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Confused about diagnosis
Recently someone very close to me was date raped. The morning after the incident she did not remember anything she was sore down below, she called the person and they denied it of course. She was confused and did not go to the doctor or police immediately. 10 days later she developed a SINGLE red sore bump, on her perineum (area between vagina and anus) it was in a oval shape. she then went to planned parent hood and told them everything. They then contacted the police and started the whole process. Planned Parenthood did a culture swab and it came back positive as HSV-2.
The bump lasted for two weeks, there was only the single red oval bump about 1 inch in size, the red bump did not blister, did not look like a ulcer, was not filled with any type of fluid at all.She had no other lesions, blisters or bumps on her vagina or anywhere else. Her other symptoms did match that of herpes though, those being, lower back pain, neck stiffness and joint pain. But those additional symptoms do match that of the side effects of the anti-viral medication she was given. This was also her first "outbreak" if it in-fact is herpes, I would think that she would have more than one bump? Generally everything I have heard about herpes sores is that they blister, pop and contain liquid, especially in the first outbreak (worst outbreak). Could this be a possible mis-diagnosis?
I told her to get a blood test as a secondary opinion too make sure. Especially considering this was plan parent hood who diagnosed her not her normal doctor. It has been a month since the incident , is that enough time for anti bodies to build and show on a blood test?
Thank you
The bump lasted for two weeks, there was only the single red oval bump about 1 inch in size, the red bump did not blister, did not look like a ulcer, was not filled with any type of fluid at all.She had no other lesions, blisters or bumps on her vagina or anywhere else. Her other symptoms did match that of herpes though, those being, lower back pain, neck stiffness and joint pain. But those additional symptoms do match that of the side effects of the anti-viral medication she was given. This was also her first "outbreak" if it in-fact is herpes, I would think that she would have more than one bump? Generally everything I have heard about herpes sores is that they blister, pop and contain liquid, especially in the first outbreak (worst outbreak). Could this be a possible mis-diagnosis?
I told her to get a blood test as a secondary opinion too make sure. Especially considering this was plan parent hood who diagnosed her not her normal doctor. It has been a month since the incident , is that enough time for anti bodies to build and show on a blood test?
Thank you
I understand that, I just wanted to share the information.
MEDICAL PROFESSIONAL
Both lines of research may be promising, but it's much too early to know. If either method eventually leads to successful treatment, it's several years in the future.
Ok great thank you what do you think about the research that is being done at Duke and florida state university? Duke thinks they may have a cure that is looking promising, florida is developing a great suppressive drug that may eliminate all future outbreaks.
see links below if interested:
http://news.ufl.edu/2009/02/03/herpes-2/
http://www.****************.com/messageforum/showthread.php?25294-Official-Professor-Cullen-of-Duke-University-Update
see links below if interested:
http://news.ufl.edu/2009/02/03/herpes-2/
http://www.****************.com/messageforum/showthread.php?25294-Official-Professor-Cullen-of-Duke-University-Update
MEDICAL PROFESSIONAL
I agree the timing alone makes a new infection likely. But still, the other aspects are atypical.
Side effects of drugs, as listed in official sources, name everything that occurs to people in the research studies conducted by the manufacturer, no matter how infrequent, and regardless of whether or not they are just as common with placebo. For valacyclovir, the side effects you mention were infrequent and occurred at equal rates with placebo. In fact, valacyclovir is one of the most side-effect-free drugs that exists.
I agree she should check with her doctor before stopping valacyclovir. However, my consistent advice to both patients and doctors is to not start ongoing suppressive therapy until a few months have passed after the initial infection. That's the only way a patient and her doctor can know the natural course untreated -- which in turn determines whether to start suppressive treatment. If your friend happens to be one of those with infrequent outbreaks (e.g. only once or twice a year) and there is no sex partner at risk, she may not need suppressive treatment at all. She should discuss these aspects with her doctor, as well as the potential interference with blood test results. (You could print out this reply, as a framework for discussion with the doctor.)
Side effects of drugs, as listed in official sources, name everything that occurs to people in the research studies conducted by the manufacturer, no matter how infrequent, and regardless of whether or not they are just as common with placebo. For valacyclovir, the side effects you mention were infrequent and occurred at equal rates with placebo. In fact, valacyclovir is one of the most side-effect-free drugs that exists.
I agree she should check with her doctor before stopping valacyclovir. However, my consistent advice to both patients and doctors is to not start ongoing suppressive therapy until a few months have passed after the initial infection. That's the only way a patient and her doctor can know the natural course untreated -- which in turn determines whether to start suppressive treatment. If your friend happens to be one of those with infrequent outbreaks (e.g. only once or twice a year) and there is no sex partner at risk, she may not need suppressive treatment at all. She should discuss these aspects with her doctor, as well as the potential interference with blood test results. (You could print out this reply, as a framework for discussion with the doctor.)
I believe she was on valacyclovir, I looked up some of the side effects and a few of the side effects I mentioned were listed. She did have a headache as well, no noticeable fever though. This is the first outbreak she has had, she has also not had sex in about two years. I understand that she could have had it previously and it was lying dormant. I think it seems a little naive to believe that this just so happened to pop up after she was assaulted.
