My tests keep coming back negative, but do I really have HSV?

[AllDipSet]

Going back to October I was sick with a sore throat,swollen glands, fever, body aches and was put on antibiotics( thinking it could be strep-came back negative) about 2 weeks later had the same symptoms arise, but a new one this time- vaginal sores, i went straight to the obgyn and they pretty much said just from looking at me it was HSV and did a vaginal swab and prescribed me Valtrez, the pain lasted a couple days and all my symptoms went away but my test results came back negative.  

Fast foward to February ( 3months later) and the same thing reccurred and I was in alot more pain than the first time, but this time they also said I have a bacterial infection.  So same thing happened subscribed me valtrex and flagyl( for the infection), but it seemed like this one was more painful this time. They also did another vaginal swab and that came back negative again, so they said to go get the blood test done but that came back negative too.

Fast forward again to now (3months later)  about a month ago i had the same symptoms but no vaginal sores so my Dr. thought it might be strep, cultured came back negative but was put on penicillan for 10days, by that 10th day I was sick again with the same symptoms but still no sores, so I was tested for mono and strep again but obviously that came back negative, but was still put on Z-pac which I end about a week and a half ago.  Now just two days ago the same symptoms came back and I noticed to little red dots on my vagina so I went back to the obgyn and the Dr. thinks I have a yeast infection from the antibiotics, in which the results came back negative. I started today Valtrex 500mg 2x/day for 5 days. The sores have finally turned into ulcers and pretty much look like craters. I haven't had another culture/blood test done yet, but from what I read it might be too late.

My question are:
1) Does it sound to you like this is HSV?
2) Do I need to have something else going on to start suppressive therapy w/ Valtrex?

[AllDipSet]

After working with a new Obgyn, she thought that I might suffer from an immune disorder. This past January I was referred to a rheumotologist and was diagnosed with Behcet syndrome. I've been taking colchicine 2x per day ffor about 9 months now. I do not have vaginal ulcers anymore. I still am sick with fever and sore throat every 3 months. I also had a multiple blood test to check my immune system in March. My doctor said half of 18 test that were done my immune system was below normal so he gave me an phuemonia shot and was checked in 6 weeks and said my levels began to come back up. So as of now I'm waiting to see him Dec/Jan for a check up.

[Edward W Hook, MD]

My vote would be for the one you feel you have the best, most open communications with. I'm not trying to dodge your question, either might work

N

[pumpkimmy]

Ask your doctor about possible fixed drug eruption. Bactrim is known to cause it, specially in the genital area.

[AllDipSet]

Do you suggest that I work with one primarily or both, and if just one, do you suggest my Physician or my Obgyn?

[Edward W Hook, MD]

I would suggest that if your tests keep coming back as negative it is more and more likely that you do not have HSV.  You need to work with a doctor, if not your current one, another, to sort out what you have, looking for other possible causes of .genital ulceration.  EWH

[AllDipSet]

Finally got all my test results back today, and yet again they are all NEGATIVE.  I am starting to get frustrated and wondering what steps do I need to take next to get to the bottom of this.  Because by the way this has been going, I'll end up with another outbreak in August ( assuming every 3 months).  Can you give me some insight of what I should be doing next.

My primary physician told me to go back to my Obgyn to be checked over again, but now all my symptoms have cleared and there is nothing to see.

[AllDipSet]

Ok sounds good. I went to the doctor today and she did a throat culture, ulcer culture and I went and had blood work done for HSV, syphilis and two other test that I am not sure of.  She talked about doing suppressive therapy if my results come back positive but we didn't talk about my throat, tonsils, etc.  She was more worried about the problem at hand.  But my results will be back in a couple days and we'll go from there.
Thanks again.

[Edward W Hook, MD]

Doctors tend to be less agressive about removing tonsils than the used to be but continue to do so for persons who have frequent and/or severe recrrent sore throats (realizing that both of these are subjective assessments).  There are many reports of "stresses", be they mental or physical, bringing on herpetic recurrences but, at the same time, this is a bit of a "chicken or the egg" question and can be difficult to study or characterize except on a case-by-case basis.  I supect it is possible that when you get the stress of a sore throat, it could lead to a recurrence, if what you have is HSV.  Once again., the first step is to define the problem.  EWH

[AllDipSet]

I almost forgot, I wanted to ask:
I always get these very bad sore throats before I get an outbreak, could chronic tonsilitis be responsible for these recurrences to happen or is that just a symptom I'll always have before I get an outbreak. Because I was looking into maybe talking to my doctor about having my tonsils removed because I am very suseptible to getting sore throats and swollen glands. I use to get severe strep throat when I was younger but the doctors never thought to removing my tonsils.

[AllDipSet]

Thank you again, I am going to see my Doctor tomorrow. Hopefully things will work out.

[Edward W Hook, MD]

The list is long and would be guided by your docotrs examination.  Take it one step at a time.  EWH

[AllDipSet]

Thank you for your help.  What kind of other illnesses are there that could be causing this though??

[Edward W Hook, MD]

The clinical description you have provided certainly could be genital herpes.  While swab tests can provide very useful information if positive, they are not too sensitive and can often be falsely negative in persons who really do have herpes.  At the same time there are other illnesses (all of them less common than herpes) which can also cause genital ulcerations and some of the systemic symptoms you have mentioned.  The best way to sort this out at this time  would be for you to get a type-specific test for herpes antibodies (a blood test) such as the HerpeSelect.  this test can tell if you have antibodies for HSV-1 and/or HSV-2.  If the test is negative at this time, you and your doctor should explore other possiblities as to the cause of your symptoms.  

Given the severity of your recurrences, my impression is that you would benefit with suppressive therapy, if your blood test is positive.   Suppressive therapy would be expected to reduce your frequency of recurrences, reduce the severity of those recurrences that you might have and reduce your chance of transmitting your infection to an un-infected sex partner.  EWH

Hope this helps.  EWH ,