Confused about symptoms and test results

[scared&alone]

23 days after having protected sex with an ex-boyfriend, I noticed a sore on my vulva, just outside the vagina. I had been walking a lot in tight pants, but went to my gynecologist anyway the next day. She said it didn't look like herpes, but rather an infected gland of some sort. She did a viral culture and put me on Keflex. The viral culture came back negative. I felt like I had a yeast infection from the Keflex, so I used one day of a 3 day Monistat pack (the cream was really irritating). A week later, the itching was back, so I used the remaining two days. Following the two days, I felt intense tingling in the vaginal area. This was followed by a couple of days of intense swelling and pain (I had difficulty walking) and pain while urinating. There was some itching, but pain was the predominant feeling. I went to the doctor on Monday and asked for a herpes blood test. The blood was taken 7 weeks after the last time I had sex. She said IgG and IgM were both negative. She gave me Diflucan, which had little, if any, affect.

The soreness and swelling has persisted now for 6 weeks straight, bothersome but less intense, and yeast cultures are coming back negative. There isn't any itching to note. The area directly outside the vagina is very red and painful tot he touch. 7 days ago (3 days after douching, for some stupid reason I thought that would help), I started to get tingling feelings that last 5-10 seconds, mostly when I moved. Thinking that it was going to be followed by the intense swelling I experience before, I started taking Monistat. 7 days later, the tingling has subsided, but hasn't gone away completely.

During this time, I got my period, and the between that and the Monistat the soreness and swelling started to subside. But now my period is over, and it is back with a vengeance. Also, now I felt as though there are bumps on my cervix.

Should I still be worried about herpes? There is so much going on I don't even know what's up with my body anymore. I have been to the doctor so many times, I don't even know what I should be worried about anymore. I have been FREAKING out about herpes. I have been a nervous wreck for now for 8 weeks.

[H. Hunter Handsfield, M.D.]

You and your provider were right to be concerned about herpes, regardless of whether or not the lesion looked typical.  Herpes is the most common cause of genital ulceration, and many cases do not have typical appearances.  On the other hand, most providers probably would be able to distinguish an "infected gland" from herpes.  In any case, the negative blood test at 7 weeks is reassuring.  But it isn't perfect; it can take up to 3 months to develop a positive result.  Therefore, retesting at 3 months would be a good idea, but most likely that result also will be negative.  (Tell your provider to tell the lab to not to an IgM test, which will be more likely confusing than helpful.  Search other threads for "herpes diagnosis", "HerpeSelect test" and "IgM".)

Your current symptoms indeed sound more like yeast than herpes.  But of course follow up with your provider and do not rely on my guess--which is all it is.

Good luck-- HHH, MD

[scared&alone]

Oh, forgot to mention - the initial sore on my vuva seemed to respond to the Keflex. A week later, it and the pain when I touched it was almost entirely gone (despite my obsessive looking/touching it for the week)

[scared&alone]

How accurate is the viral culture? That came back negative, in addition to the blood test at 7 weeks. Also, the tingling subsided when I was put on Diflucan, but the swelling hasn't yet.

[scared&alone]

Also, I went to a walk-in clinic, and the doctor there told me that my cervix did look a little abnormal around the edges, but that it didn't look like herpes.

[H. Hunter Handsfield, M.D.]

The ability of viral culture to detect HSV is best for fresh, new lesions.  Your negative culture just a day or two after onset is pretty good evidence against HIV, but not perfect.  Combined with the negative antibody test at 7 weeks, it is unlikely you have herpes.  But as I said initially, a 3 month test would be a good idea to be certain.

HHH, MD