atypical herpes symptoms, confused

[alltheotherstuff]

I have a number of confusing symptoms, and would like to put them all in one post to have them answered.  I also posted on grace and terri´s forum, and got some helpful answers back, but I think I may have more symptoms.

And I have a number of specific questions that I would love to have answered.

1.  Is it possible to break out at the same time on your neck and genitals? (the neck things were the first symptoms)
2.  All of these new symptoms seems to be cropping up all over the place, I mean it´s been 31 days!  (I never had any swollen lymph nodes or anything like that), if it were herpes, would I have an outbreak this long?  Or is this two outbreaks in a row?
3.  Regarding my titer values above, would I have to be infected with HSV 1 for a long time to show those values (1:256)?
4.  With the HSV 2 values at the cut off line, does this mean it´s a possible recent infection, or does it mean that it was HSV1 mistaken for HSV 2 (a possibility I was told happens in these types of tests).
5.  Should I try and go the pharmacy and get antiviral drugs?

Thank you! I really appreciate if you could answer these questions!

[alltheotherstuff]

Dear Dr. HHH:

Thank you for comments, I really appreciate.  I of course had faith in what Terri had said in the other form, but became worried after I had found the new bumps on my bum/back of thighs.

Thanks for your help and comments.

[H. Hunter Handsfield, M.D.]

You had accurate replies from Terri Warren on the herpes forum.  As she told you, it is not possible to be certain about the meaning of your HSV blood tes results.  Most likely you are infected with HSV-1.  There is a slight possibility you are infected with HSV-2, but most likely that result is false.  That is the main problem with the older type of HSV antibody tests:  they do not accurately distinguish between HSV-1 and 2.

In any case, your symptoms do not sound much like genital herpes.  Certainly the lesions on your back are not due to herpes of either type, which simply does not occur in that location.  Equally important, 3 physicians have told you that herpes doesn't explain your symptoms,  The opinion of a dermatologist in particular is highly reliable.  All dermatologists are experts in herpes and you can rely on that doctor's diagnosis.

To the specific questions:

1,2) No.  Nothing you describe sounds like herpes, either initial or recurrent.  Such widespread lesions do not occur in herpes.
3) No, this is not typical of herpes at all.
4,5) See above.  I cannot say anything about how soon such tests become positive.
6) As I said above, you should rely on your doctors' opinions and advice.

You don't say where you are, but I'll bet truly type specific HSV antibody tests are available.  You should ask about it.  But be aware:  If you have such a test, and it shows positive for HSV-2 (or HSV-1), it will NOT explain any of your symptoms.  The conclusion would be that you asymptomatic HSV plus other cause(s) of the skin problems.

Feel free to report back with the result if and when you have a modern, type-specific HSV antibody test.  Until then I won't have any other comments or advice.

Regards--  HHH, MD

[alltheotherstuff]

Thank you for your reply.

Essentially, I have been experiencing some possible herpes symptoms for 35 days, I have had 3 doctors tell me I don´t have herpes, but I don´t have any hard facts (i.e. swab tests) to prove this to me.  It´s possible my imagination has gotten the best of me.

The symptoms I have seen are 2 blisters (or pimple like sores on my neck, these were the first to appear).  The derm said that they were mollluscum, but refused to do a swab test. I have also noticed now more little pimples with whiteheads on one side of my face. The derm said these were not molluscum.

Starting a week after that, I have found 8 different bumps over the course of 30 days on my outer labia and backs of my thighs.  They differ, the ones on my labia have been more like raised red bumps, all separate, and the ones on the backs of my thighs are also different, 2 are just raised and red, the other two look like pimples with little whiteheads, and they don´t really look like the ones on my outer labia.

I also have had a yeast infection starting about a week after I saw the first bumps on my labia (the gyn did a pap).

My questions are as follows:
1. Does this sound like a herpes initial outbreak?
2. Is it possible/likely  to have an outbreak on your neck, and face and genitals at the same time?
3. The symptoms have been few (the bumps), and have cropped up separately over 35 days, is this typical of a minor initial outbreak? I have never seen clusters of blisters together.
4. I am concerned because the blood tests results that I have gotten back clearly say that I have HSV 1, and I am just at the cut off value for HSV 2, these are the results:
Herpes type 1, IGG 1:256
cut off value:  1/32
Herpes type 2, IGG 1:32
cut off value: 1/32
Method used: IFI

I was told that these results are unreliable, however it is the only test that I have access to where I am.  

