Likely HSV2? Transmission?

[Odd situation]

Both me and my bf have tested negative for STDs. Specifically, I had a full screening for STDs in January, he did in March and both of us had negative results.  Last Friday, after having sex, i felt some soreness but thought it was due to sensitivity from rough sex.  The next day, still felt sore. when i still felt sore sunday, i took a look and saw swollen redness in my labia maj. monday morn., i looked again and noticed redness again but on closer inspection, it seemed as though i had a raised area, which, i could not really see well.  monday night, saw that the raised area formed into one sore that was white in the middle, resembling a canker sore. saw obgyn tuesday and she said it looked like herpes. my bf said that he had the comprehensive type blood tests (that u've referred to on the forum)&actually kept the records of last 3 years; results showed neither long term nor short term HSV1 or HSV2. I have had blood tests for herpes before which were negative but maybe they weren't the comprehensive type blood tests that yourecommended.  Y negative? Is there ANY possibility that i do not have herpes?  if herpes, it seems that it's something i've had for a long time but didn't know (b/c no recognized symptoms) and friday's sex must have lead to a recurrent outbreak (was on my period, had a cold and had rough sex). is it still the 4% probability of giving it to my bf? he has had no symptoms whatsoever since friday.

[H. Hunter Handsfield, M.D.]

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As you probably anticipated, I cannot conclude with any certainty whether or not you have herpes.  You describe fairly typical symptoms (the most unusual thing is that the first episode usually has several lesions, not just one or two), and a health care provider--who probably has seen lots of cases--thinks it's herpes.  On the other hand, if both you and your partner truly had negative blood tests for both HSV-1 and HSV-2, herpes is much less likely.  Of course, even then it would be possible, if either of you had other sex partners after your blood tests and before you had sex together.  False negative blood tests are uncommon:  even the older, non-type specific tests are reliable when negative.

If you have herpes, it also isn't clear whether you were recently infected by your boyfriend, or might have had it for some time and only now are having your first symptoms.  About 40% of apparent first herpes infections in fact are recurrent outbreaks.  However, this is very unlikely if in fact you had a negative blood test recently.  

Presumably your ObG did a herpes test on the lesion (I certainly hope so!).  The thing to do now is just await the result, which should be available in a couple of days.  If it is positive, it will prove the diagnosis.  (Make sure the lab determines whether it is HSV-1 or HSV-2.  It makes a lot of difference in treatment, prevention, and what to expect in terms of recurrent outbreaks.)  If the test is negative--or if your ObG didn't do a test--then you and your partner both should have repeat blood tests, making sure that the specimens go to a lab that does a truly type-specific test, such as HerpeSelect.

The other questions, such as potential for transmitting it to your boyfriend, depend on the answers to all the unknown factors I have mentioned.

Good luck--  HHH, MD

[Odd situation]

I may have sounded calm b4 but i'm extremely freaked out. i couldn't show it b/c i needed to write the essential info. due to the space limitation.  But noticed i could continue with a comment.  I wanted to add that after tuesday's visit to obgyn, she prescribed valtrex which i've been taking.  Noticed that the canker sore looking lesion became the small mound with a hole at the top of it.  (sorry for the bad description) and as the days have gone on since tuesday, the small mound has slowly diminished and is not as much a mound anymore.  I just really don't want this to be herpes.  could it potentially be chancroid?  I forgot to mention that the lesion felt sore... i didn't touch it so i'm not sure if it was painful to the touch but, when it was in the canker sore looking stage, it hurt when pee hit it... and, when i went to obgyn and she took a swab, it also hurt.  

it will take a while to get my results.  obgyn took the swab test (culture) and blood tests.  not sure how accurate these will be but i'm assuming that the swab test will be accurate.  she was in a hurry and was not interested in catering to my questions...  if you can help me with some answers, i'd greatly appreciated it!  Thank you!  

[H. Hunter Handsfield, M.D.]

