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When to test for Herpes?
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When to test for Herpes?

After having the worst cold sore on my lip ever (took two weeks to heal), about a week later I experienced some itching in my genital area.  The next day, I noticed several small red bumps, flat with small darker cores, between my penis and right testicle.  They didn't seem to ooze, just scab.  I went to several doctors, one saying it was herpes, one unsure, and one saying it wasn't, but took a cotton swab sample to the lab.  My girlfriend and I (both monogamous for 7 years) did not kiss during the time I had the cold sore.  We did have intercourse and she performed oral sex on me.  One doctor indicates that I gave it to myself, transferring the virus from the mouth to the genitals through a towel or an inadvertant touch.  Is that possible?  Also, my girlfriend is very worried that she has contracted the virus.  What definitive tests could show if she was exposed?  She isn't displaying any symptoms.  Should she wait or should she get tested now?
Thanks.
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101028_tn?1419606604
No, you did not give yourself genital herpes.

No, it doesn't get transferred on a towel or another object.

odds are that neither you nor your gf have ever been tested for herpes before. at this point I recommend you both get a type specific herpes igg blood test done.

Did any of them suggest fungus as a cause of your rash? is the rash still there?

How long into symptoms did you get the swab test done?  Are results back yet?

grace
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Avatar_n_tn
Thanks for your reply.
First doc said it was folliculitis, the second said it was herpes, and the third said he was 50% sure it was herpes.  

The rash is still there.  It has not spread any further, but it hasn't really gotten any better, either.  I'm taking both Valtrex and Cefadroxil, to cover both a viral and bacterial infection. It doesn't itch any more, hasn't since day before rash.  I do sometimes get an uncomfortable feeling, like a dull ache.

The swab test was done two days after the initial itchiness, one day after I discovered the rash. The doctor had to lift a scab to be able to swab, b/c there was no moist surface.

I am going to a doctor today, and will ask for a "type specific igg" blood test to be done.  Is there anything else I should ask for while I'm there?
Thanks again.
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101028_tn?1419606604
When should the swab results be back?

grace
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Avatar_n_tn
I just called the clinic, and the technician there said the results were negative so far, but that they would wait a full seven days until the results were official.  I'm on my way to the doctor's office in a couple of hours.  Any other info I should know?  Other tests I should ask for?
Thanks again.
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101028_tn?1419606604
Unless one of you has hsv2 and doesn't know it, odds are that this is something non-herpes going on.  If your rash isn't gone in a week of the antibiotics, return to your provider or see a dermatologist for further evaluation.

grace
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Avatar_n_tn
Thanks again for the input. Just returned from the doctor.  He drew two vials of blood and the results will be back by Monday.  He examined me and said it may be herpes, but he wasn't sure.  My girlfriend will get the bloodtests as well.

Shouldn't we also wait 12-16 weeks to get the tests done?  Won't they be most accurate then?

Finally, if I began to have these symptoms on the 24th, but we hadn't had any sexual contact since the 14th, how likely would it be that I spread the virus to her at all?

Thanks again for all your help.
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101028_tn?1419606604
Getting blood tests now, lets you both know your status prior to this. That way if say both of you just test + for hsv1, you know this isn't likely to be hsv1 genitally due to your history of cold sores so you know that no reason for more herpes work up to be done. If say you test + for hsv1 and + for hsv2, then you know that indeed this might be a prior hsv2 infection reoccuring that you never knew that you had. If you test + for hsv1 and negative for hsv2 but your gf tests + for hsv2, then you know that there is a possibility that this is hsv2 genitally that you recently contracted from your gf so you know you'll need additional follow up testing done in the future.  Make sense?

If this is hsv2 that you had and didn't know it, is there a chance you transmitted it to your partner?  Not having sex for 10 days prior to all of this makes the risk that you transmitted it from this episode unlikely.  

grace
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Avatar_n_tn
Again, thanks.  It's comforting to learn more information.

The viral culture results from the first test, done within 48 hours of the first symptoms, will be ready on Monday.  My bloodwork should also be ready on Monday.  Unfortunately, my girlfried couldn't get to a doctor until Tuesday, so her test won't be back for several days after that.  

