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Herpes Infection Multiple Sites After Established Infection

Hi Terri,
I’ve had something very upsetting happen to me starting in October and I’m looking for your opinion on a multitude of things.  I’ve already asked Dr. Handsfield for advice and Grace from HHP and they have no concrete answers, just possible theories.   They tell me to seek specialists, but I currently have no insurance, and my symptoms are gone so that would be of little help. So here is the long convoluted story and I’ll follow it with questions:  I have had oral hsv-1 since 4/5 yrs old, confirmed with blood test in 2010.  I have had one previous relationship where the guy tested hsv-1/2 negative the beginning of our relationship and when we broke it off.  The relationship I am in now is my second relationship w anyone ever (including kissing,oral, sex) and is the only relationship I’ve had sexual intercourse in.  When I was getting to know my now boyfriend I asked him if he had ever had coldsores, and he said “once or twice when I was seven.”  I took that as the go ahead to mean it was ok for us to perform oral on eachother because of our immunity.  During these initial stages of dating, I felt very run down and was fighting a cold for almost a month, and the night I received oral for the first time from him I was still a bit run-down from the cold and had scratched my pubic area severely while shaving 2 hours before he went down on me (using a side to side motion because I was in a hurry).  This fresh, wound like environment combined with the oral very soon afterward, and my depressed immune system due to the cold could possibly explain what I’m about to tell you next.  In addition, he licked my ears, sucked my breasts, and went down on me for abt an hour and a half.  
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Avatar universal
Hi Terri,

I'm going to call planned parenthood and inquire about the specific testing done.  I remember there was a yellow packet explaining the study extensively and how the new testing was designed.  I will try to get that info and get back to you.  Also, I will have my current partner get the western blot to determine if the  
IGG results were accurate.  To answer your question about my previous partner: five months into our relationship (with copious oral sex at that point) he had an IGG done that was both negative for HSV-1 and HSV-2.  Meaning that coming into our relationship he had no prior herpes.  So, if I got HSV-1 from oral sex from him, it was my own virus transferred orally to him and then transferred back to me asymptomatically through oral sex (because he never displayed coldsores).  This seems highly unlikely, so I conclude he is not my herpes source.  If the western blot for my current partner comes up negative for hsv-1, and I'm negative for hsv-2 via IGG, I will assume planned parenthood made a mistake and I do not have genital herpes, and move on with my life.
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55646 tn?1263660809
Hmmmm.  I can see the full post from Feb. 18th

So this whole situation is pretty odd.  False positives on herpes swab tests are very unusual.  However, having said that, I have no idea what sort of swab test you had done since it appears it was experimental.  Are you able to find out more about the study that was happening?  As a GENERAL rule, we are not able to provide experimental test results to subjects in a swab study, so I am once again confused by your post.  Now that you've told me you've not had intercourse with the person with HSV 2 infection, I'm no longer concerned about mistyping of the swab test.  Let's take that off our list of possible explanations.

Now, with your first partner with whom you had oral sex.  Do you know that your first partner didn't have HSV 1 when he was the giver of oral sex?  You mention that he may have contracted your cold sore virus and infected you genitally?  Why couldn't he have had his own cold sore virus and infected you?  And then we have your history of cold sores that doesn't fit with new HSV 1 infection.  

I think I have given you as much information as you I have on your topic and have gone waaaay beyond what I am to do as a board monitor on posts.

If you have more questions, you may enter a new post if you wish.

Terri
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Avatar universal
As an fyi, part of your February 18th post is cut off.
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Avatar universal
Hi Terri,

I have only had two sexual partners in my life.  With the first, all I practiced was oral sex with him and no intercourse of any kind.  Now with my current boyfriend (2nd partner ever), when we engaged in sexual activity at the very beginning of our relationship, it was also strictly oral sex, no intercourse up until the time of the mysterious outbreaks.  My first partner was with me 5 months before getting a herpes test, and he tested negative for hsv-1 and 2.  He didn't test after that.  So, I either got the infection from autoinnoculation or oral sex, if it is herpes.  If it was from this current partner and you believe the sample was incorrectly typed, that must mean he has oral hsv-2.  If it was from my first partner, he would have had to catch my coldsore virus and be asymptomatic to then transfer it to my own genitals.  Both theories seem highly unlikely.  Your mistyping theory does fit though because the planned parenthood doctors used a new technique to test my herpes that was supposed to be "more accurate" and paid me to participate in the study.  So my blisters might not be what they thought.  My initial outbreak was actually in my pubic crease and pubic hair area, then after a few days the buttocks lesions appeared.  To your other question, I'm not concerned about Hsv-2 at all, I've researched it and accept the risk.  If someone has herpes whitlow, can they wash their hair with their bare hands or face, as long as they're not experiencing blisters?
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55646 tn?1263660809
Yes it is possible that the antibody test could have missed the HSV 1 infection because it just routinely misses one of 10 HSV 1 infections.  If he is truly negative, t

It is normal for women to have yeast in the vagina without symptoms at all, in which case it is considered normal flora of the vagina.  In your case, you are bothered by the discharge even though you don't have the itching.  I suppose you could talk to your health care provider about further treatment.

