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STDs (Expert Forum)
What Else Could this Possibly Be?
Answered by
Edward W Hook, MD - HIV Prevention, stds
Welcome to the STD Forum, which is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.
What Else Could this Possibly Be?
by baffled2005, Nov 03, 2009 01:12PM
Doctors,
I am faced with a baffling situation so please bear with me if this is long. I am a 25 y.o. female. In Jan. 2005, I had unprotected oral and vaginal sex with an ex-boyfriend and the only person I had been sexually intimate with until that point. Within 10 days, I came down with a horrible flu with fever, vomiting, runny nose, sore throat, diarrhea. Then I began to have pain in my mouth, sores on tongue, and constant sore throat for nearly 5 mos. straight. I had several HIV tests that were negative. Then, in June 2005, while on antibiotics for a possible Strep Throat, I began having HORRIBLE vaginal and anal itching (all over the genitals and not just in one spot). This itching was constant. Never went away completely. All yeast, BV treatments, etc. made the symptoms worse. Sometimes I had tingling in the vagina legs and toes, leg pains, toe pain, and lower back pain with these symptoms. Itching continues to today 4.5 years later although it is less pronounced now. I would also get tinging in the vagina and legs followed by burning in the upper right mons pubis area. No sores at all, just some redness. The itching got much worse during my period.
My gyno put me on Acyclovir in Aug. 2009. At first I saw no change but within a few months I noticed that the itching was much better. I came off of it and nothing happened. Then a few weeks later, I had the itching, tingling, and redness with burning on the vagina. I took one Acyclovir and within minutes the symptoms subsided. I skipped a dose and the symptoms came back within 12 hrs. I did this several times with same results.
My first boyfriend has had the Herpeselect and says he is negative for both types as well. I haven't seen his tests. He says he has no symptoms orally or genitally.
July 2005 Herpeselect,Dec. 2005 Immunoblot,March 2006 Herpeselect,July 2009 Hepeselect,Dec 2009 WB, Feb. 2009 WB all neg. for both types.
I am faced with a baffling situation so please bear with me if this is long. I am a 25 y.o. female. In Jan. 2005, I had unprotected oral and vaginal sex with an ex-boyfriend and the only person I had been sexually intimate with until that point. Within 10 days, I came down with a horrible flu with fever, vomiting, runny nose, sore throat, diarrhea. Then I began to have pain in my mouth, sores on tongue, and constant sore throat for nearly 5 mos. straight. I had several HIV tests that were negative. Then, in June 2005, while on antibiotics for a possible Strep Throat, I began having HORRIBLE vaginal and anal itching (all over the genitals and not just in one spot). This itching was constant. Never went away completely. All yeast, BV treatments, etc. made the symptoms worse. Sometimes I had tingling in the vagina legs and toes, leg pains, toe pain, and lower back pain with these symptoms. Itching continues to today 4.5 years later although it is less pronounced now. I would also get tinging in the vagina and legs followed by burning in the upper right mons pubis area. No sores at all, just some redness. The itching got much worse during my period.
My gyno put me on Acyclovir in Aug. 2009. At first I saw no change but within a few months I noticed that the itching was much better. I came off of it and nothing happened. Then a few weeks later, I had the itching, tingling, and redness with burning on the vagina. I took one Acyclovir and within minutes the symptoms subsided. I skipped a dose and the symptoms came back within 12 hrs. I did this several times with same results.
My first boyfriend has had the Herpeselect and says he is negative for both types as well. I haven't seen his tests. He says he has no symptoms orally or genitally.
July 2005 Herpeselect,Dec. 2005 Immunoblot,March 2006 Herpeselect,July 2009 Hepeselect,Dec 2009 WB, Feb. 2009 WB all neg. for both types.
Doctor's Answer
by Edward W Hook, MD, Nov 03, 2009 08:59PM
, Nov 03, 2009 08:59PM
Welcome to our Forum. I will make several comments and hope that they are helpful. The bottom line however is that you will need to work with a health care provider that you feel good about and may have to work with that person over time. My hope is that my comments will be helpful to you in moving in this direction.
Herpes. The only think that suggest HSV in your history is that you responded to acyclovir and to be honest, your response is not typical - too abrupt, both in terms of recurrence when you stopped the medication and in terms of relief of symptoms when you took it. Furthermore, you have had no lesions suggestive of HSV and you have had multiple negative tests with the "gold standard" test for HSV. In addition, even if you wanted to discount your own test results, your ex BF had negative tests as well. the case for HSV is just not sufficient to attribute this to that.
2. What could this be. Two possibilities come to mind, perhaps working in combination. Your vaginal and rectal discomfort are highly suggestive of yeast infection. Not everyone with yeast has the classical adherent white discharge and itching is common. Alternatively, many of your initial symptoms are suggestive on mononucleosis. Did you have a mono test? In addition, you may be thinking about it too much. Sometimes after an exposure that, in retrospect, one wishes they had not had, persons tend to examine themselves and be far more attuned to genital sensations than in periods when they are not concerned. This in turns leads to noticing what turn out to be normal sensations that might have been not noticed or ignored at other times. Perhaps this is a contributor to your situation.
3. I see no reason to worry about future sex partners. There is no evidence that this is an STD and I am doubtful that it is.
4. Nope, see above.
Hope these comments are helpful. EWH
Herpes. The only think that suggest HSV in your history is that you responded to acyclovir and to be honest, your response is not typical - too abrupt, both in terms of recurrence when you stopped the medication and in terms of relief of symptoms when you took it. Furthermore, you have had no lesions suggestive of HSV and you have had multiple negative tests with the "gold standard" test for HSV. In addition, even if you wanted to discount your own test results, your ex BF had negative tests as well. the case for HSV is just not sufficient to attribute this to that.
2. What could this be. Two possibilities come to mind, perhaps working in combination. Your vaginal and rectal discomfort are highly suggestive of yeast infection. Not everyone with yeast has the classical adherent white discharge and itching is common. Alternatively, many of your initial symptoms are suggestive on mononucleosis. Did you have a mono test? In addition, you may be thinking about it too much. Sometimes after an exposure that, in retrospect, one wishes they had not had, persons tend to examine themselves and be far more attuned to genital sensations than in periods when they are not concerned. This in turns leads to noticing what turn out to be normal sensations that might have been not noticed or ignored at other times. Perhaps this is a contributor to your situation.
3. I see no reason to worry about future sex partners. There is no evidence that this is an STD and I am doubtful that it is.
4. Nope, see above.
Hope these comments are helpful. EWH
Post Comment
Recently, the itching is not as bad but at the end of my period every single month for the past year I have had horrible anal and vaginal itching with the lower right vaginal lip becoming incredibly irritated. This usually lasts 2-4 days. One time I scratched it and it began bleeding and clear fluid came out. Just last week, my period ended and this itching began. It began to subside then got much worse and spread to the right bottom of my vulva and perineum. Itching is still there and very bad. It seemed to respond to Vagisil at first but not anymore. I shaved my genitals on Fri and saw no sores at all and not even any redness.
My questions to you are
1) Have you ever come across a situation such as this in practice where person has repeated negative blood tests but in fact has HSV with it presenting with no sores and being so often?
2) What else could this possibly be?
3) I want to let go and continue my sexual life without telling future partners. Do you think I should do so?
4) Does Acyclovir work that fast in curing symptoms within minutes and having symptoms come back full force if you miss one pill? What do you make of that?