Anorectal fissure that tested positive for HSV-1

[Angela4568]

I’ve always had anal fissures due to bowel problems. A week ago my anal fissure was swabbed at the STD clinic and came back positive for HSV-1....and also was told I had a BV...  before getting my positive results, I went to the ER the same day of hearing my anal fissure may be herpes. At the ER I was told I did not have herpes after getting my results back. At the ER the doctor explained that it’s rare that anal fissures happen b/c of herpes. And that my anal fissure was for sure infected but not consistent with herpes out breaks as the fissure didn’t have any bumps or blisters in clusters around it. No evidence of herpes from the ER from the same fissure that was swabbed at the STD clinic that gave me a positive! I don’t have any symptoms of herpes but everything I was told by ER Doc is consistent with what I’m experiencing. I’m really confused by the swabs one being negative & one being positive . As I’ve read on this site how accurate swabs are.Any insight is helpful

[sorelegs]

One swab may not have had enough virus on it to become positive. This is not uncommon and is the reason swab tests need to be done asap. 24-48 hours after a lesion is formed

[Angela4568]

My “infected” area was the lining of my but crack.  More like the bottom off my bum crack but not close to the anus. No blisters, no bumps just an anal fissure. Also could having the HPV virus alter HSV readings

[TooHip1973]

Having the HPV virus has no impact on HSV testing. A swab is the most accurate testing possibl for HSV. The IgG test, while excellent for HSV2, isn’t as reliable for HSV1.
I think you should take the swab results as accurate, the positive swab results. A negative swab isn’t rare. As sore legs mentioned, any type of sore or irritation being swabbed has to be done fairly early in its appearance for an accurate swab results.