told me he thought it was herpes, I have been reading up on it, and this site has been a great help to me.   I realize that life goes on after herpes, and that there will always be someone that I can talk to that has been thru the exact thing that I am going thru.  I am pretty sad about the situation, but I think that it will get better over time, and after some healing.  I am actually feeling better today, finally.  My partner has been very supportive, and I know that has helped too.  

Just a few more questions:

1.  Is Valtrex the best med for herpes?  As you probably know, it is expensive, even with my insurance, so I am wondering if other meds are as effective as Valtrex.  

2.  Should I just go ahead and stay on suppressive therapy?  Or should I go without for a while and see how many outbreaks I have without it?  My doc said it was up to me, and he would write me a rx if I want to stay on it.  

Thank you once again grace, you are great!

[gracefromHHP]

http://www.medhelp.org/user_journals/show/8280 is a journal entry I made on treating herpes. It should help you figure out which med to use.  If your insurance dosen't make valtrex affordable - chose acyclovir and just take it more often.

grace

[Misty24]

Hi Grace,

I have a few more questions for you.  

1.  Can you spread it to other parts of the body?  Like the eye or mouth.  I wear contacts, so I am nervous about the eye thing, but I always wash my hands anyway.  

2.  If when my partner gets tested, if he is negative, does that mean that we should not have oral sex, even when I don't have an ob?  

Thank you for all your help!  

[gracefromHHP]

washing your hands before putting in or taking out your contacts is all you need to do.

Why would you give up oral sex?  The risk of transmitting to the oral area is far lower than the risk from genital sex.  You can utilize barrier protection for oral if you both prefer it too.

grace

[Misty24]

Hi again Grace.. I have some more questions.

1.  If we decide to have children, will it have to be by C section, or is that only if you have a break out when you are going to deliver?  Also, are any of the antivirals safe to keep taking while you are pregnant?  

2.  Is it ok to going swimming in the lake and stuff like that when I have an outbreak?  They always say to keep the lesions clean and dry, so I am just wondering if it is better not to while I have an active break out.  I don't want to do anything that will affect the healing process.  

3.  Should I keep taking Valtrex 1gm 2 times a day until the ob symptoms are completely gone?  And when the ob is healed, then just 1 time a day?


Thanks again for all your help.  

[gracefromHHP]

1- the herpes handbook goes into herpes and pregnancy. give it a read when you get a chance.

2- you can swim as much as you want when you have an ob

3- 1gm 2x/day for 7-10 days and then it's the once daily dose

grace

[Misty24]

Hi Grace,

This is in one of your journal entries, and I just have a few questions about it...


So you think you might have herpes - what do you do? Well the best thing to do is go be seen by your provider within 24-48 hours of the start of symptoms.  Why? Well nothing replaces a good exam and basic testing for starters. Also viral lesion cultures are frequently false positive - in fact on average 70% of them are! Getting the culture done within a day or two of the start of symptoms increases your chances of having an accurate culture done. If you can get a pcr culture done of the lesion(s) for herpes even better!  It's more likely to pick up on herpes than a regular viral lesion culture is.

1.  70% false positive?  The reason I am asking is because I was not tested in 24-48 hrs.  I was tested 5-7 days after the first symptoms.  And also there was a delay in testing the actual culture too.  Could that have caused a false positive?  

2.  Should I get a blood test or some other testing just to make sure?  

Thanks

[gracefromHHP]

I mean false negative - sorry I thought I had changed that.

you need no further testing. time to stop denying this dahlin.  

grace

[Misty24]

Just wishful thinking I guess.  I do have a few more questions (Sorry!) about the lesions tho.  

1.  Is it normal for them to be "kissing" sores?  The reason I ask is because I have had some more spots come up, but they could just be pimples.  I can feel them under the skin, kind of like a pimple, but there is one on each side.  Is it normal to keep getting sores even after being on Valtrex for almost 10 days?  

2.  Also is it ok to shave the area even if there is still some irritation, or is it better to wait until all the symptoms are gone?  

Thanks

[gracefromHHP]

I absolutely would not shave until everything is completely healed.  If the hair is getting too long - trim it with scissors. I'd even be hesitate to use nair or anything - a chemical burn on top of all this would not be pretty.

It's not unusual during the first ob for there to be lesions on both sides.

grace

[Misty24]

Is itching during/after the lesions heal normal?  I am even itching in the buttocks region.  All the lesions except the two that I described above have healed, but I am itching like crazy from front to back.  I am wondering if I am irritating the area because I am cleaning it more often.  

Thanks again Grace

[gracefromHHP]

itching is common. If it continues even after the lesions are healed - return to your provider for further evaluation to make sure you don' t have something overgrowing down yonder like yeast or bacteria.

