Finally a dreaded bump

[MissEducated]

Good Evening Ms. Warren,

Quick Background for this current scenario as my previous thread was deleted;

Before this current situation I tested for HSV1 and 2 at the behest of an ex boyfriend who I had not seen in over a year. He had tested positive for HSV2. He and I always used condoms and I tested on November 15, 2014 and the results are as followed.

I was tested on 11/15/2014 for HSV1 and HSV2 with the following results:

Component Standard Range Your Value Flag
HSV 1 IGG, EIA <0.90 0.10
HSV 2 IGG, EIA <0.90 0.27
Hsv 1 IgM Negative Negative
HSV 1 TITER REFLEX Not indicated
HSV 2 IGM, QUAL Negative Negative
HSV 2 TITER REFLEX Not indicated

My current, now ex partner were sexually active from March-June, broke up from June-October, and were active from October-January. We had sex maybe 2-4 times a month, which involved oral unprotected and all condom protected sex.

One 1/17, I had a long sexual encounter with my partner, it included oral and vaginal sex. Oral was unprotected and the vaginal was protected. My vagina was a little tender the next morning and I just shrugged it off as irritation from condom friction.

From 1/20-1/27, the vaginal irritation continued and I just shrugged it off because my vagina feels drier and a little itchy around my menstrual cycle. I had sex with my partner on January 28 and I always make him use a condom. I do not mess around!. This time however the sex it hurt to holy high heaven, I mean it was bad. The next morning, my vaginal opening was swollen, it burned when urine touched the vaginal opening, and there was an itch.

Two days later I inspected myself with a mirror and saw what I thought was a bump, I immediately panicked and thought oh god herpes. I went to urgent care and the NP said, no there were no lesions present. She saw a red irritated vagina with grayish discharged. She ran a wet mount to screen for gonorrhea, chlamydia,, BV, trich, and
yeast.

I had a competent NP who said she see alot of herpes in her office and based on how my vagina looked, she said she was more suspicious of BV or Trich. I made it clear that I wear condoms but she explained that the oral sex could have thrown off the PH or the duration of sex of have irritated my insides.

I was treated diflucan for possible yeast and flagyl for potential BV and Z pack for possible STIs.

When the test results came back, the only positive test was BV.

The only symptoms since all the medication was this increase of smegma on the left side of my labia minor. My vaginal discharge went from white to clear to a little cloudy. I thought it was the 2 does of diflucan I had taken and the flagyl I had taken. Right now it looks little mucusy, whitish.

Itchy patches here and there on the labia major, I have checked daily over the past 3 weeks for bumps were it itched and no lesions. Inner labia a little sensitive but all sensitivity would go away during the night. I have checked the vaginal opening and the perineum, no bumps or lesions.

Today I was feeling around and I felt the one bump, I immediately took a picture and decided to send it to you. It is raised and feels a little hardened. I will let you be the judge of it and I must say that its a little frightening sending you such a private picture.

Let me know if I should call my doctor and I will try to be seen tomorrow. I apologize for not calling your office, I have been swamped with my job as a teacher. I work from 6-6 M-F and I do not want to have a private conversation at work. It may be wiser and cheaper to perhaps see a doctor here, especially if you see anything alarming.

Thank you

[Terri Warren]

I definitely see the bump and think you should make an appointment to be seen to have it evaluated as soon as possible. HOWEVER, it does not look like a typical herpes lesion to me. Are you able to be seen today?

Terri

[MissEducated]

Hello Ms.Warren,

I have just left the doctor and she assessed the bump and said it was a hair bump. She looked at my vagina and saw nothing that concerned her. She did draw blood for HSV 1 & 2, HIV, and Syphilis. She explained that because I had a swab testing on February 2nd I not need to be screened again for Gonorrhea, chlamydia, BV, Trich, or yeast. She said BV is not a precursor for herpes and wherever I heard that to ignore it. She went over the statistics and explained HSV 1 could be more likely then HSV2. However only the test would tell. I will keep you posted. Thank you for your encouragment.

[Terri Warren]

That’s great new. No, BV is not a precursor to herpes, it is completely separate.
Yes, keep me posted!

Terri

[MissEducated]

Good evening,

Hello there. I called the nurse to get my test results and my results could not be released. I have to wait until Friday. The nurse said out of the results, she said it is not the worst one. I was tested.for.HIV, HSV, and Syphilis. I did ask what test for herpes was used and she said the IGM. I am thinking this is the test that came back positive. I am not sure what to think right now. Those symptoms must have been primary herpes.

[Terri Warren]

You do NOT want an IgM. There are many false positive on this test. PLEASE don’t jump to conclusions. The only test you really want is the IgG. How long ago was your contact?

Terri

[MissEducated]

Hello again,

I know I need to get more questions paid for. My last contact was 1/17/2015. My history is listed above as well as the last time I tested in November. When I spoke with the Medical Assistant we argued about the IGM. I explained that I heard it was unreliable and she said it was a quality test for primary HSV infection. She also said I needed to trust the test results when the doctor called on Friday. That is why I am pissed. If the doctor is the only one to release the information that med assistant should have kept her mouth closed. Her comments let me know it was the IGm that I’d positive.

