Do I have genital herpes?

[1020304050]

Hi. I made a new post because I couldn’t find my old posts.

April 6 I got a fissure/paper cut between my perineum and anus. It is in 1 o clock position. It didn’t bleed, it was just blank fluid in the cut, but when I pulled it a little apart it started to bleed. It healed in maybe 3-4 days, but every time I had a bowel movement it reopened. It didn’t hurt but did sting a little if I touched it. It kept on healing and reopening but eventually healed and was completely healed on April 22. On April 28 I felt a sharp pain in my groin. The next day I saw two “sores” on a red base with dark crust over on the inside of my tigh near my groin. I never saw any blisters I only saw the scabs. Today, on May 2 the scab is off and the two spots are pinkish. I went to the doctor the same day I noticed the scabbed sores and he said that it prwas genital herpes. He took a swab of it and I will get the result soon. He gave me Valtrex which I started April 29. I took 1 tablet of 500 mg twice a day until May 1 (5 tablets in total). Today, May 2 I had a bowel movement, and the paper cut/fissure/tear near my anus reopened. It did not bleed, but leaks blank fluid. It does not hurt. I am very confused. My questions:

1) with a genital herpes recurrence, will the outbreak always present itself the same way? I mean, will you always get only blisters or always get only paper cuts/fissures or can you have both types and at the same time?
2)Do you think the tear between my perineum or the crusted sores are herpes?
3)can you get herpes that is not a blister but only looks like it was a sore but has a scab on it?
4)can you have both blister-type herpes with scab on the inside of the thigh AND a tear like herpes outbreak near the anus at the same time?
5)can a herpes outbreak reoccur in the exact same spot as before every time you have an outbreak?
6)when PCR is used, would the tiny amount of fluid from paper-cut-herpes or a crusted lesion with no fluid, still be able to contain enough virus?

[Terri Warren]

Is your doctor sure this isnt’ an anal fissure?
1) with a genital herpes recurrence, will the outbreak always present itself the same way? I mean, will you always get only blisters or always get only paper cuts/fissures or can you have both types and at the same time?

You can have both at the same time, though that is probably less common

2)Do you think the tear between my perineum or the crusted sores are herpes?

I have no idea, sorry. Have you had an IgG antibody test? If not, you should

3)can you get herpes that is not a blister but only looks like it was a sore but has a scab on it?

Yes

4)can you have both blister-type herpes with scab on the inside of the thigh AND a tear like herpes outbreak near the anus at the same time?

I think that is less likely but you could have herpes AND an anal fissure?

5)can a herpes outbreak reoccur in the exact same spot as before every time you have an outbreak?

Some people have it in the exact same spot, yes

6)when PCR is used, would the tiny amount of fluid from paper-cut-herpes or a crusted lesion with no fluid, still be able to contain enough virus?

If the timing of the swab is correct, yes, we get positive PCR’s off completely normal looking skin. it is very sensitive.

Terri

[1020304050]

Thank you.

– I never saw any blister or sore form, I only saw the scabs. It was two round shaped dry scabs, with redness around them. They are close together. The scab is dark brown. They are located on my inner thigh. Is there any other condition, like bug bites or something else than herpes this could possibly be, if so; what?

– The doctor swabbed the scabs two days after they appeared. They were completely dry. He did use PCR i think. If this is herpes could the PCR still be a false negative because the scabs were dry? Can the virus be in the dry scab?

– If the PCR is negative, should I be confident that I don’t have herpes?

– I have never had these scabs before (to my knowledge), and the last time I had unprotected sex with a new partner was 5 years ago. Is it still likely to be herpes?

– Why do herpes on thick skin turn into scabs? Is it because it was a blister and it popped? I never saw a blister. Does that mean I have to have had a blister but I just didn’t notice it, or can herpes just form as a scab with no fluid?

– Is it any chance that this is not herpes?

– How common is it to have genital herpes on the inner thigh?

– Is it possible to have a false positive PCR?

– I felt some aching pain in my thighs, groin and hips and I still do. Is this related to genital herpes? The aching pain is on the same leg as my two scabs are located. Would the pain only be on the side where the herpes outbreak is, or could the pain also be on the other leg?

– If I was your patient, what would you advise me to do next? What if the PCR is negative. Do I wait for another outbreak? Or take the IgG test? Or both? Or consider myself negative?

– If a female potentially had sex with a male that had genital herpes and they had sex 20 random times without condoms or suppressive medicine, verus if the female had sex with 20 random men only once without a condom, who might be HSV positive or negative, in which scenario would she most likely get genital herpes?

[Terri Warren]

– The doctor swabbed the scabs two days after they appeared. They were completely dry. He did use PCR i think. If this is herpes could the PCR still be a false negative because the scabs were dry? Can the virus be in the dry scab?

It could be a false negative, yes. And yes, the virus can be in a dry swab

– If the PCR is negative, should I be confident that I don’t have herpes?

