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DIAGNOSIS CLARIFICATION
ANNUAL VISIT TO GYN DISCUSSED SOME ERUPTIONS IN GROIN AREA. ARNP EXAMINED ME SUSPECTED ERUPTIONS WERE HERPES. TOOK BLOOD TEST (HERPES SELECT). CULTURE NOT TAKEN (NO FLUID). BLOOD TEST POSITIVE FOR HSV-1 AND HSV-2.
ERUPTIONS SEEMED LIKE LARGE PIMPLES/BOILS CAME TO HEADS W/WHITE TOPS. DURING/AFTER SHOWER AREAS EXPRESS FLUID W/GENTLE SQUEEZE. INITIAL FLUID WHITE PUS FOLLOWED BY BLOODY DRAINAGE. IF ALL FLUID DRAINED, RESOLVED WITHIN A DAY +. SOME QUITE LARGE & DEEP UNDER SKIN OTHERS SMALLER AND MORE SUPERFICIAL. (OUTBREAK STARTED 12/22/10 WITH SMILIAR EPISODE IN EARLY NOV.) WOULD THIS BE A COMMON PRESENTAION OF HERPES?
MONOGAMOUS RELATIONSHIP19 YEARS. HUSBAND TESTED ON 1/5/11 AND IS NEGATIVE FOR HSV-2. REVISITED GYN WHEN PIMPLE COMING TO HEAD. ARNP NOT CONFIDENT SAMPLE ADEQUATE; NO CULTURE TAKEN. SHOWED HER 3 RED AREAS ON BUTTOCKS & SACRAL AREA; ALSO HERPES PER PA. AREAS DIFFERENT IN APPEARANCE FROM THE ONES ON GROIN. LOOK LIKE "COLD SORE" AFTER SCABBING STAGE (RED AND SLIGHTLY RAISED). IS IT POSSIBLE FOR HERPES TO PRESENT SO DIFFERENTLY? STARTED COURSE OF ACYCLOVIR 1/6/11. THERE IS A LITTLE IMPROVEMENT IN THE SKIN ERUPTIONS IN BOTH AREAS. HAVE HAD RED AREAS ON MY BUTTOCKS AND SACRAL AREA IN PAST. ALSO HAD PIMPLE/BOIL TYPE ERUPTIONS AS DESCRIBED ABOVE ON MY UPPER THIGHS PRIOR TO THE NOV.
IS IT POSSIBLE TO GET HERPES W/O SEXUAL CONTACT? POSSIBLE THAT AQUIRED VIRUS OVER 19 YEARS AGO & NOT SHARED IT W/HUSBAND? OR HAVE BEEN HAVING OUTBREAKS & DID NOT REALIZE? IN WHICH CASE IT WOULD SEEM VERY UNLIKELY THAT IT HAS NOT BEEN TRANSMITTED TO MY HUSBAND.
TODAY MY HUSBAND DEVELOPED A "PIMPLE" ON HIS FACE THAT RESEMBLES THE ERUPTIONS I HAD IN GROIN AREA. READ ON A DIFFERENT SITE THAT GENITAL HERPES OUTBREAK, WHETHER CAUSED BY HSV-1 OR -2, WOULD NOT APPEAR ON FACE OR MOUTH. BASED ON YOUR KNOWLEDGE AND EXPERIENCE IS THIS TRUE?
CAN HERPES BE TRANSMITTED THRU SALIVA OR BODILY FLUIDS DURING AN OUTBREAK? OR WHEN NO OUTBREAK IS PRESENT?
ERUPTIONS SEEMED LIKE LARGE PIMPLES/BOILS CAME TO HEADS W/WHITE TOPS. DURING/AFTER SHOWER AREAS EXPRESS FLUID W/GENTLE SQUEEZE. INITIAL FLUID WHITE PUS FOLLOWED BY BLOODY DRAINAGE. IF ALL FLUID DRAINED, RESOLVED WITHIN A DAY +. SOME QUITE LARGE & DEEP UNDER SKIN OTHERS SMALLER AND MORE SUPERFICIAL. (OUTBREAK STARTED 12/22/10 WITH SMILIAR EPISODE IN EARLY NOV.) WOULD THIS BE A COMMON PRESENTAION OF HERPES?
