Is it herpes?

[alicia11]

Alicia11, kropka1

I am a female 58 years old.
Four days ago I noticed slightly itchy small translucent blisters to the left of my vagina.
The area is the size of the nickel. On the third day the blisters got bigger and filled with puss.
After doing research I concluded that it was very much like herpes.
When I was about 20 years old I had a couple tiny blisters on my genital area but the doctor
told me that it was nothing to worry about. It went away on its own. I experienced something
similar once more time many years ago.
My boyfriend of two years is a widower that had been married for 30 years and I totally trust him
that he would never infect me knowingly. We have an intercourse rarely and usually have oral sex
or mutual masturbation.
I was celibate for 10 years and prior to that I was in a relationship for 8 years and never noticed
anything suspicious on my or my partner's body.
After reading this forum I think that because of my lifestyle, it is not likely that I was infected with
STDs at any time in my life, but I never know for sure till I get tested.
I remove hair from my genital area using electric tweezers and quite often some area would
become irritated from the abrasion. I think that it could be a fungal infection of irritated area,
because the appearance of this infection looks like the fungal infection on the top of my feet
that I had several years ago. Then, it was probably caused by feet fungus combined with the
irritation of the area from shoes. I got rid of the fungus since then but it seems to me that what
I have now is very similar to this other infection.
How likely it is herpes and where can I go, besides gynecologist, to be igG tested?
The service you provide on this forum is invaluable. It takes the fear out of dealing with
STD and brings common sense to this very tricky situation.
Thank you for your input.

Alicia

[H. Hunter Handsfield, M.D.]

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

Your description of your genital lesions sounds very much like recurrent genital herpes.  Of course no distant online expert can make a definite diagnosis, and you are correct that laboratory testing is the way to know.  But it seems a good possibility you have had genital HSV-2 for many years, and perhaps that episode of genital "blisters" at age 20 was your first infection.  That long ago, most doctors probably did not understand genital herpes and, even if they did, would have told a patient it was "nothing to worry about".

Most primary care doctors and gynecologists can order a routine herpes blood test.  If not certain about your own doctor's expertise, you could visit a family planning clinic like Planned Parenthood (if you are in the US) or an STD clinic.  Also, if you experience another outbreak like the one that started a few days ago, and if you can see a clinic or doctor within 1-2 days of onset, the lesions could be tested for HSV-2.  Whether or not you have herpes, I doubt this is a fungal infection and it does not sound like it is related in any way to the skin fungus infection of your feet.

If you have herpes, it is unlikely you caught it from your current partner.  And if he hasn't had symptoms, probably he has not caught it from you.  However, he could also be tested at the same time you are.

Thanks for the thanks about the forum.  I hope this helps. Feel free to return with a comment to let me know the result of your HSV test.

Regards-  HHH, MD

[alicia11]

Thank you.

I have one more question.

I was in a few fairly long relationships and during none of them there were any problems of this kind. I am friends with the man that I had been with for 8 years and
he would tell me if he had any problems so I am assuming that he is OK.
Does that mean he got HSV2 and is asymptomatic or that I was not shedding, or he was just lucky?

Thanks again

I will let you know the results of the test.

Best regards

Alicia

[H. Hunter Handsfield, M.D.]

Among couples in which one person has HSV-2 and the other does not, over several years about half the partners become infected.  So it is quite common for partners like yours to remain free of herpes.  Also, some infections remain asymptomatic, so your partner might have been infected despite absence of known herpes. He could be tested to determine whether or not he is infected.

[alicia11]

Dr. HHH
I had igG test and it tested positive for HSV1 with a reading of 3.10 and
negative for HSV 2 with a reading of less than 0.91. My boyfriend asked
his doctor about getting tested and this  is what his doctor said:

"I disagree about getting blood testing for HSV.  Many of us have
been  exposed to this virus over the years and form antibodies....
but we aren't  actually infected and can't either get symptoms
or transmit anything.  I think getting bloodwork simply makes
things more confusing---the "gold standard" is to have any
suspicious area cultured.

