WHAT REALLY IS THIS?

[Sue07]

ABOUT 2 YEARS AGO A HAD A SEVERE YEAST INFECTION, I HAD LESURES MOLLUSCUM LIKE, THEY DIDN’T HURT OR ANYTHING BUT THEY WERE THERE. I HAD SO MUCH DRYNESS THAT I WAS GETTING CUT UP BETWEEN THE OPENING OD THE VIGINA (vagina) AND MY ANAL. MY DOCTOR TOLD ME THAT SHE THOUGHT IT LOOKED LIKE HERPES AND GAVE ME A LIST OF CLINICS TO CALL AND REQUESTED A HERPE CULTURE. I DID BUT NO ONE WANTED TO TEST ME BECAUSE I NEVER HAD PUS COME OUT THEY EVENTUALLY HEALED ON THEIR OWN. ALL I KNOW IS THAT SHE SEND ME ANTIBIOTICS, DIFLUCAN AND MONISTAT, EVERYHING WENT AWAY, EVER SINCE I’VE BEEN PARANOID. I’VE GOTTEN 5 PAP AND 1 CULTURE EVERYTHING CAME BACK WITH BACTERIAL VAGINOSIS. ABOUT THREE WEEKS AGO A WENT TO MY DOCTOR AND REQUESTED A BLOOD TEST FOR HEPES (I HADN’T HAD AN OUTBREAK SINCE) AND A PAP. THE RESULTS CAME BACK POSITIVE FOR HERPES 1 & 2. AND THEN I GOT A RASH NOT ON MY GENITAL BUT ON THE OUTSIDE LIKE WERE YOUR PANY GOES THROUGH AROUND THE LEG. I’VE NEVER GOTTEN A RASH RIGHT ON THE GENITALS. I DON’T KNOW EXACTLY WHAT BLOOD TEST HE DID, BUT I JUST FOUND OUT THAT MY FATHER HAS HAD HERPES FOR THE PAST 32 YEARS AND THAT MY BROTHER HAS HERPE ZOSTER. I KNOW THAT ON THE BLOOD TEST THEY CHECK FOR ANTIBIOTICS. BUT DOES ANYTHING HAVE TO DO WITH THE OTHER MY DAD AND ALL. I AM JUST SOO SCARED BECAUSE ON THE RASH THAT I GOT I NEVER GOT PUS OR ULCERS JUST A RED SPOT LIKE MOLLUSCUM THE PROBLEM WAS THAT I BEGAN POCKING THEM AND EVENTUALY THE LOOKED LIKE SCRAPES, I STARTED PUTTING ALCHOL AND HYDROGENPEROXIDE BUT THEY WERE HEALING WITH 1%HYDROCORTISONE I MEAN THE STARTED TO HURT AFTER I POCKED THEM BUT NOTHING CAME OUT BUT THE PAIN WASN'T UNBEARABLE. HE SEND ME ZAVORAX OINTMENT FOR MY HERPE OUTBREAK HE DIDN’T EVEN LOOK AT IT BUT WHEN I PUT THE CREAM I FELT IT BURN ALTHOUGH IT BEEN HEALING JUST FINE.  I AM REALLY SCARED BECAUSE ON TOP OF THAT THEY FOUND ME HPV POSITIVE. HE ALSO PUT ME UNDER VALTREX ONE DAILY FOR ONE YEAR, HE ALSO TOLD ME THAT IF I GOT PREGNANT THERES A POSSIBLITY THAT EVERYTHING MIGHT FLUSH OUT (HERPES & HPV) PLEASE HELP I DON’T KNOW WHAT TO DO I AM GOING CRAZY.I JUST WANT A SECOND OPINION.

[H. Hunter Handsfield, M.D.]

I will try to help, but online doctors cannot formally give a second opinion and I'm not going to do so.  Can't practice medicine from a distance.

Herpes and yeast infections often are confused with one another.  However, since several (?) health care pfoiders apparently have diagnosed yeast, and at least on some occasions your symptoms responded to yeast medications (Diflucan, Monistat), it seems pretty certain you have had yeast infections.  Recurrent yeast infections are very common.  In some cases, prolonged treatment (for example, Diflucan for up to 6 weeks) can be helpful; in others, periodic treatment can prevent recurrent symptoms (e.g., Diflucan once a week).

From your description, I can't be sure whether or not you have genital herpes, but it seems likely; otherwise your health care provider(s) would not have prescribed Zovirax (acyclovir) ointment or valacyclovir (Valtrex).  If your positive blood test for HSV-1 and -2 was the right kind of test - that is, a truly type-specific blood test such as the HerpeSelect test - then you have definitely have genital herpes, whether or not it is the cause of some of your symptoms.  Herpes usually causes lesions right on the genitals, not out at the panty line.  So I'm not certain what's going on there.

Acyclovir (Zovirax) ointment is lousy herpes therapy, as you seem to have learned.  But valacyclovir is excellent.  If it isn't controlling your symptoms, then those symptoms are not due primarily to herpes.

Using hydrocortisone is a big mistake; it will make either yeast or herpes worse.  Alcohol and hydrogen peroxide will only cause pain, but will not speed healing.

