Confusing Diagnosis

[FridaDog4]

Hello,
I’m a 26 female and have had 10 sexual partners over the years. None of them have ever mentioned that they had HSV1 or HSV2. I’m in a long term relationship and have not had intercourse with anyone besides for my current male partner in 3 years.

In December I noticed I had an enlarged lymph node on my neck, and over the course of a week I got more enlarged lymph nodes on the left side of neck. I had headaches and pain in my left ear. I went to the doctor and he didn’t find any reason for treatment (no ear/sinus infection). I never had a fever or other symptoms during this time.

After 5-7 days the lymph nodes started to get smaller. I had a terrible stomach pain and had very bad diarrhea one night. I woke up the next morning and thought I had a yeast infection. I used the yeast infection cream, but it didn’t decrease my discomfort. That night I looked in a mirror and saw 2 small sores on my vagina. I went into the urgent care the next morning and was told that the sores looked like herpes. I was given a week’s worth of anti-viral medication and the sores were gone within 3 days – I haven’t had any other reoccurrence. I was swabbed for cultures and I had a blood test for the IgG blood testing. The culture was negative at the 7 and 14 day mark and the blood test came back negative for HSV1 and HSV2. My long term partner was also tested, and he came back negative for HSV1 and HSV2. We were both tested for all other STIs and all of our other tests came back negative. I use an IUD and we don’t regularly use condoms.

My primary care doctor told me that it probably wasn’t herpes and I shouldn’t be concerned. I went to Planned Parenthood for a second opinion. The doctor told me that it did sound like possible herpes and recommended that my partner and I use condoms and I take a daily anti-viral and get my blood tested in 4 months. I am a very anxious person and this has caused a lot of anxiety in my life.

I am planning to get my blood re-tested at the end of April (the 4 month mark); however, I was curious if you had any ideas. If a clinician says it looks like herpes – is it likely herpes? Also, I’ve never had any cold sores. Could it be possible that I didn’t clean myself well enough after the diarrhea and that caused the liaisons? Should my partner and I continue to be using condoms and should I continue to take the daily anti-viral in the mean time?

Thank you.

[FridaDog4]

I forgot to mention that my IGg levels were: HSV1 0.43 and HSV2 0.32. I’m also concerned that the acyclovir (400mg 2x daily) for suppression and protection of my partner will impact any repeat IGg tests.

[Terri Warren]

You are correct to be concerned that the antiviral medicine taken daily will interfere with the antibody test. So either the clinician examining you was incorrect or the antibody test was incorrect. The test is actually very good for HSV 2, not as good for HSV 1. In fact, it misses 1-2 out of 10 infections with HSV 1. Your antibody levels are negative but your HSV 1 could actually be positive. Do you recall the index value of your partner’s HSV 1 or HSV 2 test? If you haven’t been with anyone else in three years, and neither has he, then his antibody test is the one I am most curious about. You could be together for years and become recently infected by him. Do you have any concerns that he has had sex with anyone else?

Terri

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