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Should I trust the lab tests and medication?

My NP at dermatologist popped one of the vesicles on my tiny back patch 48-72 hours after it appeared and sent it to the lab.  Instead of shingles, it came back HSV2.  Not even sure if I should trust the results!  I've never had a lesion on my genitals...but my butt was burning for a long time about 3 years ago which doctors thought was IBS and hemorrhoids.  Even had a hemorrhoidectomy and the surgeon didn't note anything abnormal.  Although, the burning started the day after I had sex.  Who knows?!
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207091 tn?1337709493
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You had a positive culture - it's very rare that those are false positives, though it's always possible.

You could get a blood test - a type specific IgG blood test - to confirm if you have hsv2 antibodies if you need to in order to accept the diagnosis.

It's not uncommon to get outbreaks on your back, depending on where it is on your back. The sacral ganglia is essentially waist down, and you can get outbreaks anywhere where boxer shorts would cover.

Shingles very rarely recurs, so I'm not surprised it's not shingles.

You could have IBS, hemorrhoids, and herpes and those things are not connected. It would just be separate things you have.

I don't know why you started with symptoms the day after sex - it takes at least 2 days to show symptoms of herpes, so maybe what you felt was just irritation or something else entirely.

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4 Comments
I've never had a genitalia outbreak anywhere.  I remember a very bad flu feeling one morning around April 2022 (felt like I got hit by a Mack truck, no energy, low grade fever) and hadn't had sex with anybody for many, many months.  A week later there was a patch on my right middle back.  Dr said shingles.  I actually had my first shingles diagnosed under my left armpit near flank in 2002.  I felt better after a week of Valtrex in 2022.  Since then I've had 2 Shingrix vaccines and 2 of Gardisil 9.  My STD panel was all negative September 2022.  Since April 2022, I've had 4 patches appear.  They arrive spring and fall to early winter.  This bout in 2023 is now weirder.  I had one tiny patch mid September right on my vertebrae lower back and then 2 weeks later another one right mid back AFTER 5 days of Valtrex 1 gram/3times daily (remember they thought it was Shingles).  I will not live with this.  I will not take Valtrex every die.  I made a vow with myself after passing terminal illness legislation that if I ever got HIV, then I would promptly end my life legally with that legislation by effectively taking suicide pills prescribed by a MD.

P.S. I have a clinical doctorate in medicine
If you have a clinical doctorate in medicine, than you know that herpes is NOT HIV.

Herpes is NOT terminal. I've lived with hsv2 for 20 years. I take Valtrex every day. I also have other medical conditions that bother me far more than herpes ever has, including migraines and indoor/outdoor allergies.

HIV isn't even terminal anymore, but that's something else entirely.

Since you have had outbreaks near your under arm, it would be worth it to get this confirmed.

Someone in my family had what the docs thought was recurring shingles for decades. She got them on her tailbone. Finally, someone swabbed it and it was hsv1.

I don't know what you have. Only lab tests can tell you that. If your doctor won't do a blood test, and you are in the US, you can go to stdcheck.com or letsgetchecked.com to get the test. They always run specials and you can check Google for coupons.

If you are even thinking of suicide over herpes, then counseling is a must. I can promise you it's just not that bad.
Thank you for your prompt response, compassion with this website, and sharing advice.  I've had professional counseling off and on for many years for the past 22 years.  Naturally, HSV2 is not HIV...but it still causes major fatigue and hurts!  We all forget to take our meds occasionally or get sick from the meds which expedite damage to our liver and kidneys.  However, the slipperiest slope is that having sex with HSV2 makes it easier to contract HIV.  So, I basically have to be even more selective, interrogative and careful with sex if I am ever going to have it again at 44.  I am moving to a city that will soon start the Moderna mRNA-1608 HSV2 vaccine trials.  I have already been placed on the call list for the first 300 volunteers.  
Yes, hsv2 does make it more likely to get HIV, but condoms and testing can prevent HIV. Also, less than 1% of the world has HIV.

Antivirals don't affect the liver. If you have current kidney disease, they may affect the kidneys. If your kidneys are fine, there is no concern.

Before you do the vaccine trials, which would be very cool, definitely get your diagnosis confirmed. There's enough questions around your diagnosis that a blood test won't hurt.

At 44, most people know someone with herpes and aren't freaked out about it. I got it in my 30s, and have had no issues dating. I'm surprised at how many say they have it too.

I promise you it is just not that bad.
Avatar universal
"It's not uncommon to get outbreaks on your back, depending on where it is on your back. The sacral ganglia is essentially waist down, and you can get outbreaks anywhere where boxer shorts would cover."

I wish I could upload photos.  My HSV2 patches have been way, way above the waist line . Imagine placing a hand or two above your waist...at the very top of that hand is where I'm getting them.  Literally as high as just below the shoulder blades...to where the adrenals would be on the back.  I guess I will ask for a blood test at my annual physical next week to make sure everything is diagnosed properly and second-tested.  Yes, of course, the trials require that the diagnosis to be 100% correct before participation can occur.
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That's... really, really unlikely to be hsv2 there.

