Initial Herpes Symptoms

[momo619]

Hi Doctors,
I have a question about the symptoms of an initial herpes outbreak. I have a yeast infection (same symptoms I've had with them in the past). I've been treating it for less than a week and it's mostly gone. This morning, I noticed a small cut almost like a paper cut on my outer labia. It bled a little when I wiped with paper, but otherwise does not hurt. It is barely visible. I have had some itching, tingling and discharge that I have attributed to the yeast infection. I did an online search (stupid, I know) and read that this "paper cut" is apparently a symptom of an initial herpes outbreak and that herpes is often mistaken for yeast infections.

My questions- is this correct? Should I be concerned? I remember asking my OB/GYN about herpes years ago and he said that "You'll know for sure when you have it." Would all infections have the blisters one thinks of with HSV?

I have only had two sex partners total. My most recent partner (of almost a year) was tested for the usual panel of STDs in Dec. and was clean, although I'm not sure which HSV test he received. In the absence of symptoms, I'm not sure they even did one at all. He does not have any visible sores and never has in the past. We are not using condoms and the last time we had sex was 3 weeks ago. I know in general I am low-risk, but am concerned about the "paper cut" symptom. Should I be worried?  

Thanks for your help.

[H. Hunter Handsfield, M.D.]

Thanks for the follow-up.  LSC is a very common cause of genital area rash and lesions.  As your doctor undoubtedly told you, it is generally harmless -- and not an STD or otherwise related to sexual activity.

[momo619]

Hi,

I just want to update my situation in case anyone with similar symptoms and worries comes across this thread.

I had a biopsy done earlier this week and I have been diagnosed with Lichen Simplex Chronicus. No herpes, no HPV.

Thanks

[H. Hunter Handsfield, M.D.]

You should consider asking your current partner to be tested as well.  If both your results are negative, you will know both that you are not infected and that you are not currently at risk.

[momo619]

Dr. Handsfield,
Thanks for your response, it has allayed some of my concern and I am glad to know it's most likely from the yeast infection.

I have made an appt. for a herpes blood test at Planned Parenthood next month. Hopefully, this will give me a definite answer either way.

Thank you.

[H. Hunter Handsfield, M.D.]

Welcome to the forum.  I'll try to help.

Can some initial herpes infections have symptoms that are misdiagnosed as yeast?  Yes, but it is rare.  If a yeast infection has typical symptoms and is professionally diagnosed, almost always it was truly a yeast infection -- not herpes.  And yeast infections commonly are associated with small, linear fissures.  Such lesions can be a sign of herpes as well.  But still, yeast if by far the most likely explanation of your problem.  And yes, most initial herpes infections have multiple blister-like sores or ulcers.

And if your partner indeed had a negative HSV blood test, it is obviously unlikely he could have transmitted herpes to you.  But if you remain concerned, you should raise it with your doctor.  If you still have active fissures or other sores, they can be tested for the virus.  If symptoms have cleared up, you can have a blood test to see if you are infected.

I hope this helps.  Best wishes--  HHH, MD