It sounds as though your girlfriend has recurrent herpes; it is
not uncommon  for the virus to be dormant for many years
and then pop up again if there is a change in the person's
immune status.  (For instance, recurrent lesions often occur
after major surgery, after a pregnancy, etc).  You'll need to
be careful to not get infected, so avoid contact with the area
from the time any symptoms start (even just tingling or burning
prior to seeing the blisters) to at least 10 days later."

Now, I am really getting confused because of my test results and my
boyfriend‘s doctor’s advice. I hope you can clarify some things
and give me answers to those questions: (for now I assume my
boyfriend is HSV2 negative)

1. Am I correct wanting to get my boyfriend tested?
2. If he tests positive for HSV1, are we both immune to each other
    and I cannot infect him?
3. If he tests negative, will there be the possibility of infecting him
     from my virus asymptomatic shedding?
4. Is it possible for a test using a culture of the lesions to result
    in a positive test for HSV2, even though I only tested positive
    for HSV1 via the blood test?

Thank you

Al

[H. Hunter Handsfield, M.D.]

Welcome back.  Thanks for the additional information.  You are infected with HSV-1, just like half the population.  Since the test was positive so soon after onset of your genital lesions, it is most likely that you have an oral infection, most likely dating back to childhood.

Your HSV-2 test is negative.  It is still possible your genital lesions were due to an initial infection with HSV-2.  A follow-up blood test in about 3-4 months will help sort that out.  If it remains negative, then for sure you don't have genital herpes due to HSV-2.  If it turns positive, it will nail down the diagnosis.

MedHelp moderators are supposed to try to avoid overt disagreements with patients' own doctors.  But if your boyfriend is correctly stating his doc's beliefs, the doc is simply wrong in large part. Identifying HSV in a lesion indeed is the best proof that a particular genital outbreak is due to herpes.  But in many circimstances the modern blood tests are very close to a "gold standard" themselves.  Most important, everybody with HSV-1 or HSV-2 antibody is infected with that virus, not merely "exposed".  Your boyfriend's doctor simply does not understand HSV infections and interpretation of the blood tests.  I'm happy to stack up my expertise in this with his.

1) Yes, you are correct. Your partner could be tested and he should be.

2) Yes.  When someone is infected with HSV-1 or HSV-2, he or she is immune to a new infection with the same type.  Therefore, couples to not "ping pong" their HSV infections back and forth.

3) No, for the same reason.

4) Since your lesions by now undoubtedly have healed, there is no point in culture.  If a similar outbreak occurs, however, you could have a culture.  To be accurate, it has to be done within 2-3 days of onset of the lesions.  If that doesn't happen, have another HSV-2 blood test in 3-4 months.  Or just await your partner's HSV-2 test, whether he talks his own doctor into it or has a test done elsewhere.  If that's negative, then there is no possibility your own problem was due to HSV-2.

All things considered, my guess is that your HSV-2 test will remain negative, that your partner's is negative, and that herpes was not the cause of your genital lesions.

[alicia11]

Thank you for your very helpful reply.

I have more questions because my boyfriend was tested, and the result came
positive for HSV1 with IgG 3.13. Now we know that we both are HSV1 positive,
however we do not know where the site of his infection is because he hasn’t had
any symptoms.
1. Can we spread the infection to different parts of each other bodies?
2. How concerned should we be about oral sex?
3. In the last paragraph of your reply, you stated: “that herpes was not the cause
of your genital lesions”. What else could that be?

I really appreciate your help with this difficult issue.
Alicia

[H. Hunter Handsfield, M.D.]

That's good news.  Since your infection is HSV-1, you can expect few recurrent outbreaks.  And since both you and your partner are infected, you cannot reinfect each other.  That is because once someone has HIV, he or she is immune (or at least highly resistant) to catching a new infeciton with the same virus type.

1) No.
2) Not at all.
3) Perhaps it was herpes after all, due to HSV-1.  However, there are many non-STD causes of genital ulcer.  Herpes is the most common, but not the only one.  I can't guess at other possible explanations in your case.

That should end this thread.  Feel free to carry on more discussions on the herpes community forum.