I like dermoplast spray for the itching - the blue can, not the red can for the genital area.You can find it at most drug stores for under $8.  

grace

[Misty24]

Not only is there itching, but my skin in the "boxer short area" feels like it is crawling, and it is driving me crazy.  Is that normal?  I also keep getting sharp, shooting pains in gential (genital) area.  I have called my doctor, but it always takes a day for them to get back to me, and I am worried that it isn't just herpes.  Maybe it is just time for me to get a new doc.  

[gracefromHHP]

It could be many things. I'd make an appointment to be seen again - a phone call isn't going to cut it from the sounds of things.

try soaking in the tubby and throw in a packet of aveeno bath or some baking soda or cornstarch and see if that helps until you are seen.

grace

[Misty24]

The itching and crawling is so bad, I can't even sleep.  If I can't be seen by my doc today, what should I do?  I have been uncomfortable for weeks. All the lesions are healed, so I konw this is probably something else.  

[auntiejessi]

You need to be seen, and insist on it.  Tell your doctor that you can't sleep, etc.  I wonder if you have bacterial vaginitis along with the rest of it.

If he absolutely can't see you today, then try taking a benedryl tonight, if its medically safe for you to do so.  That might help with the itching, and it will help you sleep.

Aj

[Misty24]

I have an appt tomorrow finally.  I think that I finally convinced them that something else is going on too.  In the mean time, I bought some of the dermoplast that Grace recommended and it seems to be helping.  And also I will try the benedryl tonight AJ.  Thank you both for the help.  This forum has been way more help to me than my doctors office has.  I am really just looking forward to feeling healthy for a little while, it seems like I have been uncomfortable forever.  

[auntiejessi]

Let us know what the doc says.  Grace is offline this week, but I am sure she'll be reading when she comes back.

Aj

[Misty24]

I went to the doc today, and they gave me some cream, which I already had that doesnt help, and I told them that, but they said I just was not using it enough.  They also did a urine test and said there was blood and protein in my urine, but she said it was from spotting, which I am on depo and dont even spot, so I am not sure how that is even possible.  They also did a swab test to test for bacteria or yeast, but I probably wont know the results of that unitl tomorrow.  Also my pap smear came back abnormal again, so now I am worried about that too.  I just cant seem to get any good news right now.  I am really trying to stay positive, but it is really hard when I feel crappy and keep getting bad news.  

[auntiejessi]

Aww I'm sorry you didn't get any real answers.

Let us know what the results say.

Aj

[Misty24]

Well I got my results today and it is a yeast infection.  They gave me a rx so hopefully I will be feeling better in a few days.  Its one of the yucky cream ones, so I am not looking forward to it, but anything that will help me feel better is worth it.  

Thanks again for all your help.  

[Misty24]

Just one quick question.  All my lesions have healed, but I do still have redness in the genital area, which might be from the yeast infection, but I am wondering if it would be ok to shave the area.  I dont want to make anything worse, but the hair is driving me crazy.  

Thanks

[auntiejessi]

I wouldn't shave just yet.  Use the cream first, and then shave.

You can trim now if its making you crazy.

Aj

[Misty24]

Hi Aj.  So the itching has gotten a little better, but my skin is still crawling.  Is it normal to have crawling skin?  Could it be something else?

[Misty24]

The itchng is in the genital and anal area.  

[auntiejessi]

Crawling skin?  I don't remember ever having crawling skin with herpes.

Anyone else here?

Maybe you have bacterial vaginosis on top of things - that could cause a mad itch.

Aj

[Misty24]

Maybe it is what they call tingling, but I think it feels like my skin down there is crawling, which makes me want to itch.  Did you ever experience tingling?  It also seems to be worse at night, but also occurs some during the day.  

[auntiejessi]

I get tingling when I have an outbreak, but not after.

This could be irritated nerves.  Try taking some ibuprofen to see if it calms it down.  

If its worse at night, you can also try taking benedryl, if you don't have any reason why you shouldn't take it.

Aj

[Misty24]

The icthing/tingling seems to be getting better, so maybe it is irritated nerves, or maybe it had something to do with the yeast infection.  Is it possible to get a yeast infection in the anal area?  And if so, would the med they gave me for the yeast infection cure that too, or would I need a different med for that?  My anus has been itchy, and when I had a bowel movement this morning, there was blood when I wiped.  Does that sound like hemmroids, or something else?  Sorry for all the questions.  

Thanks for your help.

[auntiejessi]

If there's blood, that's hemmies.  And yes, I know you needed just one more thing going wrong down there, huh?

