Tested positive for Genital Herpes on my chest through viral culture

[ria84]

One morning, about a month ago I woke up with what I thought was an insect bite or a rash on my chest. I was extremely concerned because i've never had anything like it. I went to the dermatologist the following day and she said it looked like I had a Herpes outbreak; I was shocked. I always thought Herpes outbreaks appeared on the Genitals or on the face. She proceed to do a viral culture of the sore to determine whether it was HSV I or II. The culture came back positive for HSV II;  I discussed it with my boyfriend and he was as shocked as I was because he had never had any symptoms or outbreaks. My boyfriend and I have been together for a little over a year and have been having unprotected sex the whole time. As a matter of fact, after the results we continued having unprotected sex (I still had the active sore on my chest) because we were certain at that point that we were both infected. This is the confusing part: He got tested this week (Blood work) and his results were negative for both HSV I and II. What's even more confusing is that I had been tested months before he and I got together and I tested negative. Which made me and him certain that I got it from him. Just for clarification, I have not cheated on my boyfriend in any way, shape or form. Since we've been together, I have not had any sort of sexual contact with anyone.  Could I have been misdiagnosed in the the past (False negative)? Could my current results be a false positive? Could his results be a false negative? How did I get genital herpes on my chest? I have made a decision to go back to the doctor and get tested again through blood work just to be certain. The doctor gave me an lab order to test HSV I/II-IGM and HSV I/II IGG. I am so confused....  

[angel4000]

A related discussion, HSV 2 was started.

[Edward W Hook, MD]

Yes although as I mentioned earlier, this entire story is a bit bizarre. That you might have a lesion on your chest is possible and that could be why he has not gotten infected.  Such lesions are less, far less infectious than genital ones.  EWH

[ria84]

I tested positive for type 1 and 2. My boyfriend is negative for both. Is this possible? Could it be that because of the location of my Type 2 outbreak (My chest) he never acquired it?

[Edward W Hook, MD]

Parts of this (who you got it from) are peculiar.  That yo had a lesion which turned out to be HSV on your chest is less so.  During sex and foreplay, on occasion, people get sites other than their genitals or mouth innoculated with the virus.  "Geographically"  we most oftersee such lesions on the buttocks, the thigh or the lower abdomen but they can occur anywhere.

Cultures are very, very rarely false positive.  The only reason for a false positive culture would be inf the specimen got mixedup in the lab and that is quite unusual.  

So what's going on?  Here are some possibilities.  For you to get tested with the blood test is a good step in the right direction.  At the same time, I would make sure that  you are getting a type specific test,  That there is an IgM test ordered makes it unlikely that this is what your doctor has ordered.  The Herpes Select would be the way to go.  Possiblities:

1.  Your BF could have HSV-2 and a negative blood test (false negative).  This occurs rarely (in less than 1 in 20 cases but it does happen).  The absence of prior episodes on his part argues against this a bit.
2.  You could have had this from a prior exposure and this was your first outbreak.  It does happen.  If this is the case, you antibody test may be ositive.
3.  You could have caught it incidentally from another kind of exposure (do you engage in sports of any sort?)

Hope this is some help.  Please let us know what your blood tests show.  EWH