Bacterial vaginosis is overgrowth of otherwise normal bacteria in the vagina.  It's often a sign of STD, but probably not usually acquired by sex with men.  You don't really describe any symptoms that sound like molluscum contagiosum.  And you don't mention HPV at all, until the last line.  Have you had warts?  Or HPV on a pap smear?

The bottom line:  You need to see an STD-knowledgeable health care provider to sort all this out.  There is nothing more I can do on line.  If you are in the US, your local health department probably has an STD clinic.  Alternatively, call any major medical center and ask for the name of a gynecologist who is also an expert in infectious diseases or STD.

Good luck--  HHH, MD

[Sue07]

well theres another problem hpv just came on my last pap smear, hpv high he said, i never saw the actual test result, and the doctor won't release the result from the lab due to that theres an error on the last name (although they look similar) they are checking with the lab. i found that out when i received a $400.00 bill with my name but different last name. as for the warts, no i haven't gotten any although the doctor told me that i wouldn't cause the hpv that i got was not the one with warts. he told me that most likely my immune system will flush it out. well as for another std other that herpes. i though t about that but the wierd thing is that my dischrage doesn't smell bad, have a yellow grey color, nor it itch. nothing just a bit like cottage cheese its not heavy or something uncontrolable(it hasn't given me any reason to think about another std and when i have mentioned it to my doctors they've told me i am paranoid). yet all the gynocologst i've gone to always tell me that i look great, just a bit of a discharge even this time around. it was to my surprise when he told me the results. as for the zovorax its worked. I yet have to receive the blood test results so really don't know if its herpes selct. i don't have another sympthoms soo what do i do? i was also told that it was really wierd that the outbreaks that i got were not the the genitals it self? infact i don't even get puss and they gone away with baby rash creams. soo what else do i check for. i don't know what to do nor where to turn. my only thought is that why does my father and brother have it and now me???????????????

[Sue07]

also i thought it might have been molluscum beacuse they looked very similar they are red shine bumps, when i pocked the current rash that i had nothing came out my biggest mistake was toughing them they seemed to get better through out the week. thank you for your time i will let you know what type of booldtest they did when i receive the results by fax.

[Sue07]

also i thought it might have been molluscum beacuse they looked very similar they are red shine bumps, when i pocked the current rash that i had nothing came out my biggest mistake was toughing them they seemed to get better through out the week. thank you for your time i will let you know what type of booldtest they did when i receive the results by fax.

[Sue07]

okay i just received the results and they 5.8 positve for hsv I &II. and it says IgG. how accurate is this?

[H. Hunter Handsfield, M.D.]

The types of HPV that most commonly infect the cervix and that, in rare cases, lead to cancer, are different than the types that cause warts.  It is true that with time, your immune system probably will eradicate the HPV, or at least reduce it to levels that make it non-transmissible and eliminate (or nearly eliminate) the chance of progression to pre-cancerous disease.  But you will need to follow up with your health care provider with repeat paps to make sure it goes away; or you may require colposcopy, biopsy, and perhaps minor surgery to remove infected tissues.  Follow your health care provider's advice.

Yeast doesn't usually cause the sorts of vaginal symptoms you describe.  The most common symptom with yeast is itching, sometimes with scant discharge (sometimes cottage-cheesey, but not usually), without odor.  Discharge with odor is more common with other conditions, such as bacterial vaginosis or trichomoniasis.

I forgot to say in my first response that your family history has no bearing on the case; the presence or behavior of herpes of any type (HSV-1, HSV-2, herpes zoster/shingles) in your brother and father do bit predict how herpes would behave in you.  Nobody can say why herpes recurrences, asymptomatic viral shedding, etc are so differently from one person to another.

A HerpeSelect ELISA ratio of 5.8 is positive, but you don't say whether that is for your HSV-1 result, HSV-2 result, or both.  The lab report will specify both.

As to not knowing where to go, I gave suggestions in my first response for finding a highly qualified specialist.  In any case, it sounds to me that you might benefit by speaking with an expert counselor about the disease.  Consider contacting the Amercan Social Health Association (www.ashastd.org), where you can find the number for the herpes help line.  ASHA also can put you in touch with a herpes support group in your area.

HHH, MD

[cnd_anthony]

I was diagnosed with Herpes this past month. I would like to know how it can be transmitted. I have a 10 month old and she baths in the same tub and she had some sort of breakout/rash(< i hope) and i am scared like hell... I am so SCARED, I CAN'T EVEN START TO EXPLAIN THE MESS I AM IN. i'm so frustrated and sick to my stomach about this I can't eat, sleep, or think straight. I have caught myself spacing off about how I have messed up my daughter's entire life. What should I do? Should I be concerned? Should I rush her to the hospital? Should I get tested because the docter just gave me a "visual diagnoses" which is understandable, but I can't hold my feeling from the pit of my stomach and I fear the worst; maybe that is the feeling in my stomach that I can't get over. IS SOMETHING WRONG WITH MY DAUGHTER?????????????????
PLEASE ANSWER MY QUESTIONS...

[teddyd]

A related discussion, Pop Smear was started.