So, I'm a bit confused about the testing hypotheses you mentioned. Since we have both had cold sores on the mouth in the past, wouldn't we automatically test HSV1 +?  How do we know if I have genital HSV1?  Is there a test that differentiates between oral and genital?  Also, if we both tested + for HSV1, why did you say we wouldn't need anymore testing?  Sorry, but I don't understand.  I'm still trying to learn as much as I can, but I'm still a bit confused.

Besides this community and website, is there a readily available book that can answer FAQs about this situation?  Thanks again, Grace.
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101028_tn?1419606604
No, a blood test can't tell you where you are infected, it only tells you what you have. Having hsv1 previously gives you significant protection against contracting it genitally, not 100% but it's up there close. You can get hsv1 genitally after having a well established oral infection but it's not likely to happen.  The only way to diagnose hsv1 genitally is thru a lesion culture and typing of active symptoms.

I can recommend some herpes books but at this point, you are better off waiting for test results so we can see if this is even herpes going on or not before you spend money.

grace
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Avatar_n_tn
So, I have received some results from different tests that I had done. My first culture from the first 48 hours from showing symptoms tested negative for Herpes Simplex Virus, according to the lab results.  I know there are a lot of cultures that produce false negatives.  The doctor did have to remove a scab to use the swab, so there is a chance the site was dry of the virus, correct?  It was the second day that I was showing symptoms, so it was within the 48 hour window.  

Here are the results from the other tests that were done 4 days later:   There was a blood test marked "Herpes Types 1 7 2 IGM ABS(EIA) w/Reflex IFA"  that tested < 0.8 for both HSV 1 and 2.

Another test under "Molecular Diagnostics" that says HSV 1 - DNA Result: Not Detected and HSV 2 - DNA Result: Not Detected.

I am still awaiting the results of the IGG test, which was delayed a day or two.

I know that the IGG is the best test, and that the other two, cultures and IGM, have a high false negative result.  After the IGG tests are in, assuming they are negative, when else should I have test work done, and what type, to really be sure of my results.
Hopefully optimistic, but realistically still concerned.
Thanks
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101028_tn?1419606604
If your hsv2 igg is negative and your partner gets tested and is also negative then not likely it was herpes going on.

grace
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Avatar_n_tn
OK, I hope it's not.  When the IGG comes back, considering the fact that both me and my girlfriend have had cold sores in the past, what numbers should be in the normal range?  If the swab test was a false negative, then I need to wait for an outbreak and have it cultured again, if it even happens? We should both also be tested at 12-16 weeks as well, only the IGG, correct? Realistically, since both my swabs tested negative but we'll likely test positive for HSV1 (cold sores) there's no way to tell if I have genital HSV1 unless I have another outbreak and have it swabbed in the correct timeframe, is there?  I just wish there was a test that could identify if you have HSV1 genitally, for certain, without a doubt.
Thanks.
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101028_tn?1419606604
when is your partner getting a blood test done for hsv2?

grace
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Avatar_n_tn
She got the blood drawn on Tuesday.  We'll probably get the results by Monday, Tuesday the latest.  Why?  
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Avatar_n_tn
Just a question, I also happen to have Fordyce spots on my genitals. Would scratching and itching them too hard (perhaps b/c of folliculitis) cause them to look like Herpes?  I'm really worried that the only way I'll be getting a definitive answer regarding this issue is if I have another outbreak and catch it in a timely swab. This is really getting very frustrating.
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Avatar_n_tn
So, I finally got the blood test results back.  The nurse read them to me over the phone, so this is what she told me.  The IGG test was at 5.23 for HSV -1, which I assumed would be high because I have a history of cold sores.  She said it was an old infection.  Could the test determine that?  I had a cold sore about two weeks before the rash "down below." The HSV -2 results were 0.18, which is negative, correct?  My main question is, however, could I have autoinnoculated myself with the HSV-1, orally to genitally, and how would that affect the numbers?

Also, my girlfriend got her test results back.  She has not had any symptoms, whatsoever.  Her results were
                     IgM                 IgG
HSV - 1        .8                    6.24 (History of cold sores)
HSV - 2        .07                  She didn't get a number, the nurse said negative, though.

Both of us will obviously be tested again, in one month and again two after that.  I'm still concerned though.  Any thoughts?
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101028_tn?1419606604
I don't recommend any further herpes testing at all for either of you at this point. You already know you have hsv1 from your cold sore history.  You are both negative for hsv2. No reason for more testing.  You've ruled out genital herpes in this relationship :)

grace
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