Herpes Anxiety

[endlessanxiety]

Hi everyone, I have been having extreme anxiety about herpes and was hoping you could shed some light on herpes swabs and the potential of post-herpetic neuralgia.  I am unsure if I have herpes, I had a single ulcer on my inner labia that did not present as typical herpes symptoms nor typical progression of the lesion.  I have read the herpes handbook and the majority of posts in the expert forum.  I'm 23, and have been in a committed relationship with my boyfriend for 4 years (having unprotected sex the whole time) which is why this is all so confusing. Neither of us have oral cold sores. We've both had partners prior. We also had sex a few times 2.5 weeks into me having the ulcer as it was healing, still slightly painful, and he still has no symptoms. I can get into more detail about my ulcer in additional posts if you feel as though it will help - I didn't want to make this too long.

1) If an ulcer was swabbed within 30 hours of noticing it, and it lasted three weeks after this (so the ulcer was not close to healing at all), what are the chances the negative swab was accurate? I am unsure the type of swab it was, I live in Canada, I am going back to my doctor on Wednesday and will inquire further.  For arguments sake, let's say it was a standard culture and not PCR.  I should also note I saw two doctors 5 days apart and neither could determine the cause by looking at the ulcer (obviously could not rule out herpes for certain as it is a genital ulcer).  I was prescribed fucidic acid 2% cream which seemed to assist with the pain almost right away when the ulcer was open and very deep (started using this a week after getting the ulcer).

2) The main point of my post... this ulcer showed up 7 weeks ago now.  Other than a very noticeable atrophic scar that I have from it (it looks the same size the ulcer was - pretty large, perfectly circular, with a raised border and deeper middle, just with healed skin now) I no longer felt any pain three weeks after I got it.  Fast forward to 10 days ago, about a month after the ulcer went away.  I started getting stressed out and obsessively checking for more ulcers, and the next day I got a strange tingling sensation on the left side of my vulva. No lesions present. It is hard for me to even describe the sensation, or where it is exactly.  It is not on the skin's surface, it does not hurt to touch the skin, but it feels like a deep tingling.  I'm unsure whether this is deeper in my vagina or just the labia in general.  Does this sound like it could be post-herpetic neuralgia? I am aware that there is no proven link between herpes simplex and PHN.  However - I have read about many people getting nerve damage symptoms after being infected.  For arguments sake again, what would this nerve pain feel like? I understand it's often shooting pains and painful to touch, sit, or wear pants.  I feel no pain with this sensation, but it has been constant for the entire 10 days whether I am standing, sitting, laying down, wearing tight pants, whatever.  The only time I don't notice it is when I'm out and distracted with friends (having drinks usually).  Could this be anxiety? Could it be herpes related? I am terrified and I don't think my doctor will have many answers for this indescribable tingling.  I will ask for a gynecologist reference (I was going to one for years but everything has been normal for three so in Canada I no longer qualified to go).

Thanks so much in advance.  I have always had severe anxiety disorder especially relating to health but never have I been so paranoid.  I know I need to get the IGG test done, I am trying very hard to get up the courage to do so.  

[endlessanxiety]

Sorry to repeat myself, but can anyone comment on whether there are any actual stats on the accuracy of negative swabs if they are taken within 24-48 hours of onset? Provided she did it properly which I am confident in.

[endlessanxiety]

Thank you for your response! You reiterated what I have thought about my ulcer but my irrational anxiety gets in the way. Are there any actual stats on the accuracy of negative swabs if they are taken within 48 hours of onset?

Definitely no blister. No itching and not even any redness on the skin around the single ulcer. Does anyone have any experience with other genital ulcers called reactive non sexually related acute genital ulcers? Also known as lipshultz and ulcus vulvae acutum? I have found some great studies on these but I'm not sure if I can post links. Mine sounds pretty much identical to these ones. It actually had a white-ish crust loosely hovering over the deep ulcer I want to call adherent necrotic crust that fell off on it's own a few days after it appeared and left an open deep gaping ulcer for another two weeks. This is what the fucidin cream helped thankfully. I've read this has helped other non sexually related ulcers which makes me hopeful. If only it was not such an obvious scar now.

My boyfriend is not keen on getting a blood test for herpes. He is very non chalant and doesn't think us both having it would change anything and feels we don't have it (probably because he has no symptoms!). I've been in and out of the hospital many times, more in the first 1.5 years of our relationship, with severe illnesses which I also think would have brought out the herpes if I had it. My last stay was this past October. Would you agree on this? My doctor seemed to think the same thing, and said she'd be surprised if this was herpes as she as swabbing it (she knows me well - I'm always sick!) I will be sure to get a requisition for the IGG bloodtest at my follow up tomorrow. Just need to get up the courage to do it!

My tingling feels a little less today - hopefully it is in my head or some other infection. When my mind is distracted I tend not to feel it. Thanks so much again!

[Fleetwood20]

The ulcer does not sound like a herpes lesion associated with a first outbreak of herpes after infection. It sounds too large, too singular and too long lived to be herpes. More likely you'd have multiple smaller sores, probably some with blisters that would heal in about 2 weeks. Not everyone follows such a pattern it must be said.

A blood test for you and your partner right now would help. In Canada we see a lot of people told they can only get a combined IgG HSV1/2 test but be insistent on IgG type specific for HSV1 and HSV2. These results will give you a lot of information; particularly of course if they are negative.

A negative swab is only of some value. The virus could have dissipated by the time the swab was taken although you suggest you got it swabbed early on. I think this can only be taken as an indicator toward this not being herpes but further confirmation from blood testing is desired.

Deep tingling like you describe could be stress and tension in the area, or an unrelated ailment. Some people do experience what you describe, but maybe more often the tingling is surface related around the genital area.