I won't say impossible, but it's certainly very atypical.

Wrestlers can get something called herpes gladitorum, which is essentially mat herpes. It happens when one wrestler has a cold sore, and the fluids get on the mats, or rub against the other wrestler with serious friction on irritated/broken skin.

It's always hsv1, though, because hsv2 is almost always genital. Are/were you a wrestler? Maybe someone had an oral hsv2 outbreak.

Get the blood test. I'll be interested to see what it says.
Will do!  Physical is on October 23!
Let me know what happens! :)
HSV Type 2 Ab, IgG, S = 4.60 IV, Second lesion PCR HSV2 DETECTED
Where was the second lesion?

If you've had nothing near the sacral area, then you don't have genital herpes, and can't transmit it via sex. If it's all been up near the arm pits and upper flank areas, it's infected a different nerve group.

Since regular skin doesn't shed like mucous membranes, you'd only be infectious from those areas when you have an outbreak.

Burning in the genital area isn't enough to say that you have it genitally. That could have been anything. I know that's easy for me to say, though.

If you want an expert consult, I'd talk to Terri Warren. You can either post on her forum or do a video call with her - https://westoverheights.com/

I'm really sorry. I know this isn't what you wanted to see in your test results.

The second lesion was also mid-back above the waist.  My primary care physician agrees that the case is atypical.  He may suggest consulting with an infectious disease expert.
Sounds good. Keep me posted.
My blood tests returned negative for absolutely everything.  I am very healthy except for elevated neutrophils and this HSV detection both in blood and through 2 separate scrapes from different clinics.  I am self treating with Prunella Vulgaris and a concentrated Gypsy mushroom tincture.  I cannot take a daily antiviral.  It is against my medical beliefs.  I even apply gypsy mushrooms directly to the area on my back.  My PCP is a bit stressed, so my move to Seattle will hopefully greet me with better experts.  Until then, I must stay out of the sun as that is what caused this outbreak in September.
If western meds are out of the question, (or whatever your beliefs are), what about L-lysine? It hasn't been proven to do a whole lot in some studies, but some people really swear by it.

The sun can trigger some people, for sure. In Seattle, that probably won't be a problem. ;)

This might help, too - https://www.healthline.com/health/sexually-transmitted-diseases/home-remedies-for-herpes

Wishing you the best.
BTW, my Vitamin D is has been VERY low (testosterone high) during this whole experience.  I was getting regular injections to bring levels up to 65.  Once you test high, the clinic requires the results and ceases to give more injections. So now yesterday, lo and behold my Vitamin D is 25 again which definitely affects immune function.  I take L-glutamine for my digestive tract and creatine for cell washing.  Those haven't been that helpful, but maybe Lysine can help.  Thanks!  Here's hoping Moderna can eradicate these viruses!
I hope it does. I hope your Vit D gets to where it needs to be, too. Perhaps just take that and the Lysine for now, and not the glutamine, which can increase testosterone by some reports.

I have a vit D absorption issue, so I take it weekly at a high dose, in pill form. If I don't, it hovers around 15-19. I feel you on that.

Good luck!

I recently had a full consultation with the U of W clinical virology researchers about my case of HSV2.  They agreed that it sounds like gladitorum and that it may have been the first shingles diagnosis in Feb 2002 under the armpit.  Because I have never had a genital lesion, I am not able to participate in the moderna 1608 vaccine study.  For that study, lesions myst present below the waist line as participants will be asked to routinely swap the genital area.  We are indeed closer to a "cure."
*must...*swab....sorry for typos
Well, while I'm happy that we're closer to a "cure", I'm sorry that you're not able to participate.

I hope you're doing better with the diagnosis than you were originally. If it's gladitorium, you are only infectious with outbreaks, as the skin doesn't shed like mucous membranes do.

Thanks for the update. :)
Thanks, Jessi... they also said that in accordance with the CDC and best information available that I cannot get infected again and will 99+% likely not present in the genital region for the rest of my life or transmit through sex even with an outbreak on my back.  I should also not contract HSV1.  Valtrex will likely not be used.
That's all true. You have antibodies for hsv2, meaning you have protection from getting it in another location (or another nerve group, really), and hsv2 antibodies offer very strong protection against hsv1. (Hsv1 antibodies don't offer the same protection against hsv2, though.)

So long as someone's broken or mucosal skin doesn't come into contact with an outbreak you have, you won't transmit.

Valtrex for you would be a choice, and would likely be for episodic treatment if needed. It's always available for that or suppression if things ever get really bad. I know you don't want to take it, and it's always, always a choice.

Hang in there, have a great holiday season, and we're here if you need us. :)
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