Even though the NP has said what I had was BV and a hair bump, the constant itchy labia made get tested again. I may have herpes and was infected a little after resuming relations with my ex. Who knows. It’s just an annoying situation. I am going celibate. Geez.

I will call my primary care physician to request a new UGH test once I talk to the NP in the urgent care clinic I went to.

Ps- found another bump and I have also started my period. The bump is hard, however the labia itched. Could it be the pad? I also itches all over my belly back and neck. Could be stress.

[MissEducated]

I am headed to my doctor today because I broke out in a red rash and have a fever. I will ask for the IGG to be run again.

Thank you

[MissEducated]

Good Afternoon,

Ok. I went to my primary care physician at Kaiser. She did order the IGg test, however, she claims that the IGM is a good test when it comes to an active infection. She thinks if the test is positive then I would have herpes and could only use the IGg to figure out the type.

I am so irritated because I am so sure what information to trust. I hear good and bad for the IGM. She also believes that the Medical Assistant may have said that the type of herpes I has was type one, which is not the worst vs. Type II. But why would I need the IGg if the IGM can type the virus as well.

She does not think I have genital herpes II and I explained that the symptoms are so suspect that I do not know what is going on. If it is type I it could be genital. I have had no bumps on my lip aside from mild tingle and itch here and there.

I was given prednisone for the rash. She said it could be stress or a reaction to something. Food, soap, lotion.

[Terri Warren]

Your doctor and I could not disagree more about the IgM test. I have no desire, however, to undermine your doctor. The IGM purports to type the virus, but in reality, the typing of the IgM is as suspect as the test itself.

Did she do any testing from the bump?

You are a bit caught in the middle and it is not my desire that this happens to you, please believe me. But this is the one thing I’ve focused 30 year of practice on and I believe that my information about IgM testing as more accurate than hers. Was there an IgM result that we are talking about here?

Terri

[MissEducated]

I will get the results tomorrow and I will contact you after.

Thank you,

MissEducated

[Terri Warren]

Sounds like a plan!

Terri

[MissEducated]

Hello there,

I just received news that my for was reactive. Both HiV and IGM came back negative. Waiting for the IGG to come back next week. I was told do not trust the IGM therefore I will wait for that. I have had a positive RPR in the past but I was told the secondary test was non reactive and that I was good. I am just awaiting records from the urgent care clinic to be sent to my primary care physician.

Thank you

[MissEducated]

Oh crap. I forgot to edit my last response. I wanted to let you know that the RPR for syphilis did come back positive twice and the urgent care NP was a little concerned because I did tell her, during the blood draw that I had a previous test with a false positive, however, a T. pallidum-Particle agglutination assay [TP-PA] was run and came back non-reactive. The NP sent my records to Kaiser and pressed my doctor to order another test because she was nervous that I might have a valid syphilis infection and needed a PCR and treatment.

My doctor ordered a T. pallidum-Particle agglutination assay [TP-PA] and I will go to the lab at Kaiser to get another test and I am still awaiting the results of my IgG. The NP made it clear that the HIV test was non-reactive and the IGM was negative and my doctor believes I am in the clear, however, I do not trust the IGM based on the information I have heard.

The doctor also requested a test for pregnancy and auto-immune disorders, which she explained can cause a constant false positive on the RPR.

I will touch base next week and wrap up this thread. Whew, what a past few weeks.

[Terri Warren]

Yes, you have had an intense week! If the TP-PA came back negative, I think it is likely the RPR was a false positive – we see them all the time and we do not pursue testing for immune disorders.

Keep me posted.

Terri

[MissEducated]

Good Afternoon,

I called for my results which were sent out last Friday 3/6/2015 and I was told that my results are still pending. Is this a cause for concern because it made me nervous.

I had a negative IGG in November both numbers had values less than 30.

After my vaginal issues in January the urgent care clinic ran the IGM and it came back negative, however the IGM is bad and that negative can be a false negative.

The last time I received results it was a quick turnaround. I am just nervous that they must be doing additional testing for some reason. Is a pending test something to be worrisome about?

[Terri Warren]

The IgM is bad only with false positives, not with negatives. We don’t honestly know how accurate or inaccurate it is with negatives, actually. I’m not clear what the delay might be = it doesn’t make much sense to me. It is a straightforward test. It’s been almost a week, right?

Terri

[MissEducated]

Good Evening,

Kaiser just released the following test result.

Hsv1 is .11 up from .10 in November
HSV2 is .44 up from .27 in November
Plus one negative IGM from 3/9/2015

Designated negative for both types. Last sexual contact was January 28th, 2015. I waited about Six weeks for HSV, HIV, and RPR testing. I can test in another 6 weeks and I will be calmer until then. Thank you.

[Terri Warren]

I don’t think these numbers are significantly different than the last batch – these were run against different controls and we would expect somewhat different results. The slight upwards ticks are nothing to be concerned about, in themselves. Yes, another test in 6 weeks should be reassuring.

Terri

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