A bit Confused

[Melissa567]

Hi Grace - hoping to get your opinion on this as I am a little confused at conflicting info. I have done a fair bit a reading on herpes and wanted to know what you might think. (I am 28 yr old Female)

I had a reaction to an antibiotic, so my body was pretty run down. About three & half weeks later I had these white patchy blotches, I guess they could have been blisters, (not a blister I am used to seeing- they may be lesions but I havent a clue what a 'lesion' would look like) but there were about 3 or 4  of these white patches stuck on each side on my vagina (on the inside bits). I had very bad thrush aswell.

I went to my doctor the next morning, she said it was candida, but also looked like it could be herpes, so she scraped one of the white patches for a culture test, got me thrush treatment and put me on Valtrex for 10 days. It cleared up over the next few days, kinda of leaving a hole there where the patches had been and then completely disappearing. Anyhow the culture came back negative.

Two weeks after the outbreak I got a blood test done as I wanted to know what it was. My last sexual contact was 6 months ago, so the doc said it should show up on the blood test.The blood test then came back negative.
(I have started dating a new man - we have not had any kinda of sexual contact yet - but this is why I want to know what it is as I dont want to pass it on).

I am very confused, as the doctor who looked at it said it might be herpes, but the tests suggests otherwise. They tell me to wait until I have another outbreak to culture it......but if I got this 6 months ago, how long will it be until my next one comes up? I just dont want to worry this man if its not what it is, but I dont want to assume it wasnt and pass it on. Do I make him wait 3 months....6 months until I get another outbreak?  Should I get retested with my bloodtest?

Do antibodies come after the initial exposure....or the first outbreak?

Im so sorry I have written so much and have questions, just not sure where to go from here, would appreciate your opinion and help
Thanks

[gracefromHHP]

Yes. congrats on being negative!! Finally you can move past all this :)

grace

[Melissa567]

Hi Grace

I got my blood test results back today, however there wasnt any numbers given with it. It says this :

Herpes Simplex Serology

Herpes Simplex 1 IgG (EIA)  Negative
Herpes Simplex 2 IgG (EIA)   Negative
Herpes Simplex IgM (EIA)     Negative


Does this look like a credible/reliable test was done? I am from Australia.

Kind regards

[gracefromHHP]

This is all covered in the herpes handbook - www.westoverheights.com.

grace

[Melissa567]

Thanks Grace

Is there any difference in the way they shed down below or that one is more contagious than the other?

[gracefromHHP]

they look the exact same. No way to tell which is the cause of the ob without laboratory testing.

grace

[Melissa567]

Hi Grace,

Have a quick question for you, does the type of herpes you get on your genitals change the difference in appearance of the outbreak?

Can someone who has herpes one, get the same blistery result as herpes 2?  Or does this make no difference, in that the first initial outbreak can be just as severe in one or two?

Thanks again :)

[gracefromHHP]

I've seen some rather NASTY fungal infections down yonder.  Don't underestimate them.

You can have herpes lesions anywhere in the entire boxer short area as we call it.  

grace

[Melissa567]

Thanks again Grace, will get my paper results soon. I called the pathology clinic who run these tests and they said they do a PCR on the lesion, they also said they did IgG testing, although when I asked if it was 'herpes select' he wasnt sure. So thats a good start do you think?.

If this was not herpes Grace, I am finding it hard to find any information on anything else that causes blisters in the genital area. Is there anything documented on drug reactions or candida that cause blisters similar to herpes? I did see Steven Johnsons....but that seems to be pretty bad in comparison to what I have. I feel for anyone having to go through that.

To your knowledge Grace, does it occur often that a females symptoms/lesions would appear just on her cervix or inside the vaginal wall and have no symptoms appear externally to see? If this is the case, any wonder this virus is passed on.

Thanks again for your opinion :)

[gracefromHHP]

I'd be guessing as to what testing you specifically had done.  I know it's hard but wait until you can get a copy of your results and see exactly what they did do.  I'd like to think you had a pcr lesion culture and a type specific herpes igg blood test but it's hard to tell.

grace

[Melissa567]

Hi Grace - what would you make of this one......

I emailed the pathology centre to see what tests are run for blood tests and the information I got was this....

"Serology (IgG testing in the serum) is done mostly for epidemiological purposes. Positive HSV IgG only means that the person has been exposed to the virus (and is therefore latently infected), but does not mean that the current illness is caused by the herpes virus"

Would that type of description mean IgG testing has been done?  Sorry to ask you this one, I cant get in to see my doctor for two weeks to get my results, and they wont give them over the phone. Tough crowd.

Thanks again Grace.

[gracefromHHP]

google images are your best bet if you want to look at pictures. Prepared to go eeewww since most of them are the worst case scenerios so that you aren't there playing where's waldo looking for the herpes lesions.

I've found that some practioners  just get confused and order the pcr as a blood test.  If you had herpes serology done that means you had blood work for herpes - just ask for a print out of what all your test results were so  you can better figure out what you really had done.

there is a pretty active herpes group in australia - they might be able to help you find a practioner you feel more comfortable with than the one you have now. google them  too :)

grace

[Melissa567]

It sure does make sense thanks Grace, the part that doesnt make sense is why they did the PCR at all? Are we behind on the correct testing over here?

My doctor did speak of Antibodies aswell though, so Im thinking he must have done some other testing along with the PCR? The words written on the form when I went to pathology was 'herpes sereolgy' . Have you heard of this one?

