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Valtrex didn't work?

Quick sexual history overview-
My last sexual intercourse was 12 months ago.
Fooled around with same partner this past April. No direct contact between genitals, but definite contact with hands. And there was nobody inbetween.

Five days later, I noticed a red pimple/bump on the right labia an inch and a half away from the opening of my vagina along with a swollen right lymph node. I also noticed a small flesh like pimple on my upper right thigh.

I freaked and went to see a random OBGYN Since i didn't have insurance.  She immediately diagnosed hsv-2 and did a culture (along with all other std standard tests) to be sure and put me on 1g/day for 10 days of valtrex.  HSV culture came out positive, and other std tests came out negative (pap smear was normal).  After she did the culture (broke open the leison), another developed on the opposite side (left labia) and one on my anus opening.

Oddly enough, at the same time I experienced an almost identical blister/leison on my scalp, and a couple odd pimples on my back and neck behind my ear.  I began taking Valtrex and the vaginal leisons and pimples on my body started to calm down and fade away. There was  no yellow-filled blister nor scabbing with the "herpes" lesions..  I went to the dermotologist to confirm the herpes diagnosis but since I was in the middle of my treatment with valtrex, she was inconclusive and blamed the leison on my scalp as folliculitis (spelling?). and she blamed the little bump on my upper thigh as Molluscus Contagiousm and tried to freeze it off.

Immediately after completion of my valtrex treatment (within 48 hours) I have noticed itching in the genital region where the leisons first occurred.  I feel like my lymph nodes are starting to become sore again, and itching on my anus that looks like the herpes lesion has come back.  

My question is:
Is it possible for an outbreak to not 100% go away with the valtrex treatment I was on even though I took it as directed? Could herpes have recurred so quickly? Could this have been a herpes lesion on my scalp? Or could this be some other infection or bacteria? Does this make any sense to you? I would go get an HSV blood test to be sure of hsv3 but i'm waiting for my insurance policy to kickstart.

5 Responses
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Avatar universal
A related discussion, Bump on the Scalp was started.
Helpful - 0
Avatar universal
Dr. HHH,
I am confused that this initial hsv-2 outbreak occured after an incidence where there was no sexual intercourse or genital on genital contact for that matter.  You were correct- I did not feel ill with fever nor did I require hospitalization so I am less focused on the disseminated herpes theory. Is it possible that the infection was due to HSV-1 rather than HSV-2 considering that the leisons were "in" the skin rather than "on" and that I had a leison on my scalp, and I did not have sexual intercourse?

Can a CBC (INC. DIFF & PLT)blood test show warning signs against HIV?  I did have this test done and it came out normal.

Helpful - 0
101028 tn?1419603004
It also wouldn't hurt to return to your gyn for testing for vaginitis. In us gals it's not unusual for either yeast or bacteria to overgrow in our genital area which can also cause itching.  

If you haven't already - read the herpes handbook at www.westoverheights.com. It's a terrific resource to learn more about herpes, treatments, how to talk to a partner about herpes and how to reduce the chances of transmitting the virus to a partner :)
Helpful - 0
239123 tn?1267647614
MEDICAL PROFESSIONAL
Please understand that I am making no specific diagnosis; I can only speculate.  I guess I misunderstood your opening comment about the nature of your recent sexual activities.  If you had no genital or oral intercourse in the 2-4 weeks before onset of symptoms, then you didn't have initial herpes.  Whether or not it was a highly atypical recurrent outbreak, I cannot say.  All this makes it extremely unlikely your non-genital lesions were due to herpes.

You seem to have misinterpreted what I have said about lesions "on" the skin (perhaps suggesting herpes) versus "in" the skin (herpes less likely, more typical for folliculitis etc).  Those descriptions do not distinguish HSV-1 from HSV-2.

Often there are abnormalities in the CBC in advanced HIV disease (i.e., overt AIDS). Otherwise it provides no useful clues about HIV.

Bottom line:  You need to see a herpes-knowledgeable health care provider. I simply don't know what's going on.  Good luck--

HHH, MD
Helpful - 0
239123 tn?1267647614
MEDICAL PROFESSIONAL
It seems likely you were experiencing your initial HSV-2 infection, i.e. acquired within the few days (up to 2-3 weeks) before your symptoms started.  On rare occasions, initial HSV infections disseminate body-wide, wit herpes lesions popping up on various areas of the body.  So conceivably that explains your scalp and other lesions.  However, disseminated HSV infection usually makes people extremely ill, with high fever, usually servere enough to require hospitalization.  So the fact you weren't all that sick (at least you don't say you were) is against that possibility.

And yes, primary herpes sometimes can relapse immediately after stopping anti-herpetic therapy. Whether the new genital lesions and groin soreness are due to that or something else, I cannot say with certainty.  But you might need to resume Valtrex.

So you need to return to a health care provider, either the ObG or derm; or even better, find an infectious diseases specialist to manage this problem.  Insurance coverage or not, you need to do it.  Among other things, you need HIV testing.  While disseminated herpes and rapid relapse after stopping treatment usually occur in immunologically healthy people, sometimes it is a mark of immune deficiency.

Good luck--  HHH, MD
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