Negative HSV IGG/Swab/PCR with symptoms

[unsure454]

After seeing 6 gynecologest, 2 internal medicine specialists, 1 gi surgeon and a few general practitioners, I STILL have no diagnosis;

Symptoms began in February of 2010 with very small anal verge tears or cuts and have been recurring on average every other week, remaining for about 4-5 days at a time. They typically present as one tear, however have been located in all areas of the anal verge. The cuts cause stinging and itching. My last sexual encounter before the symptoms began was 1.5 months prior, with the man I had been seeing for about 3 months.  It was male/female sex mostly protected, with one incidence unproctected.  My partner had been tested before and post me- negative igg.

In June of 2010, skin colored bumps started to appear on the butt/thigh every two to three weeks. They would not blister, however would leave scarring over about a 4 week period. Doctors have said benign or bacterial after examining.

Vaginal itching, tingling and discharge has also occurred a few times over this period however with no alteration in the vaginal skin.

I have had two cultures and three PCR swabs of anal symptoms within 1-2 days of sore onset.  All have been negative (5 total swabs). I have had HSV IGG type specific blood tests at 10, 14, 18.5, 24, 31 and 40 weeks post encounter; all negative for hsv2, 10 and 31 equivocal for hsv 1 (herpeselect).  I have had testing for bacteria, worms, diabetes and yeast which have all proved negative.  Also testing for all other std’s, which have been negative as well.  I also had a sigmoidoscopy yielding only a small fissure, all else healthy.

Is there any general feedback you can provide regarding my symptoms, test results, potential diagnosis & next steps?  

Also, if I had equivocal hsv 1 igg blood test results twice, does this prove my body has capabilities of producing hsv antibodies?

Thank you in advance

[Terri Warren, RN, Adult Nurse Practitioner]

It would be a simple matter to try some over the counter antifungal cream to see if it would help you.

Terri

[Brezzy123]

I have had similar symptoms without reassuring results. I had found a sore on my labia about six months ago. I was tested for herpes via culture and the result came back negative (however, at the time I was diagnosed with pelvic inflammatory disease and possible yeast. While a month later treated for bacterial vaginosis which I believe was present at the initial visit to the clinic). Then about four months later I noticed another paper-cut like sore around my anus and labia. I had tested again via culture for both HSV-1 & 2, with negative results and this time a blood test for HSV-2 which was negative. Still the fissures keep appearing. They will subside for a day or a few and come back again. This has lasted for the past month and a half. I have a feeling this has to do with some kind of topical issue, due the the consistency of the 'outbreak'. I do not know what it is and am driving myself mad considering these negative results are false. Let me know if the fungal cream helped you at all and any further response helps.

[Terri Warren, RN, Adult Nurse Practitioner]

Well, I thought maybe you were pretty worried about herpes, but I believe I can reassure you about that as there is just nothing that fits with herpes, not the swab tests, not the antibody tests, and not the symptoms!  Herpes doesn't come and go this often for hardly anyone!  

You might try some antifungal cream around the area and see if that offers you any relief, but you have to use it twice a day for a couple of weeks to treat fungus.  Sometimes when clinicians look for yeast, they don't find it, but treatment helps, so maybe it is there in small numbers.

That's about all the info/reassurance that I have to offer.  Sorry I can't be more helpful

Terri

[unsure454]

Thank you for your prompt reply Terri. Though it is quite uncomfortable when present, I am most likely pursuing so aggressively due to my fear of my symptoms actually being HSV and transmitting to others. I am currently in a relationship with protected sex and had thought I closed the issue. Everytime I think the issue is resolved, it returns. I now fear I am putting my partner at risk. If there was a differential diagnosis, I think it would be much easier to either deal or put this issue to bed. This has taken a strong mental toll on me, however I do know, contrary to some opinoins, that my symptoms are not just in my head.

*The GI Specialist said he found very small external hemorroids and provided hemorrhoid cream which I have used off and on. I'm not convinced there is an issue there as the only issue would be occasional itching.  (No straining, constipation, bleeding, etc)  I have used the cream when there is itching and it does help some.

*I have also had anti-bacterial cream which was subscribed, though soothing, did not seem to fix the issue.

*I also now utilize wipes vs toilet paper to avoid unnecessary friction.  

This is pretty much the extent of my treatment plan.  Any advice or non-hsv reassurance you could provide would be appreciated.  Thanks again for all you do.

[Terri Warren, RN, Adult Nurse Practitioner]

I would definitely believe all the negative herpes tests.  
Are you pursuing this so aggressively because it is so uncomfortable or because you are worried that it is really herpes and you just haven't sorted that out yet?  I ask, not to be disrespectful, just wondering, I guess, how severe this is for you.  
You've basically ruled out the things that I would suspect to cause the splits.  Have you tried anything at all to deal with these?  If yes, what have you tried?

Terri