Equivocal with symptoms

[Anxiousme]

Hi Terri,

10 weeks ago I had one encounter of received oral sex, a few seconds of unprotected vaginal sex, and then semi-protected sex (I saw the condom had fallen half way down). I have a 10 yr history of vulvodynia and had a flare up within days. I had exams at 11 and 24 days post encounter and was told nothing was visible; it was vulvodynia flare. At 4 weeks post encounter, I had a small blister inside my lip. I had it swabbed 3 days later, negative. Another blister on lower lip popped up later and lasted a week. At 5 weeks post, I tested positive for Covid with extreme sore throat and within days had severe vaginal pain and irritation- very red with what looked like the skin was scraped and possible bumps, with one small area that looked white. The pain went away 5 days later when I started my period but I no longer looked for visible signs. It was gone when period was over. 10 weeks post encounter, I had the exact same severe pain and irritation in the same place. It has lasted 11 days and is still here.
I had negative HSV1 and 2 IGG tests in 2012, 2015, and at 2 weeks post this encounter. I tested again at 8 weeks post encounter and got a negative HSV1 but equivocal HSV2. I plan to get the WB at 12 weeks. Since I’ve always tested negative, does this equivocal mean something? I have seen you post that only one equivocal has shown positive on the WB, but is that even after someone has previously tested negative? My OB/GYN said it’s an unreliable test and advised not to take another.
How likely is it I got HSV2 from this one encounter? The first possible outbreak lasting 5 days didn’t seem consistent with first outbreaks. I’ve been in pain daily since this encounter due to anxiety flaring the vulvodynia, or so I thought. I also have wondered if blisters on the wet area of the vagina would crust over or not. I have had severe anxiety over this as it was a stupid decision that may affect the rest of my life. Please advise.

[Terri Warren]

I think, given your symptoms, that HSV infection is unlikely here.
Your doctor said the western blot is unreliable or the IgG test? The western blot is very reliable, the IgG test is not reliable, correct.
I think given the equivocal result that a western blot at 12 weeks is a very reasonable thing to do.

Terri

[Anxiousme]

Yes, my doctor said the IGG is unreliable. I had an exam yesterday and this doctor said he thinks it’s vulvovahinitis but that first outbreaks can be atypical. He did a swab test which came back negative. He believed there was still enough going on that it would have shown up. So my questions:

1. Is 14 days after onset of symptoms too late for a reliable swab test?

2. What are the chances of transmission from a one time unprotected encounter?

3. Is 12 weeks long enough to wait for a reliable WB blood test?

4. How likely is an equivocal IGG result to change to a positive inbetween 8 and 12 weeks?

5. Can you explain why my symptoms make infection seem unlikely when they pain was nearly unbearable?

[Terri Warren]

1. Is 14 days after onset of symptoms too late for a reliable swab test?
Not necessarily, especially if symptoms are still present and the swab test is a PCR< not a culture. 2. What are the chances of transmission from a one time unprotected encounter? Very low but not impossible 3. Is 12 weeks long enough to wait for a reliable WB blood test? It is 4. How likely is an equivocal IGG result to change to a positive inbetween 8 and 12 weeks? Very unlikely 5. Can you explain why my symptoms make infection seem unlikely when the pain was nearly unbearable? I think the pain that is continuous makes it seem like its not herpes as that's not how herpes normally behaves. Terri

[Anxiousme]

I just wanted to update my situation. My doctor said I had sores but they were not consistent with herpes. It turns out the lidocaine I had been prescribed was causing inflammation. Of course anxiety got the best of me, and I was still convinced I had HSV. I did the Western Blot at 13 weeks, and both HSV1 and HSV2 came back negative. I am thankful to God for this outcome, not because it would have been a horrible diagnosis but because it would have ruined other parts of my life. I can put this worry finally to rest, correct?

It’s quite crazy what our brains can do and I encourage anyone else reading this to spend the money and get the WB for peace of mind. I have learned quite a bit on this forum and thank you for that. It’s unfortunate HSV has such the stigma it does.

[Terri Warren]

Correct, you can put this to rest. I’m glad you did follow up western blot testing.
thanks for letting other readers know your situation

Terri

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