HSV I/II Results: Positive and Equivocal

[Bowman843]

After a questionable oral outbreak of one large, single head looking pimple that presented just outside my bottom lip with a slight tingling at the same time a bump presented, I was tested with IGG for HSV I/II as well as a culture swab within 48 hours. I had popped it earlier in the day with bleeding because it was quite raised and hurt horribly. Doctor believed it to be bacterial; however, he prescribed Valtrex while awaiting testing. This would be my 3rd/4th outbreak in the exact same location in the past 3-4 years. Yet, in the past, I have had what I now believe to be a typical HSV outbreak on my actual lip that oozed clear liquid and formed yellow, crusty scabs. It was after an aggressive laser treatment about 6-7 years ago. I had another similar outbreak about 2 years after. Since that time, I have had the pimple like outbreaks. Last year, a different doctor believed it to be a pimple, even injecting it with cortisone. All that said, I am not sure if I had an HSV breakout or a pimple that happens in the same area. All of this was in late April 2019.

Results from testing:
Swab Negative (Right at 48 hours with some oozing)
HSVI IGG positive at 22.4 (Going back to the laser at minimum)
HSVII IGG equivocal at .97 (recommendation of retesting in 4-6 weeks)
Both IGMs were very low negatives

I have never had a genital outbreak nor has my partner of 3 years. I was married prior for 13 years without any genital breakouts….myself nor my ex. My ex was a college wrestler and I know HSV I is commonly acquired through that particular sport so I am assuming he has HSV I but not that he gave it to me

Questions:
1. Do you feel it is necessary to do a Western Blot test for HSV II?
2. Can HSVI present in two different ways at different times?
3. Can I use Valtrex to suppress OBs during stressful events? How soon prior to the event? Obviously it is not 100%…I am getting married next year and want to minimize the possibility of an OB.

Thank you!

[Terri Warren]

1. Do you feel it is necessary to do a Western Blot test for HSV II?

Has your current partner been tested for HSV and have you had any genital symptoms?

2. Can HSVI present in two different ways at different times?

yes, certainly
3. Can I use Valtrex to suppress OBs during stressful events? How soon prior to the event? Obviously it is not 100%…I am getting married next year and want to minimize the possibility of an OB.

You should start the medicine AT LEAST five days before the wedding.

It’s difficult to say if the pimple was herpes or not but a negative swab test suggests maybe it wasn’t but the location is concerning. do you know if the swab test was a culture or PCR?

Terri

[Bowman843]

1. No he has not been tested for HSV. He does get cold sores but only one in the past 4 years that I have known him. It was in his nose….thinking back now. He was married for 16 years and he nor his ex had any genital symptoms. I have been his only sexual partner since. We have been together for 3.5 years. Neither of us had sex for close to two years prior to meeting.

Would you advise him to be tested IGG first for both? He feels confident he would test positive for HSV I but not for HSV II.

2. I feel certain it was an outbreak although it didn’t present as typical. It is in the exact same place. It was a culture swab which I understand can be negative for many reasons. I understand that HSV II can be higher during a breakout.

Should I accept it as negative? Or get a second IGG to determine if a Western Blot is warranted?

3. Curiously….Consider both partners HSV I positive. If one has an outbreak can it cause the other to breakout within a week? Thinking back, I feel that I had my pimple like outbreak about a week after his nose pimple like outbreak. This was the most recent outbreak. I have had two prior in the same location.

Thanks for all of your time and energy with everyone on here.

• This reply was modified 3 years, 8 months ago by Bowman843.
• This reply was modified 3 years, 8 months ago by Bowman843.

[Terri Warren]

If he would agree to be tested for HSV 2, it would be useful in sorting this out. If he is negative and you have an index value of .97, I think you are safe to assume you are negative, though it is not perfect – more perfect is the blot
You might want to retest with IgG. Herpes really doesn’t look so much like a pimple, I wonder if you could having boils in the genital area?
One infected person with an outbreak does not cause someone else to have an outbreak, no

Terri

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