HSV 1 and 2 testing discrepancies?? help please

[candace42]

I think its great that a community like this exists for people to get real medical advice. In any event here is the brief story that I will wrap up with my questions. 1 week ago I felt a tiny sting after urinating, it felt like the sting you would get from a papercut. I grabbed a hand mirror and took a look, I saw a small cut..that looked like it was healing. It was at the bottom opening of my vagina. two days later 2 to 3 bumps appeared. I only felt them when I was urinating or wiping myself. I took a look again and decided to see a medical professional first thing in the morning. I couldn't sleep or eat for fear that i could possibly have herpes. I called my partner and told him about my bumps and discomfort while peeing and together we went to the nearest walk-in clinic. the doctor asked me the routine questions...I told him that I didn't experience any flu-like symptoms, fatigue, body aches or even the intolerable pain I hear that comes with first OB's. for me it was when i pee'd or tried to press on the bumps that i felt discomfort. he peeled back my paper towel skirt and before i could ask him if I need to scoot down further he said "Oh this is herpes!" and in a small voice I said, "are you certain??" and he said "it is overwhelming me consistent with herpatic blah blah blah" (I can't remember what that was) he then says, it looks like you have a yeast infection and vaginal infection too. Then he begins the herpes acceptance speech..."its not the end of the world you will be fine, i will give you some valtrex to treat it and we can go from there" I didn't want to accept it because my partner and I had been together for 2 years and he was tested for a panel of tests in the summer and I was confident he wasn't seeing anyone else. Plus I also knew I wasn't. He also said he had never ever had an outbreak and was far too willing to get retested. Then the doctor prescribed valtrex, metrogel, and diflucan. I then asked if we could take blood work because I've been told a visual examination is not adequate or reliable. He argued that would do it but that it was a waste of time because they are faulty. I then asked what if my results indicate that I am negative? and he said "I still say you are positive" I was so discouraged.  The nurse collected my culture and blood samples he eventually agreed to and walked out the room to allow me to dress. My partner who was just seen by the same doctor waited in the lobby for me after his testing. I emerged from the room, before him i had only been with one guy and only one guy. We sat in the parking lot silently. 3 days later my blood results came in and here they are...

Labcorp

HSV 1 and 2-Specific Ab, IgG
    HSV 1 IgG, Type Spec                  <0.91


T pallidum Screening Cascade
    T pallidum Antibodies                    Negative                                        

HSV 2 IgG, Type Spec                      <0.91                               Ratio          0.00-0.90
                                                                                                  Negative            1.09



When I went in to talk to him I said, "this looks negative" and he said "No look at your IgM you were mostly likely recently infected since you never had bumps/blisters like that" I was so confused and as a patient I felt foolish challenging him so I asked for a print out and accepted his valtrex prescription. My viral culture hasn't come back and I should find out my partners blood results today.

a little more detail prior to the bumps

-the day after i saw the cut I continued my routine boric acid suppositories as a prevention for BV. However, I ran out of double zero capsules so I used an un-used monistat applicator and filled a little bit of boric acid powder in the applicator and inserted it in my vagina. I suffer from recurrent BV...

----
Question?

-can you please interpret my bloodwork? it appears as if Im negative so why did this doctor say Im positive?

-what do you medically suspect might be the problem?

-was the wrong blood test administered? I thought IgM was irrelevant...right?

-what should I do next?


Any information you guys can offer would be wonderful. I greatly appreciate it.

[Fleetwood20]

You are one complex little lady, but I think you knew that already ;)

If there is HSV1 involved here, then interpretation is more difficult. You should get the paper work for all tests that you have had done.

We have been assuming you are negative for HSV1 and HSV2 at the outset. Commercial tests miss 1 in 10 HSV1 infections but are much more accurate for HSV2. Speak with your parents, do either of them have oral cold sores and are they aware of whether you had oral cold sores as an infant? This is a critical piece as many people do have an oral infection. IN your case this could have been missed by your first Labcorp test, but your second test may not have been Labcorp.

The swab may be more helpful, but you will also need to push hard to ensure they have typed the culture correctly if it is positive. It doesn't seem like you are dealing with overly knowledgeable people in the HSV arena.

If you still get keystone cop treatment over the next few days, then the next best thing you can do is wait until 12 weeks post symptoms appearing and consult a new doctor who seems knowledgeable about herpes. Request IgG antibody testing, type specific for HSV1 and HSV2 and that you will be returning person to work through the printed results in detail.

[candace42]

My gyno's office called to tell me my results are in and show that I'm hsv1 positive. I asked what testing and  she said it's igg and igm combination.

The bumps appeared on Monday and were gone by Saturday. For an initial outbreak I thought it was 2-3 weeks? Also my viral culture still isn't in, apparently it was coded incorrectly so it's going to be run now. Idk what that means. I broke up with my bf so I can't confirm his results, when he told me he tested positive he didn't see his results, they were given to him over the phone. Therefore I can't even put pieces together.

How can my blood test distinguish that I have hsv1 but not detect hsv2. My doctor said it's pretty much all the same. What do you think about the recent developments? And what steps should I take next to get to the bottom of this?

[Fleetwood20]

IgM or IgG are antibodies detected in a blood test, no question. Cultures either detect or do not as you suggest.

5 days is about right, although more common for a recurrence or for someone who has oral cold sores already. Neither applies to you. An initial outbreak can be longer with sores coming up progressively over a few days.

[candace42]

I have a question, when viral cultures are taken do they come back separate from blood tests? I called the clinic i had my tests done at and the nurse who was there when my test was administered said my VIRAL CULTURE came back as 1.04. She claims thats what the HSV IgM 1/11 combination number is. That didn't sound right to me because I thought it either comes back positive or negative, no numeric value. right?

-Also, in most cases of initial outbreaks is it possible for the bumps/lesions/sores to be there for only 5 days? without treatment? is that common or uncommon?

[candace42]

He is hysterical. I will  have to Get my hands on it. He isn't  all there right now.  Here is what I will do, find out the specific  test  and igg levels. Oh and confirm if it's HSV1. I will also post my culture results. They are due back Monday. I'll be honest, I'm impressed with this site...you guys have been abundantly helpful.

Idk if you pray but if you do, send one up for me...:(

[Fleetwood20]

Pretty unlikely don't you think?

Have you confirmed whether it is the type specific for HSV2 test or a combined test?