Not necessarily

– I have never had these scabs before (to my knowledge), and the last time I had unprotected sex with a new partner was 5 years ago. Is it still likely to be herpes?

Not likely, but possible

– Why do herpes on thick skin turn into scabs? Is it because it was a blister and it popped? I never saw a blister. Does that mean I have to have had a blister but I just didn’t notice it, or can herpes just form as a scab with no fluid?

– Is it any chance that this is not herpes?

Yes, of course

– How common is it to have genital herpes on the inner thigh?

Not common

– Is it possible to have a false positive PCR?

Extremely unlikely

– I felt some aching pain in my thighs, groin and hips and I still do. Is this related to genital herpes? The aching pain is on the same leg as my two scabs are located. Would the pain only be on the side where the herpes outbreak is, or could the pain also be on the other leg?

I have no idea if this is related to herpes or not, sorry. Pain usually happens at the site of the lesion. The pain would likely not be in the other leg.

– If I was your patient, what would you advise me to do next? What if the PCR is negative. Do I wait for another outbreak? Or take the IgG test? Or both? Or consider myself negative?

If you were my patient, I would advise you to do an IgG or western blot, for sure.

– If a female potentially had sex with a male that had genital herpes and they had sex 20 random times without condoms or suppressive medicine, verus if the female had sex with 20 random men only once without a condom, who might be HSV positive or negative, in which scenario would she most likely get genital herpes?

I have no idea, sorry.

Terri

[1020304050]

Thank you so much for the answers. I have a few more questions.

– I have been to several doctors and they have all ordered the non-type-spesific antibody blood test. I have even tried to tell them that they need to order the type spesific test but they never do. Do you have any suggestions to how I can convince them of ordering the type spesific blood test? I don’t want to be rude and act like I know better than them. If you have any advice that would be great. Or is it possible for you to order the type spesific blood test for me and I can go to a lab and get it done and they will analyze it here? I live in Europe.

– Is it possible for genital herpes to NOT be an ulcer or blister but ONLY a scab/crust?

– what color is usually the crust?

– with recurring genital herpes, how fast will the blisters pop or the ulcers crust/scab? How many days?

– how sensitive is PCR when swabbed on a scab/crust?

– in my case, the doctor looked at the crusts and said it was herpes, but the PCR was negative. Should I trust the doctor or the PCR more?

– in your practice and experience, will swabbing a crust/scabbed lesion and using PCR more likely pick up virus or not?

– how do you know if a PCR swab is a true or false negative?

– i read somewhere that when you have a recurrence, that the place where the virus first entered your body might itch. For example if the virus entered through the perineum, but you have an outbreak on the thigh, that the perineum might itch the days before the recurrence even if the recurrence is in another location. Is this true?

– is it possible or normal for oral herpes recurrence to always only present itself inside the mouth (for instance on the hard palate) and not ever on the lips?

– if the same person took several blood tests for HSV antibody and they all where negative. Does that increase the probability that they are all true negative?

– do you know of any current research on a herpes cure? Or have researchers given up hope?

Thanks.

[Terri Warren]

– Is it possible for genital herpes to NOT be an ulcer or blister but ONLY a scab/crust?

You might not notice an ulcer but usually there is one, if there is a scab

– what color is usually the crust?
reddish brown tan

– with recurring genital herpes, how fast will the blisters pop or the ulcers crust/scab? How many days?

it varies from one day to probably four days

– how sensitive is PCR when swabbed on a scab/crust?

There is nothing more sensitive than PCR so we have nothing to compared it to to get sensitivity percentages

– in my case, the doctor looked at the crusts and said it was herpes, but the PCR was negative. Should I trust the doctor or the PCR more?

Probably neither. You need to figure out how to get a type specific serology. I know that they are offered in Europe. I don’t know how to help you with the “how” of that – can you order tests online there?

– in your practice and experience, will swabbing a crust/scabbed lesion and using PCR more likely pick up virus or not?

I think PCR picks up virus in a scab about 15% of the time

– how do you know if a PCR swab is a true or false negative?

You compared your PCR result to your type specific serology result

– i read somewhere that when you have a recurrence, that the place where the virus first entered your body might itch. For example if the virus entered through the perineum, but you have an outbreak on the thigh, that the perineum might itch the days before the recurrence even if the recurrence is in another location. Is this true?

that’s possible

– is it possible or normal for oral herpes recurrence to always only present itself inside the mouth (for instance on the hard palate) and not ever on the lips?

It is possible and not normal

– if the same person took several blood tests for HSV antibody and they all where negative. Does that increase the probability that they are all true negative?

Depends upon the test. The tests used in the US miss 30% of HSV 1 and 8% of HSV 2 and they miss is repeatedly, in my experience.

– do you know of any current research on a herpes cure? Or have researchers given up hope?

There are certainly research studies ongoing on herpes, yes

This is your final post on this subscription.

Terri

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