Chancroid is unlikely; it is vanishingly rare in the US and other developing countries.  I haven't seen a case in 20 years.

The apparent improvement on valtrex suggests herpes is the problem. However, it could be clearing up on its own.

Glad to see a culture test was done. That's the sort of information that should have been in the question itself.  Wait for the results; most of the other issues then will become clear.

[Odd situation]

Thanks for your response.  So, are you basically saying that it is likely that, as described, i have HSV2?  It's just that it does not look like any of the pictures and does not appear to be similar to the symptoms posted on many websites...  

i know i should just wait for the results, but, that could take another week so any of your input would be greatly appreciated.  also, what about the likelihood of passing it on to my bf?  If what i have is HSV2, then, does that mean i was having a recurrence and if so, then, does that mean i was in the "shedding" stage?  

[H. Hunter Handsfield, M.D.]

You're asking me to re-answer the same questions with different words.  I did my best with the replies above.  I do not know whether or not you have herpes and it is pointless for me (or you) to speculate on many of your questions until the diagnosis is known.

[Odd situation]

I'm sorry, for some reason i saw your second reply before i saw the first reply...that's why i re-asked my question but in a different way.  

Thank you very much for your replies.  Although I still have to wait for my test results, and i still don't know if i'm infected or not, for some reason, it made me feel better to just to be able to ask an expert.  

[Odd situation]

I am still awaiting my test results.  My boyfriend got his results.  His results say:  Herpes 1&2 IgM  Result is .91; Reference .91-1.09 (equivocal)
Herpes 1 IgG Negative, <.9; Herpes 2 IgG Negative <.9

Does this mean that if my test results are positive that i gave him herpes?  My symptoms first arose on Friday (6/8) and he got tested on 6/13.  We're assuming that he has to get re-tested b/c it was too soon for the virus (if it is) to peak.  

On a side note, I was given valtrex by my doctor on tuesday due to the appearance of the sore, I noticed that the sore has slowly diminished but is not entirely gone yet and my course of taking the meds is done.  isn't the sore supposed to last 7 to 10 days on its own?  doesn't valtrex diminish the sore quicker than its usual course?  does the fact that i still have the sore minimally present mean that it may not be herpes that caused the sore at all?  We are just so confused because both of us were tested within the last 6 months and both of us had negative blood tests for herpes and both of us have been completely monogamous w/each other.  If friday's sore is really herpes, does it mean that our prior blood tests were not accurate?  

If anyone out there can give some insight, i'd really appreciate it!  

[H. Hunter Handsfield, M.D.]

Your boyfriend's test results are totally negative.  (IgM testing is useless, often falsely positive, and should not have been done.  Ignore that equivocal result.)

It can take a week for herpes lesions to clear up, even with treatment.

Continue with plans for follow-up testing.  But most likely your follow-up testing will be negative.  Since your boyfriend is the only possible source of your infection (if I correctly recall the details of your long story), his negative result probably means yours also will be negative and that herpes is not your problem.

HHH, MD

[Odd situation]

I just got my results.  Unfortunately, my ObG did not perform a blood test!  Why, i have no clue.  pretty frustrating...  but, the good news is that she said my culture was negative.  I am a bit skeptical, however, because the result says:  "Source not given; None isolated"  That seems to indicate that perhaps it was not a good culture?  As i had indicated in my prior post, i did not check to look at the source of my pain until sunday, at which time, i found the canker-sore looking lesion.  She took the culture on tuesday.  Based on the stated result, was my ObG's comment that my culture was negative accurate or was it simply that the sample was not a good specimen?  

I'm sorry to obsess, but, as you can tell from the forum, this is a realm in which most become paranoid, lose sleep, can't work, etc.  i have definitely learned a lot from the forum and i do feel that my experience was a bit different from others' on this forum in that i only found the one sore and the background info. i gave,  so i do hope that my postings helped someone in a similar situation...  

Thank you SO much Dr. HHH!  I am so glad that i happened upon this forum.  it definitely eased some of my frustrations and paranoia...