MONOGAMOUS RELATIONSHIP19 YEARS. HUSBAND TESTED ON 1/5/11 AND IS NEGATIVE FOR HSV-2. REVISITED GYN WHEN PIMPLE COMING TO HEAD. ARNP NOT CONFIDENT SAMPLE ADEQUATE; NO CULTURE TAKEN. SHOWED HER 3 RED AREAS ON BUTTOCKS & SACRAL AREA; ALSO HERPES PER PA. AREAS DIFFERENT IN APPEARANCE FROM THE ONES ON GROIN. LOOK LIKE "COLD SORE" AFTER SCABBING STAGE (RED AND SLIGHTLY RAISED). IS IT POSSIBLE FOR HERPES TO PRESENT SO DIFFERENTLY? STARTED COURSE OF ACYCLOVIR 1/6/11. THERE IS A LITTLE IMPROVEMENT IN THE SKIN ERUPTIONS IN BOTH AREAS. HAVE HAD RED AREAS ON MY BUTTOCKS AND SACRAL AREA IN PAST. ALSO HAD PIMPLE/BOIL TYPE ERUPTIONS AS DESCRIBED ABOVE ON MY UPPER THIGHS PRIOR TO THE NOV.
IS IT POSSIBLE TO GET HERPES W/O SEXUAL CONTACT? POSSIBLE THAT AQUIRED VIRUS OVER 19 YEARS AGO & NOT SHARED IT W/HUSBAND? OR HAVE BEEN HAVING OUTBREAKS & DID NOT REALIZE? IN WHICH CASE IT WOULD SEEM VERY UNLIKELY THAT IT HAS NOT BEEN TRANSMITTED TO MY HUSBAND.
TODAY MY HUSBAND DEVELOPED A "PIMPLE" ON HIS FACE THAT RESEMBLES THE ERUPTIONS I HAD IN GROIN AREA. READ ON A DIFFERENT SITE THAT GENITAL HERPES OUTBREAK, WHETHER CAUSED BY HSV-1 OR -2, WOULD NOT APPEAR ON FACE OR MOUTH. BASED ON YOUR KNOWLEDGE AND EXPERIENCE IS THIS TRUE?
CAN HERPES BE TRANSMITTED THRU SALIVA OR BODILY FLUIDS DURING AN OUTBREAK? OR WHEN NO OUTBREAK IS PRESENT?
THANK YOU SO MUCH FOR ALL THE INFORMATION. IT IS OF GREAT HELP TO US.
THERE ARE HOWEVER, A COUPLE OF THINGS THAT I STILL NEED TO ADDRESS.
1. SHEDDING OF THE VIRUS. DOES THE SHEDDING OCCUR AT THE SITE(S) WHERE ONE HAS HAD A SORE OR IS IT MORE SYSTEMIC FOR INSTANCE IN BLOOD OR BODILY FLUIDS?
IF ONE HAS NEVER HAD AN OUTBREAK, CAN THEY STILL SHED THE VIRUS?
3. I AM PLANNING TO SEE A DERMATOLOGIST FOR HELP WITH CLEARING UP WHAT IS MOST LIKELY A BACTERIAL INFECTION. BASED ON THE ASSUMPTIONS THAT THESE ERUPTIONS (BOTH VARIETIES) ARE BACTERIAL AND THAT IT SEEMS THAT I HAVE BEEN INFECTED FOR AT LEAST 19 YEARS, HOW IS IT THAT I DID NOT PASS IT TO BY HUSBAND? (HIS BLOOD TEST IS NEGATIVE AND MY BLOOD TEST IS POSITIVE FOR HSV-2) IS IT POSSIBLE THE VIRUS IS STILL IN DORMANCY IN ME?
THANKS, STILL TRYING TO LEARN TO LIVE WITH THE DIAGNOSIS.
THERE ARE HOWEVER, A COUPLE OF THINGS THAT I STILL NEED TO ADDRESS.
1. SHEDDING OF THE VIRUS. DOES THE SHEDDING OCCUR AT THE SITE(S) WHERE ONE HAS HAD A SORE OR IS IT MORE SYSTEMIC FOR INSTANCE IN BLOOD OR BODILY FLUIDS?
IF ONE HAS NEVER HAD AN OUTBREAK, CAN THEY STILL SHED THE VIRUS?
3. I AM PLANNING TO SEE A DERMATOLOGIST FOR HELP WITH CLEARING UP WHAT IS MOST LIKELY A BACTERIAL INFECTION. BASED ON THE ASSUMPTIONS THAT THESE ERUPTIONS (BOTH VARIETIES) ARE BACTERIAL AND THAT IT SEEMS THAT I HAVE BEEN INFECTED FOR AT LEAST 19 YEARS, HOW IS IT THAT I DID NOT PASS IT TO BY HUSBAND? (HIS BLOOD TEST IS NEGATIVE AND MY BLOOD TEST IS POSITIVE FOR HSV-2) IS IT POSSIBLE THE VIRUS IS STILL IN DORMANCY IN ME?