If the lesions on the breast are herpes, you could have further outbreaks in the nerve group that supplies that area.  For the specific information on where the nerve dermatorme is, google nerve dermatorme and you can check it out.

Again, if you get any more lesions in that area, please go in right away for swab testing.

I am a bit confused about something:  is the person who tests negative for HSV 1, the person you were having sex with when you got the buttocks lesion?  If yes, and it is a true negative for HSV 1, this was not your first infection, which is consistent with where it showed up.  Most first infections with HSV 1 that are acquired sexually will show up in the genital area first, not buttocks.  But this is so complicated, I kind of lost track of things here.  And I am still a little concerned about the possibility of mistyping of the sample.

If you are truly negative for HSV 2, then you know you are vulnerable to new infection from him, right?

Terri

You do
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Avatar universal
Hi Terri,

I appreciate your responses and I find them perfectly coherent :).  To the yeast question, I'm still concerned because I have yeast discharge inside and yeast peeling outside of the vagina.  Also, when my boyfriend fingered me recently, he used my vaginal fluid as lubricant to my anus.  Is it plausible that I have an anal yeast infection?

Recently I shaved my pubic area, then minutes later shaved a spot I missed on my armpit, how likely is it that I'll get a herpes outbreak in my armpit?

If the lesions on my breast were herpes, where else on the nerve path am I infected?  Can I get an outbreak on my armpit, arm, or hand/fingers due to breast infection?  How about if my armpit was infected? (same question about arm/hand/fingers).

My boyfriend got his results back (now from IGG) and it still reads HSV-1 negative, HSV-2 positive.  Could the HSV-1 still be a false negative?

I'm experiencing no more outbreaks currently of anything, so I'm trying to keep my immune system strong to keep it that way! Thanks for all of the help :).
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55646 tn?1263660809
Sorry, I missed all these follow up questions.

No, I don't think this chancroid.  
We have no idea if the lesions on other body parts are herpes, right?  That honestly would be unusual to have them all over the place, especially in light of your previous HSV 1 infection.  
The risk to you is your boyfriend's likely HSV 2 genital infection.  If you are the giver of oral sex to him, yes, you could acquire HSV 2 orally but as you know, that recurs infrequently and would look like a cold sore.  

The western blot is a blood antibody test.  You can have the University of Washington send you a test kit and your health care provider would draw the blood and send it to UW.  You can also order it through our clinic, but that is likely to be more expensive.  

If you get more lesions, and you don't have much money, I would go to a county STD clinic.  Did you check to see if there is one in your area?  If there is one, I might suggest calling in advance of any lesions and see if they are able to see you for genital lesions if they com up again.  Then you will know where to go and that they can provide the testing that you require.  The county, if they do testing, might only do culture.  That's better than nothing but PCR is better than culture.  

I don't think you need to change your shaving habits.  What is, is.  

Once four months have passed since your lesion that was positive for HSV 1, I think a standard IgG test is fine.  What you really want to know is if you have HSV 2, right?  And that somehow the swab test was typed incorrectly?  

If you no longer have itching, why are you still concerned about yeast??  

I'm sorry if my answer are not always coherent.  Your post are so long and there are so very many of them, I honestly get lost in it all.  But I"m trying!

Terri
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Avatar universal
Hi Terri,