I will update with the blood test results and have her consult with her doctor on whether or not to stop taking the medication for the test.
Yes he has been identified and is the only possible person that could have done it. It was rumored that her friends friend got herpes from the same person, which is why she was tested. I am sure he will not be cooperative, but i'm sure it will be mandated by court if it is already not known by his doctor.
Lastly, what do you think about the research being done at Duke and Florida state university in relation to herpes?
I will update with the blood test results and have her consult with her doctor on whether or not to stop taking the medication for the test.
Yes he has been identified and is the only possible person that could have done it. It was rumored that her friends friend got herpes from the same person, which is why she was tested. I am sure he will not be cooperative, but i'm sure it will be mandated by court if it is already not known by his doctor.
Lastly, what do you think about the research being done at Duke and Florida state university in relation to herpes?
MEDICAL PROFESSIONAL
Welcome to the forum. I'm sorry to hear of your friend's unpleasant and traumatic experience. Please wish her well for me.
First, there is no mis-diagnosis. A positive culture for HSV is definitive, so there is no doubt she has genital herpes due to HSV-2. However, I am not certain she has a new infection acquired during the sexual assault. It is certainly possible to have initial genital herpes with only a single lesion, and the systemic symptoms you describe are compatible with initial herpes. However, a bump that does not turn into a blister or ulcerate is atypical, the onset was on the late side (10 days isn't rare, but usually it's within 5 days), and you say nothing about lymph node inflammation in the groin (tenderness, swelling) that usually is present. So there is at least a possibility your friend had HSV-2 before the assault, and happened to have a recurrent outbreak 10 days later. (It is not rare for someone to have an entirely asymptomatic infection, that starts producing recognized outbreaks several months or even years later.)
I'm a little puzzled about the "anti-viral medication"? The anti-herpes drugs (valacyclovir, acyclovir, or famciclovir) very rarely cause side effects at all, and would not be expected to result in back pain, neck stiffness, or joint pain. On the other hand, those symptoms also aren't very helpful in judging whether or not she has a new HSV infection, which doesn't usually cause joint pain, and not stiff neck unless there also is prominent headache and fever.
Your suggestion for blood testing for HSV-2 is excellent, and I recommend it. She should have the first test now, and a second in 3-4 months. In an initial infection, an early blood test should be negative, but it should turn positive in 3-4 months. However, since more than a month has passed, even the first test might be positive, even with an initial infection. But it might still be negative, and the results also can be helpful if a weak positive result becomes stronger in a few weeks.
If your friend is taking one of the anti-herpes drugs, I suggest she stop treatment now. It can always be restarted if symptoms flare up, or if she wants to take suppressive treatment to prevent outbreaks or help prevent transmission to her sex partner(s). However, these drugs can interfere with the blood test results.
Finallly, if your friend's sexual assailant can be identified and located, perhaps it can be learned whether he has known genital herpes; or if that isn't known, perhaps could be convinced to have a blood test. Of course I recognize he may not be cooperative, given the legal situation.
I hope this helps. Please return with follow-up information as appropriate, including eventual blood test results.
Regards- HHH, MD
First, there is no mis-diagnosis. A positive culture for HSV is definitive, so there is no doubt she has genital herpes due to HSV-2. However, I am not certain she has a new infection acquired during the sexual assault. It is certainly possible to have initial genital herpes with only a single lesion, and the systemic symptoms you describe are compatible with initial herpes. However, a bump that does not turn into a blister or ulcerate is atypical, the onset was on the late side (10 days isn't rare, but usually it's within 5 days), and you say nothing about lymph node inflammation in the groin (tenderness, swelling) that usually is present. So there is at least a possibility your friend had HSV-2 before the assault, and happened to have a recurrent outbreak 10 days later. (It is not rare for someone to have an entirely asymptomatic infection, that starts producing recognized outbreaks several months or even years later.)
I'm a little puzzled about the "anti-viral medication"? The anti-herpes drugs (valacyclovir, acyclovir, or famciclovir) very rarely cause side effects at all, and would not be expected to result in back pain, neck stiffness, or joint pain. On the other hand, those symptoms also aren't very helpful in judging whether or not she has a new HSV infection, which doesn't usually cause joint pain, and not stiff neck unless there also is prominent headache and fever.
Your suggestion for blood testing for HSV-2 is excellent, and I recommend it. She should have the first test now, and a second in 3-4 months. In an initial infection, an early blood test should be negative, but it should turn positive in 3-4 months. However, since more than a month has passed, even the first test might be positive, even with an initial infection. But it might still be negative, and the results also can be helpful if a weak positive result becomes stronger in a few weeks.
If your friend is taking one of the anti-herpes drugs, I suggest she stop treatment now. It can always be restarted if symptoms flare up, or if she wants to take suppressive treatment to prevent outbreaks or help prevent transmission to her sex partner(s). However, these drugs can interfere with the blood test results.
Finallly, if your friend's sexual assailant can be identified and located, perhaps it can be learned whether he has known genital herpes; or if that isn't known, perhaps could be convinced to have a blood test. Of course I recognize he may not be cooperative, given the legal situation.
I hope this helps. Please return with follow-up information as appropriate, including eventual blood test results.
Regards- HHH, MD
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