THANKS, STILL TRYING TO LEARN TO LIVE WITH THE DIAGNOSIS.
MEDICAL PROFESSIONAL
OK, this information helps sort things out.
This doesn't sound like genital herpes, which rarely shows up in the groin, doesn't cause such widespread recurrrent outbfreaks, and don't cause large (half inch) boil-like lesions. Your positive blood test suggests you may have been infected with HSV-2 for a long time, and recurrent herpes outbreaks generally are much more limited, e.g. a cluster of bumps/blisters, usually recurring in pretty much the same spots every time. This might apply to your buttock lesions, but I most of what you describe sounds more like a bacterial infection, perhaps staph or strep.
It may be reasonable to try acyclovir for a few weeks, but I do not expect it to make any difference in frequency or severity of the groin lesions or any others that behave like pimples or boils (see the first paragraph of my original reply above). If you continue to have these sorts of outbreaks despite acyclovir, I strongly recommend you stop it, and then plan on re-testing any recurrent lesions for HSV by culture or PCR.
This doesn't sound like genital herpes, which rarely shows up in the groin, doesn't cause such widespread recurrrent outbfreaks, and don't cause large (half inch) boil-like lesions. Your positive blood test suggests you may have been infected with HSV-2 for a long time, and recurrent herpes outbreaks generally are much more limited, e.g. a cluster of bumps/blisters, usually recurring in pretty much the same spots every time. This might apply to your buttock lesions, but I most of what you describe sounds more like a bacterial infection, perhaps staph or strep.
It may be reasonable to try acyclovir for a few weeks, but I do not expect it to make any difference in frequency or severity of the groin lesions or any others that behave like pimples or boils (see the first paragraph of my original reply above). If you continue to have these sorts of outbreaks despite acyclovir, I strongly recommend you stop it, and then plan on re-testing any recurrent lesions for HSV by culture or PCR.
CURRENT OUTBREAK STARTED AROUND DEC 22. THE ERUPTIONS ARE IN THE FOLD WHERE THE THIGH MEETS THE PUBIC AREA (WHERE UNDERPANT ELASTIC LIES). THEY STARTED AT LOWEST POINT AND EXTEND ABOUT 4 INCHES ON FRONT SIDE OF GROIN.
FIRST ERUPTION WAS A LARGE BOIL WHICH WAS 1/2-3/4 OF AN INCH IN DIAMETER
AND ABOUT AS DEEP UNDER THE SKIN ON THE LEFT SIDE. TENDER TO TOUCH. AFTER SHOWERING THIS DEVELOPED A WHITE HEAD WHICH COVERED THE TOP AND WHEN SQUEEZE PUS CAME OUT FOLLOWED BY A LARGE AMOUNT OF MOSTLY BLOODY DRAINAGE. AT THE SAME TIME A SIMILAR BOIL APPEARED ON RIGHT SIDE. ABOVE THESE TWO LARGE BOILS WERE A SERIES OF 3 OR 4 PIMPLES IN A ROW ABOVE THE LARGER ONES (ABOUT 1/2 INCH APART). THESE WERE RED, RAISED AND FIRM TO TOUCH. ALSO SORE TO TOUCH OR WHEN CLOTHING RUBBED. THESE HAVE VERY SMALL WHITE HEADS AND DO NOT EXPRESS MUCH FLUID. THESE PERSIST TODAY AND SEEM TO BE RESOLVED IN AM AND IRRITATED IN EVENING.
I HAVE HAD SOME INTERMITTENT TENDERNESS IN LYMPH NODES OF GROIN AREA DURING THE PERIOD FROM DEC 22 UNTIL NOW. NO FEVERS. DID HAVE A HEADACHE OF SHORT DURATION ON DEC 23 OR 24TH. DID HAVE A FEELING LIKE I WAS COMING DOWN WITH SOMETHING AROUND THAT TIME, BUT WAS ALSO TIRED AND STRESSED.
IN EARLY NOVEMBER HAD 2 BOIL TYPE ERUPTIONS IN SAME GENERAL AREA WHICH RESOLVED AFTER THEY DRAINED.
SAW ARNP ON DEC 28 WHEN BOILS WERE RESOLVED BUT PIMPLES WERE STILL ERUPTED BUT NOT DRAINING.