Can you please answer my follow up questions (especially about the Western Blot)?  I don't mean to sound impatient. Thanks.
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Avatar universal
Do you think that the sores could be chancroid sores, or is that not possible if all he gave me was oral sex up until that point?
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Avatar universal
Can you explain in detail how to procure the western blot test.  How much do you pay for it out of pocket?  The University of Washington website confused me.  Also, I have continued sexual contact w/ my partner with the assumption that I have genital and oral hsv-1 and he has genital hsv-2 and oral hsv-1.  Should we stop all sexual activity at this point (including kissing) due to the ear, breast, leg/buttock lesions, even though they are only scars now?  I gave him unprotected oral sex 3 days ago, was that high risk?  I'm not worried about oral hsv-2 and I haven't had any new oral symptoms.  What procedure should I take if I get new lesions (gyno, dermatologist)?  How fast should they be swabbed?  And what should I ask them to test for?  What are your recommendations for herpes and shaving body parts?  I may breakup with my partner, in that case, should I get the western blot for myself, or just get a standard IGG and stop there?  Also, because a doctor at a clinic in Hartford thought what I had was a skin infection, her prescribed me keflex antibiotic.  As a result I've had a yeast infection since November.  The itching has ceased completely, but I have yeast discharge inside my vagina, and little balls of yeast on the outside of my vaginal area.  I have taken diflucan pills, terconazole internally as a suppository, and clotrimazole lotion externally, but the infection persists.  Any suggestions?
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Avatar universal
Hi Terri,
I would appreciate help finding a clinic, thank you.  As of now, I have a limited benefit family planning insurance, but am working on getting full medicaid.  My boyfriend first went to his primary care physician to get a battery of tests done.  Since you say the test he took for herpes was IGM, that explains his bogus results (his results had no numerical antibody values).  Because of this, I instructed him to get an IGG test at planned parenthood.  I'll let you know the antibody readings when they come in.  The primary care physician he initially went to didn't seem very educated on herpes, he said such outrageous things as "since you have hsv-2 and your girlfriend has hsv-1, you are immune to catching each other's strains."  He said this on the assumption that my boyfriend's Hsv-2 was oral because my boyfriend had mentioned childhood coldsores, and no genital symptoms.  My boyfriend mentioned that he had a "urinary tract infection" several years ago, which leads me to believe that was his Hsv-2 outbreak in his urethra.
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55646 tn?1263660809
I have read everything you wrote to me and to Dr. Handsfield.  This is indeed a very confusing situation.  While it is extremely unlikely to get HSV 1 at a new location after having it in a different location, I think both Hunter and I would agree that it is not impossible.  There are several confusing things here in addition to that.  The first is the positive swab test from the buttocks.  I'm wondering if there is a possibility that the typing was wrong, since your partner does not have HSV 1 based on the traditional antibody test.  Herpes does leave scars on the buttocks while not leaving scars on other genital areas.  People of color will lose pigment on the skin with outbreaks but most always, that returns.  There can also be scarring on the breasts.  But that doesn't mean you have herpes on the breast, just saying.  

One of the problems here is that you don't have money for evaluating this further.  You are aware that you must have health insurance now, right?  Where do you stand with that?  Have you tried to purchase health insurance through the state exchange or federal program (I don't know what CT does about this)?  Even if you have no money, the county in which you live likely has an STD program that you need to find out about so you can get care there for free or at a greatly reduced rate.

I would also suggest that your partner who was the giver of oral sex to you for one and one half hours (really???  wow) get a western blot to see if the traditional test missed an HSV 1 infection.  It would also confirm his HSV 2 status.  The IgM should be ignored, was the HSV 2 positive an IgG?  You mention an IgM in a post with Dr. Handsfield.  

If any more lesions appear, it is VERY important that you get them evaluated which is why you need to tie in quickly with the county STD clinic.  Do you need help finding that clinic?  Can you search it out?