Get some tucks pads and use them - that will help, and won't hurt yeast or herpes.

Aj

[Misty24]

Is hemmroids common when you get herpes?  I have never had them before, so I am just wondering.

Also,  I  remember reading somewhere that about 50% of people get another outbreak within 2 months of the first one, and am wondering if that is people that are on antivirals or not.  

How many outbreaks do you ususally get in a year, and are you on antivirals?  I am just wondering what I should expect in the future.  Someoen I know that has herpes, has never had another outbreak since they went on antivirals, and I am hoping that I will be that lucky.  I also have another dr appt so I can ask my doc some more questions too.  

Also, I read this in the herpes handbook:  "Women who have herpes should not be concerned about a greater risk for cervical cancer if they do not have HPV (genital/cervical wart virus)."  I have had a postive test for HPV this year, and I am wondering if I am at higher risk for cervical cancer now that I also have herpes.  

Thanks again for your time.  

[gracefromHHP]

There's some info that having coinfection with hsv2 and high risk hpv makes it more likely to not clear on its own but it's really not something I"d personally be too overly concerned about.  Most folks have low risk hpv that clears on its own and even most high risk also clears on its own. Your gyn is following up on you as recommended I'm sure so even if you would be one of the unlucky few who has all the "right" conditions for it to be an issue - it's not likely to be. Does that make sense?

Hemorrhoids are common in EVERYONE. They have nothing to do with herpes. More so gravity ( it is not our friend ) and constipation and childbirth than anything.

The average number of ob's is 4-6. It's different for everyone.

grace

[Misty24]

Do you think that the crawling skin sensation that I have been having could be a side  effect of Valtrex?

[gracefromHHP]

I would be totally guessing as to what it's from. Continue to follow up with your provider and if you can't find anything else at all that could be causing it, try stopping valtrex for a few months and see what happens.

grace

[Misty24]

I think that I am going to stop taking Valtrex now, I have an appt with my doc on Friday, and was planning on switching to acycolvir anyway because it is so much cheaper.  If it is a side effect of Valtrex, is it likely that I would have the same side effect while on acycolvirsinc they are so much alike?  Also, I read somewhere that some other people have had the tingling in the genital area on Valtrex, I think it was here or on HHP.  All I know is that I can't stand it anymore!  I just want to feel normal downtown for a while you know?

[Misty24]

Hi girls.  Just have a few more questions for you!  First off, I had my doc appt today, and he switched me Famvir and I also was tested for all STD's, however they said that they wouldnt test my blood for herpes, that they usually only diagnose that with a culture.  Why would they do that?  I know I have herpes, but was hoping that I could maybe at least get a better idea of who it came from if I got the blood test, and I guess there is still a small part of me that wants to think that it was just a false positive.  I will get the results to the STD test next week sometime.  But anyway, I will get to the questions.....  

1.  I have no smyptoms, so is it ok to have sex now?  It has been a month now, and my partner has been very supportive, but is getting a little impatient, and so am I.  

2.  I havent heard or read much about Famvir, have either of you taken it before, or know someone who has?  If so, did it work well for them, etc.?

Thanks again for your help!  

[gracefromHHP]

Famvir is similar to valtrex and works just as well.  Is your insurance making it affordable? If it's still too pricey - look into acyclovir instead. To me, if you have to take a medication 2x/day for suppressive therapy you might as well be taking the cheapest one!  

At this point a blood test probably isn't going to do a lot for you - you do know your type right?  Has your bf gotten tested yet?  I glanced thru the thread but couldn't see if he had been yet.

If your yeast infection has cleared up then you can resume sex.  

grace

[Misty24]

He has not been tested, but plans on it soon (he just swithced jobs and does not have insurance right now).  I dont think that we are soig to stay together, which just makes this situtation that much harder, but I know I will be fine in the long run.  (Who needs boys anyway?  They are more trouble than they are worth!).

I do know my type (type 2), but kinda wanted a blood test just to confrim.  Darn wishful thinking anyway.

I have met my RX deductible this year, so famvir is only $10 a month, but will probably switch to the acyclovir next year.  Is acyclovir the only RX for gential (genital) herpes that has a generic?  Sorry, I have read so much about herpes lately, I cant even remember!  

Thanks again.

[gracefromHHP]

Famvir is available as a generic too but depending on your copay depends on how much cheaper it is than acyclovir.  Can't beat $10 though!!!

grace

[Misty24]

Well I seem to be having another ob.  Do people usually get them that fast after the initial ob has healed?  Also, I dont know how to take the Famvir while I am having an ob.  How much should I take during the ob?  

Thanks.

[gracefromHHP]

1gm 2x/day for 1 day.