ON SECOND VISIT TO ARNP ON JAN 5, STILL HAD RESOLVING PIMPLES AND ALSO HAD THREE AREAS ON BUTTOCKS. AREAS ON BUTTOCKS ARE RED AND SLIGHTLY RAISED (NO HEADS). THE FIRST ONE IS ON MY SACRUM, THE NEXT ONE IS 3-4 INCHES BELOW ON MY BUTTOCKS AND THE THIRD ANOTHER 3-4 INCHES BELOW IT. THESE WERE SORE/ITCHY WHEN WET WHEN THEY FIRST ERUPTED. NOW THEY ARE JUST RED AREAS. I HAVE HAD SIMILIAR ERUPTIONS IN THESE AREAS IN THE PAST WHICH USUALLY LAST A FEW DAYS AND ARE IMPROVED BY APPLYING CALADRYL.
ON JAN 6, 2011 STARTED COURSE OF ACYCLOVIR.
HOPE THIS HELPS.
FIRST ERUPTION WAS A LARGE BOIL WHICH WAS 1/2-3/4 OF AN INCH IN DIAMETER
AND ABOUT AS DEEP UNDER THE SKIN ON THE LEFT SIDE. TENDER TO TOUCH. AFTER SHOWERING THIS DEVELOPED A WHITE HEAD WHICH COVERED THE TOP AND WHEN SQUEEZE PUS CAME OUT FOLLOWED BY A LARGE AMOUNT OF MOSTLY BLOODY DRAINAGE. AT THE SAME TIME A SIMILAR BOIL APPEARED ON RIGHT SIDE. ABOVE THESE TWO LARGE BOILS WERE A SERIES OF 3 OR 4 PIMPLES IN A ROW ABOVE THE LARGER ONES (ABOUT 1/2 INCH APART). THESE WERE RED, RAISED AND FIRM TO TOUCH. ALSO SORE TO TOUCH OR WHEN CLOTHING RUBBED. THESE HAVE VERY SMALL WHITE HEADS AND DO NOT EXPRESS MUCH FLUID. THESE PERSIST TODAY AND SEEM TO BE RESOLVED IN AM AND IRRITATED IN EVENING.
I HAVE HAD SOME INTERMITTENT TENDERNESS IN LYMPH NODES OF GROIN AREA DURING THE PERIOD FROM DEC 22 UNTIL NOW. NO FEVERS. DID HAVE A HEADACHE OF SHORT DURATION ON DEC 23 OR 24TH. DID HAVE A FEELING LIKE I WAS COMING DOWN WITH SOMETHING AROUND THAT TIME, BUT WAS ALSO TIRED AND STRESSED.
IN EARLY NOVEMBER HAD 2 BOIL TYPE ERUPTIONS IN SAME GENERAL AREA WHICH RESOLVED AFTER THEY DRAINED.
SAW ARNP ON DEC 28 WHEN BOILS WERE RESOLVED BUT PIMPLES WERE STILL ERUPTED BUT NOT DRAINING.
ON SECOND VISIT TO ARNP ON JAN 5, STILL HAD RESOLVING PIMPLES AND ALSO HAD THREE AREAS ON BUTTOCKS. AREAS ON BUTTOCKS ARE RED AND SLIGHTLY RAISED (NO HEADS). THE FIRST ONE IS ON MY SACRUM, THE NEXT ONE IS 3-4 INCHES BELOW ON MY BUTTOCKS AND THE THIRD ANOTHER 3-4 INCHES BELOW IT. THESE WERE SORE/ITCHY WHEN WET WHEN THEY FIRST ERUPTED. NOW THEY ARE JUST RED AREAS. I HAVE HAD SIMILIAR ERUPTIONS IN THESE AREAS IN THE PAST WHICH USUALLY LAST A FEW DAYS AND ARE IMPROVED BY APPLYING CALADRYL.
ON JAN 6, 2011 STARTED COURSE OF ACYCLOVIR.
HOPE THIS HELPS.
MEDICAL PROFESSIONAL
Thanks for the additional information. You definitely have both HSV-1 and 2, and your husband has HSV-1 only.
But as I suggested above, your positive blood test doesn't necessarily mean your genital pimples/boils were due to herpes. Can you describe that outbreak in more detail? How many lesions? Where exactly were they located? How long did they last? Or if continuing now, how long has the problem been going on? Any other symptoms, like fever, headaches, or swollen/tender lymph nodes in the groin?
But as I suggested above, your positive blood test doesn't necessarily mean your genital pimples/boils were due to herpes. Can you describe that outbreak in more detail? How many lesions? Where exactly were they located? How long did they last? Or if continuing now, how long has the problem been going on? Any other symptoms, like fever, headaches, or swollen/tender lymph nodes in the groin?