Terri
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Avatar universal
If the lesions on the left breast are herpes, does that mean my other breast is infected too?  When you have breast herpes, where on your body can outbreaks appear?
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Avatar universal
I forgot to add something (sorry for all of the additions!)  When performing oral, my boyfriend would sometimes go from vagina to anus and back, could that have given me a vaginal infection?
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*jumping directly into oral
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Avatar universal
I researched hsv-1 before allowing my bf to perform oral on me and took the risk bc I thought my antibodies would suffice, I had no idea that things would be so troublesome on so many dermatomes!  But it must have been the severe irritation from shaving (and not allowing it to heal a few days before jumping directly into hour a few hours later) and my compromised immunity from the cold that caused all of this.
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Avatar universal
* As an addition, I forgot to mention that my boyfriend did not have a coldsore during any of this.  And never had any hsv-2 breakouts despite testing positive
for it and negative for hsv-1. His test must have been a false negative for hsv-1.  Also, I licked my left nipple about 8 months ago while masturbating, could that be the explanation for the two blisters on my breast skin?
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Avatar universal
1) Was it stupid to shave my legs during a possible herpes outbreak on my legs? (I shaved both legs, but lesions didn’t spread to my shins or most of my right leg at all, I think one formed on the side of my lower left leg though, the bugbite type).  Or does it not matter since if it is genital herpes I’m infected in the lower spine, lower stomach, buttocks, anus, vagina, legs and feet?
2) What do you make of this situation?
3) I’m paranoid that if this is herpes it will spread to my eyes, hands, arms, and other areas because it seems it already spread so easily (because of the ear lesion, and also bc the possible coldsore on my cheek suggests the herpes is migrating further up the nerves), showering too scares me now, although I shower I’m scared each time.
4) Is it idiotic/dangerous that we resumed sexual contact (anal, oral, vaginal sex) after the lesions healed and now I have scars if we don’t even know what all of this was? Was it dangerous for me to give oral/kiss him while I had the ear lesion, and he to suck my breast/give oral for a few seconds while I had the lesions on there?
5) If we break up, how would I begin to disclose this to anyone?  Is kissing off limits because of the itchy ear rash/sliver that healed w/o a scar?  Could I have transferred that ear thing to his penis/mouth during the kissing/oral I gave him.
6) How should I bathe, continue with a sex life, and live daily life?  Can you give me advice because its getting overwhelming.  I fear that I have spread whatever it is I have all over the inside of my vagina and around my body and his penis/body even though I have had no additional symptoms as a result of these acts besides the continual coldsores.
7) What do you make of his Hsv-2 result? And my HSV-1 culture result?
8) Is it worth it to see someone about this now that the symptoms are no longer active, if so, who?
9) How should I deal w/ the stress of possibly inoculating other areas? (especially my hands/eyes)
10) Do you think the red dot on my clitoris, and the labial swelling is inconsequential seeing as it went away in a day?  I also had intense vaginal itching that day and a few days afterward as well.
11) Should I get my vagina, inside of my anus, and mouth checked since I did all these sexual activities?
12) Could switching the ear I used for the phone cause the lesion to spread to my other ear asymptomatically? (I haven’t had symptoms on my other ear).
13) I shaved my armpits, then my legs, then my private area with the same razor, put the razor down for a minute or two and then shaved my right armpit, do you think I could have spread the potential herpes to my armpit? (I have no symptoms, its been 2 and a half weeks)
I would be so grateful if you could answer all of these questions to the best of your ability.
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Avatar universal
They gave me 50 dollars to participate in a study using a new culturing technique that was very accurate at detecting the prescence of hsv-1 and hsv-2.  I never got the ear or breast cultured bc I didn’t figure out what might be going on in time.  While I had the lesions on my breast skin near my chest (not my nipple) my boyfriend sucked my nipples several times, but the two lesions remained and no new ones formed.  We also kissed while I had the ear lesion and I think I switched ears while talking on the phone while I had the ear lesion, I think I might have given him oral while I had the ear lesion and the genital symptoms kept popping up.  The scab like lesions only broke out once, but the bugbite ones kept coming in droves and droves for a good month.  While I waited for the planned parenthood results I went to another clinic and they prescribed me antibiotics bc they thought it was a skin infection, but couldn’t culture anything because everything had dried up.  They prescribed me cephalex/Keflex and it had no effect on the lesions.  As a result, I have a persistent yeast infection now since November that won’t go away.  This all happened from oct 1st –november 10.  Since November, I have had no new genital outbreaks, but starting in December I had 4 coldsores in a row, and I just healed my last one 2 days ago.  I had one coldsore on my lip (directly on it) and then a weird formation on my left cheek that itched and scabbed which I also think was a coldsore (getting one on my cheek has never happened before).  I now have abt 30 scars on my leg from the outbreaks, and the two on my breast.  While I had the genital outbreak my boyfriend gave oral for a few seconds (unexpectedly) but he has no symptoms of anything, anywhere.  And despite the yeast infection, ever since the scars formed and the outbreak stopped my boyfriend has given me oral regularly with rimming and alternating licking the anus with the vagina, as well as sex twice with a condom, and anal sex/anal fingering without a condom on 4/5 occasions.  I have also given him oral several times.  He seems to have no symptoms of thrush, his tongue is completely pink and so is the rest of his mouth. Even more perplexing, he got tested for herpes after all of this and it said HSV-2 positive, HSV-1 negative. Here are my questions:
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Avatar universal
.  I woke up two days after this sexual activity  with purple scab like lesions in my pubic area that burned before appearing, then the same kind of scab like lesion on the pubic crease on the left side of my body.  They both disappeared within 3 days w/ no scarring (which seems indicative of herpes).  The same day that these scabs showed up, I got 2 lesions on my left breast that looked like red blisters and burned, and that morning I had (what I thought was a familiar skin itch on my left ear that I’m used to feeling, only to find that I had a red blister like line on the ear too, that was near where the face connects to the ear (where my ear piercing was).  The ear thing went away without scarring, while I still have two scars on my breast.  I then developed a red dot on my clit and swollen labia minora that went away the next day.  Then I started to develop two kinds of blisters, one type that burned and was fluid filled before crusting like a scab (on the buttock area, on either side of my vaginal lips, probably 30 or so, 3 on my top left thigh and two on the back of  my left knee).  The second type started out as bugbite looking pimples before becoming the red open blisters that looked exactly like what I had on my breast.  These blisters kept coming and coming and were concentrated on the back thighs and inner thighs.  I held off for awhile, but then was shaving during the time these continued forming.  I did not go to the dr. when all of the outbreaks were fresh because I didn’t have insurance (and still don’t) and my friends/family assured me that it was razor rash or staph because I already had hsv-1 orally.  Well, I went to planned parenthood to get one of the crusty scab lesions cultured when some fluid was still in it but it was mostly crust, and a week later they say it was hsv-1 positive, I was so confused.
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