One last question Grace (I promise - hehe)  do you know of a trusted website which shows a wide range of pictures of herpes or candida/bacteria infections. Dont worry I wont go selfdiagnosing myself, but I guess deep down I keep thinking the doctor would know what she saw, who am I and the tests to assume she was wrong. Once again, I really do not want to risk passing it on to this man. Hard part is, I cannot get suppressive therapy unless I have a diagnosis. Hello Catch-22.

Thanks so much for your help on this Grace, I keep saying it but its so good being able to ask for help and a trusted opinion, as most doctors are too busy too care.

[gracefromHHP]

pcr as a blood test really isn't helpful outside of research purposes when it comes to adults.  In newborns it could be helpful since they are more likely to have the virus actually detected in their blood since their immune systems are so immature that the virus is more likely to give them a system viremia ( I like to use big words sometimes so it sounds like I know what I"m talking about...he he he ).  pcr testing actually looks for herpes dna - it doesn't look for antibody production like regular herpes igg blood tests do. Since in most adults the virus doesn't cause a systemic  infection, it's not going to be of much use for routine herpes screening since there isn't going to be any active herpes virus in the blood for the test to detect.  pcr for lesion swabs though is very useful since instead of relying on actually getting active virus on the swab and being able to grow it out in the lab like a regular viral lesion culture does, it looks for herpes dna present on the skin which is what makes it so much more sensitive for lesion cultures.  Does that make sense?

grace

[Melissa567]

Thanks again Grace - one last question though - when would a PCR in a blood test be useful in your opinion?

Is that something that can be used when the exposure was recent?

Cheers :)

[gracefromHHP]

No I don't get paid one cent for this - it's all volunteer.

The pcr as a blood test isn't of  much use in a situation like this.  You will need to repeat the blood test with a type specific herpes igg blood test at some point to be sure.

Yes nasty fungal infections can cause all sorts of things down yonder :(

grace

[Melissa567]

The PCR test my doc spoke about was for my 'blood test', as I had the swab test done through another doctor. (Saw two doctors - a different one for swab test as I was away from the location of my normal doc at the time of outbreak- the other bloodtest with my regular doc)

So my swab test should have had a PCR done on that? Hopefully thats what she did then?. She just called it a swab test and took it from the white patch or lesion. She said they looked like a blister, and she tried to break it with the swab which is why it has me so worried, because if the doc is calling it a blister then it must have been?

To your knowledge Grace, can a bad fungal infection cause blisters?

Such a confusing situation. Geesh I hope your getting paid for this :)

[gracefromHHP]

When you go back - ask if your pcr test was of the lesions or of the blood.  

Yes you can get type specific herpes igg blood tests in australia too.

grace

[Melissa567]

Thanks again Grace, so if I go back to the doc in a few months time (leaving atleast 16 weeks since outbreak to be sure) and request an Igg blood test and this then comes back negative, I should be fairly sure ? My doctor did talk of antibodies, and said to me no antibodies have yet showed up,  so for him to be speaking of 'antibodies' I was under the impression, more than just a 'PCR' test was done with the blood test?

I live in Australia, so I am unsure - but do you know if we have those Igg tests over here? Do you know what type of swab testing we do? Just wanted to ask you if you know if our medical system is any good or if Im wasting my time.

The outbreak surely was a humdinger, thanks again for your opinion - truly grateful :)

[gracefromHHP]

There are hundreds of different kinds of fungal infections that can infect our bodies. You had a humdinger of a reaction to antibiotics from the sounds of it and were run down way more than usual.  White patches wouldn't be unusual with a genital fungal infection.  

If you are hsv1+ then you aren't likely to contract hsv1 genitally later on . You can but the risk of it happening are significantly reduced enough that it's not something worth worrying about.  Your partner not performing oral on you when they have an active cold sore though is still a good idea since it's best to err on the side of caution for starters and also because they are an open portal into the body for bacteria that normally wouldn't be in the oral area so it's never a good idea.

pcr as a blood test was a waste of time. Pcr as a lesion culture of active symptoms is helpful but even they aren't 100% accurate.

I understand why you are worrying but there doesn't seem to be any reason to do so.

grace

[Melissa567]

Thanks so much for your reply Grace, it is hard not to be concerned as the doctor couldnt think of anything else that it could be as I felt so unwell/flu symptoms along with it. From your knowledge can the blisters/white patches (each probably a 1cm in width & length) be anything else? Ive had thrush before, and have never known it to show symptoms like that. The hard call is, my reaction to antibiotics caused hives all over me, but this outbreak on the genitals was three weeks after this, which is why the doc doesnt think it was that.

I dont want to be paranoid, its just all so confusing tho. I dont want to go assuming its not - as the testing process is all so conflicting evan my doctors say this. Knowing my story may help you to see why I cant just forget about it - this new man I am dating has just been through cancer (chemo -etc), so his immune system wouldnt be like everyone elses to suppress it. And I dont want to risk him getting this.

The doc said when I got the results back, the 'PCR' showed nothing aswell. Is this a reliable test to your knowledge? If the infection/outbreak was a recent one, would the PCR bloodtest show something?

I have one more question (it may sound stupid but bare with me :) As a child (9 yrs old) I had a coldsore - only one outbreak. Does having this herpes type in my system (type 1) then make my genitals immune later in life if I received oral sex  from a man with a coldsore (if ofcourse - that was type 1 too)?

Thanks again for your help Grace, your opinions and knowledge is very much appreciated (I apologise for the long story)

[gracefromHHP]

Antibodies form when you are infected, not when you have your first noticeable symptoms.

Even the best herpes practioners misdiagnose herpes 1/3 of the time.  No reason to continue to suspect you might have herpes if you had negative hsv igg blood tests after 6 months since the last time you had sex.

darn antibiotics...

grace