LAB RESULTS:
MINE
QUEST DIAGNOSTICS - "HSV 1/2 IGG, HERPESELECT TYPE SPECIFIC AB"
RESULT: HSV 1 IGG >5.00H
HSV 2 IGG >5.00H
MY HUSBAND
LAB CORP- "HSV 1 AND 2-SPECIFIC AB, IGG
RESULT: HSV 1 IGG 5.58 HIGH
HSV 2 IGG < .91
HOPE THE TEST INFO AND RESULTS CAN HELP YOU SHED SOME ADDITIONAL LIGHT ON OUR SITUATION.
MINE
QUEST DIAGNOSTICS - "HSV 1/2 IGG, HERPESELECT TYPE SPECIFIC AB"
RESULT: HSV 1 IGG >5.00H
HSV 2 IGG >5.00H
MY HUSBAND
LAB CORP- "HSV 1 AND 2-SPECIFIC AB, IGG
RESULT: HSV 1 IGG 5.58 HIGH
HSV 2 IGG < .91
HOPE THE TEST INFO AND RESULTS CAN HELP YOU SHED SOME ADDITIONAL LIGHT ON OUR SITUATION.
MEDICAL PROFESSIONAL
Welcome to the STD forum.
If the ARNP who first examined you is quite experienced in herpes, her opinion has to be seriously considered. However, your description doesn't sound like typical herpes, which generally doesn't cause "large pimples/boils". Pimples, boils, etc generally begin deep in the skin and are firm and tender, and may eventually develop white heads. Think of them as starting "in" the skin. By contrast, herpes lesions are superficial; think of them being "on" the skin, usually without a firm lump. Also, most herpes outbreaks occur in clusters, pretty much localized within an area no more than an inch or so in diameter. (Initial herpes can be more widespread -- but since your HSV-2 blood test apparently was positive at the time of the outbreak, if you have herpes it must have been present for several weeks or months, of not year.)
Also, the HSV blood tests are not perfect, and many apparently positive results are false. Further, false positive HSV-2 results are more common in people who also have HSV-1. This can often be sorted out according to the strength of the positive result. Ask your doctor's office to tell you the exact test that was done (trade name and/or the lab where it was done) and the numerical results for both HSV-1 and HSV-2.
I doubt your husband's facial pimple has anything to do with your symptoms or your apparent positive blood test results. However, it would be a good idea for him to also have an HSV blood test. If that is done, please also tell me the details of his test, as for your own.
If it turns out your HSV-2 blood tes is accurate, it doesn't necessarily imply sexual infidelity by you or your husband. Depending on age and other factors, up to a quarter of all Americans have HSV-2, and it often lies dormant for years and years.
So my bet is that herpes is not the explanation of your genital are lesions -- even if your HSV-2 blood test turns out to be truly positive. I suggest we not get ahead of ourselves; let's see what the diagnosis actually is, then if necessary we can address how HSV is and is not transmitted.
I hope this helps get you started on the answers you need. While we sort it out, stay mellow. Most likely this won't turn out to be such a big deal one way or the other.
Regards-- HHH, MD
If the ARNP who first examined you is quite experienced in herpes, her opinion has to be seriously considered. However, your description doesn't sound like typical herpes, which generally doesn't cause "large pimples/boils". Pimples, boils, etc generally begin deep in the skin and are firm and tender, and may eventually develop white heads. Think of them as starting "in" the skin. By contrast, herpes lesions are superficial; think of them being "on" the skin, usually without a firm lump. Also, most herpes outbreaks occur in clusters, pretty much localized within an area no more than an inch or so in diameter. (Initial herpes can be more widespread -- but since your HSV-2 blood test apparently was positive at the time of the outbreak, if you have herpes it must have been present for several weeks or months, of not year.)
Also, the HSV blood tests are not perfect, and many apparently positive results are false. Further, false positive HSV-2 results are more common in people who also have HSV-1. This can often be sorted out according to the strength of the positive result. Ask your doctor's office to tell you the exact test that was done (trade name and/or the lab where it was done) and the numerical results for both HSV-1 and HSV-2.
I doubt your husband's facial pimple has anything to do with your symptoms or your apparent positive blood test results. However, it would be a good idea for him to also have an HSV blood test. If that is done, please also tell me the details of his test, as for your own.
If it turns out your HSV-2 blood tes is accurate, it doesn't necessarily imply sexual infidelity by you or your husband. Depending on age and other factors, up to a quarter of all Americans have HSV-2, and it often lies dormant for years and years.
So my bet is that herpes is not the explanation of your genital are lesions -- even if your HSV-2 blood test turns out to be truly positive. I suggest we not get ahead of ourselves; let's see what the diagnosis actually is, then if necessary we can address how HSV is and is not transmitted.
I hope this helps get you started on the answers you need. While we sort it out, stay mellow. Most likely this won't turn out to be such a big deal one way or the other.
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.