[Misty24]

I am still having some trouble believing that I have herpes... For a bunch for reasons really, which I just wont get into.  As I mentioned eariler, I have had a positive culture.  But my question is are they 100% accurate all the time...  Also, if it is herpes that I have and I had unprotected sex 2 times with someone, while I had no symptoms, and am not on antivirals, what are the chances of him catching it?  Also I have read a few places that a diagnosis should be confirmed with a blood test... Is this not true?  

Thanks for your help.

[curious1231980]

IgG blood tests are type specific and accurate after 3-4 months from your last exposure. If you're not sure and want to be positive about your status...ask for a type specific blood test. That's what i'm doing!

[curious1231980]

How long did it take for your herpes sores to form and burst? did you just have ulcers? How long did you have the bumps/pimples/blisters (whatever they're called) before they burst and became painful?

[gracefromHHP]

only a visual diagnosis needs confirmed with a blood test. You had a + lesion culture so you are infected. It's time to get out of denial sweetie.

The herpes handbook at www.westoverheights.com is a terrific resource. bookmark it and keep going back to read it whenever you need info. You can even print it out at home and have a paper copy of it handy.

A male partner's risk over the course of a year is about 4% on average if all you do is avoid sex during obvious lesions.

grace

[Misty24]

So no one has ever heard of a false positive culture?  It has never happened?  I just seem to have different symptoms.....

[Misty24]

I have no tingling before a spot appears, only some general tching.  And the spots are gone in a day or two.  They dont crust over or burst, they are just gone.  Plus I am itching and redness for weeks before and after a spot a appears.  How long does it usually take the lesions to heal on reoccurances?  I think I read somewhere that during reoccurances spots are usually on one side and that also isnt the case with me.  The fact that I didnt respond to the Valtrex at all also makes me wonder.  Have you ever heard of anyone having a false positive lesion culture?  

[Misty24]

bump

[gracefromHHP]

I'm not sure why you have such denial about this misty?

Are you continuing to follow up with your provider to make sure that there isn't something in addition to herpes going on?

grace

[Misty24]

I dont really know why I am having denial, just that a lot of it doesnt make sense I guess.  I had sex one night and a spot the next day, which my dr says wouldnt be from that exposure, but it had to be, unless I was carrying it for a while with no symptoms that is I guess.  Plus I didnt respond to the valtrex, and my spots dont fit the most of the descritptions.  Do they usually just disapear within 1-2 days during a reoccurance?  I just still have so many questions, and it is a pretty hard thing to come to terms with.  I thought it was just a raw spot from rough sex, but to my surprise I tested positive and just wonder if there is even a chance that a culture could come back as a false positive.  I even quit taking the antiviral and didnt have any problems for months until now, and I have general itching and redness and a few spots that have came up but are completely gone in 1-2 days with no scabbing, or puss or anything.  I guess my symptoms dont have to be typical though.  I just want to be 100% positive that herpes is what I have, and I'm just not convinced for some reason.  I have also read a few posts on some sights that say that they had a false positive lesion culture becasue they tested neg on the blood test later.  But I have also read that the culture is also the gold standard of herpes tests and false positives are extremely rare, but not that they never happen.  So it is kind of confusing and gives me a gleamer of hope that my culture could have been wrong.  

I am in between insurances right now and looking for a new dr, I still have to have another follow up for another abnormal pap, but will get seen asap.  

[gracefromHHP]

The only way a lesion culture is wrong is if it's clerical error. It happens but not often. In folks who have a + lesion culture but have a negative blood test later on they are still to assume that they have genital herpes and just one of the few who won't test accurately on the blood test.

As I said - return to your provider to see if anything other than just herpes is going on. Sounds like you might have something else also going on in addition to having genital herpes.

grace

[Misty24]

I am afraid that I had sex with an active lesion.  I am not actually sure that it is a lesion, it might just be a sore spot from rough sex, because it showed up the day after sex and is sore, but not really painful.  Does that sound like a lesion?  Also if it is a lesion, what are the chances that it would be passed to my partner?

[gracefromHHP]

You should avoid sex at this point until you feel better down yonder just in case.

Have you talked to your partner about this?

grace

[Misty24]

Yes I have talked to my partner.  I am also having some general redness and itchiness down yonder.... Does that sound like an OB or maybe a yeast infection? It seems almost like it always happens after sex and is that way for a few days..... Do OB's cause general redness like that?  And what are the chances that my partner would get it if it is an OB and we had sex?  

[gracefromHHP]

If this is always happening after sex then it's probably not herpes related. You'll need to follow up on it with your gyn and/or a dermatologist to try to figure out what is going on.

grace