4. My question is:  Does this type of test pick up on antibodies quickly?  Does this mean that I have had HSV 1 for a very long time (I have never had a cold sore, just cankers inside my mouth).  

5. Do the HSV 2 values show that I could have recently picked up HSV 2? or are the values skewed because HSV 1 is so high (I was told by Terri that this often happens with this type of test).

6. 2 gyn´s and 1 derm, based on physicl exams told me I don´t have it, should I just chill the hell out and believe them without hard data?

[H. Hunter Handsfield, M.D.]

There is a limit to the length of questions that can be asked.  I think it is 2,000 characters, i.e. around 400 words.  I have neither the time nor the energy to read and digest the large amount of information in the comment window below.  Please condense your question, including all supporting information, to 2,000 characters or less and post it in a new comment window, after which I will be happy to respond.

HHH, MD

[alltheotherstuff]

Per the question above, below is a timeline of symptoms:

Here is the timeline:

Day 1:  two zitlike things on my neck
Day 7:  two bug bite like things on outer labia.  Like raised ingrown hair, I think it was pink.  No whitehead. Raised for about 3 days, then dissipated, pink mark remained 1week.

Day 8:  Possible bump, very small, not exactly red, but not flesh colored, kind of like the color of my skin if it were tan, around back of labia, close to my bum, not close to my anus. Went away after maybe 4 or 5 days

Day 10: Serious internal vaginal itching,  some yeast-like discharge, and just mucousy discharge.

Day 12: Went to gyn, showed her my ´symptoms´,  I asked her if it was herpes, she told me no, and wouldn´t do a full internal exam because I had my period.  Ordered an hiv and syphilis test blood, I had to beg for a herpes blood test.

Day 15:  Went to a dermatologist, for ´zits´on neck.  She told me they were irritated molluscum and she "squoze them out," she said def. not herpes.  I asked her to do a culture  of what was on my neck, she said absolutely not. She gave me cortizone to put on the areas where the "zits" or molluscum had been.  One immediately was flat, the other was raised.  I treated that one with cortizone, it oozed for about 2 or 3 days, then started to dry up (about 15 days later, it is still pink and raised, but seems to be dried up.

Day 18:  I went to a new gyn (different than the first).  They did a full exam, said he didn´t see anything, and told me that I had some discharge which was causing the itching.  did a pap.

Day 19: Very small canker sore on inside of mouth cheek side. Lasted about 2 days

Day 23: Went back to dermotologist for a check-in for what she had treated as molluscum.  said it looked fine, reiterated that it wasn´t herpes.

Day 23: Got my blood tests result back, negative for HIV and syphilis, and then these were my results (mind you, I am not in the us)

Herpes type 1, IGG 1:256
cut off value:  1/32
Herpes type 2, IGG 1:32
cut off value: 1/32
Method used: IFI

(I was told by Terri (thank you, by the way), that this type of test is no longer used in the US, they are titer values and that the HV2 values could have been altered because of high HSV1 values)

Day 26: Went back to second GYN with blood tests,  said it meant I probably had a cold sore once before (I had canker sores sometimes but never had a cold sore on my lips or on the outside of my mouth), and then told me that the HSV 2 1:32 was  the cutoff point, that it didn´t mean anything. told me I didn´t have herpes and to stop thinking about it. told me my pap tests were normal, that they had seen extra candida.

Day 26: pimple like bump on the corner of my mouth, never really got a white head, just barely scabbed, lasted about a week.

Day 27: Canker sore inside my mouth on my cheek, lasted maybe 3 or 4 days.

Day 26 - 31:  More discharge, but really seems like a yeast infection, itchy on the inside.  Call doctor, he tells me to take 6 days of yeast infection tablets with antibiotics in them.

Day 31:  Now I´ve noticed another zit like thing about an inch south of the other healing zitlike things on my neck (that my doctor had said was molluscum), zit like because it has a red base and white center.  It popped in 1.5 days. It´s just a tiny dark red spot now.

Day 31:  Noticed 4 more red bumps, this time on my bum / inner thighs.  I don´t know if they are itchy.   They are different in appearance, one is just a bump that is slightly red.  One has a really wide red base, with a tiny, tiny, tiny little white head, like a zit.  The other one is a bump that is small and red.  I may be imagining this, but there may a few tiny,tiny,tiny other little bumps that look like little zits. None of the bumps are touching.

The moment that I feared this might be herpes I freaked out, and have been obsessed with every little mark on my body.  I also seem to have more little zits on my face than usual. I know you can´t make diagnosis over the internet, but should I take the doctor´s word for it (I did have three doctors telling me it wasn´t herpes)?