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Hi Terri,
I’m very concerned that I’m experiencing a primary HSV-1 genital outbreak, and that my doctors are failing to properly diagnose it. I had a brief unprotected oral sex encounter a month ago with someone who has HSV-1. He did not have any visible cold sores at the time of the encounter.
Two days after the encounter, I started experiencing vaginal discharge and a general sense of unwellness.
A week later, I started experiencing intense burning and tingling in the genital area. My doctor did not detect lesions or bumps of any kind, but I tested negative for UTI, gonorrhoea and chlamydia. The doctor thought my symptoms might be caused by anxiety. The burning eventually stopped but the discharge and itching didn’t.
Two weeks after the encounter, I started experiencing flu symptoms (swollen lymph nodes, feeling feverish all of a sudden, nausea, body aches) and I went back to the doctor. (I had recently gone on a date with someone who ended up coughing a lot and kissed me goodnight so I could have caught something from him) I told my doctor I was concerned about herpes. She did another inspection and said everything looked fine. She did a viral culture of vaginal fluid that came back negative. She did an IGG blood test that was negative for HSV 2 but positive for HSV 1 (2.5 I think).
I’ve never had an obvious oral cold sore. However, everyone in my family gets them and two years ago, I had a round, reddish brown crack in my lip that suddenly appeared and burned intensely for two weeks. I had no clue how it got there, as I couldn’t remember cutting myself, and it never bled. Chapstick made it worse. Since then, I’ve assumed it was a mild herpes blister.
It’s now been a little over a month since the encounter and I’m still feeling sick. I’m having heavy discharge (sometimes watery, sometimes thick and white), pain in my thighs, some vaginal burning, and itching all over my body, but especially in my feet. Sometimes my throat feels swollen too.
I’ve checked myself every single day for the past month and haven’t noticed anything resembling a bump, rash, insect bite, pimple, or lesion anywhere in the genital region. But I’ve also felt sick everyday.
I saw a gynaecologist yesterday and she thinks I have a bacterial vaginosis infection or yeast infection that the general practitioners missed. I want to believe her, but I also don’t want to get my hopes up. I’m hoping your expertise can help me find peace of mind. Thank you.
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If you have had a herpes sore or crack in your lip, then that is where the antibody is coming from. Of course I don’t know if that was oral herpes or not, really. But if you have oral herpes all ready then you will not acquire HSV 1 in a new location. If your GYN thinks you have BV or yeast then they would explain the discharge. Acquiring genital herpes would not make you itch all over nor would it cause you to have symptoms for the duration you are describing.
Terri
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I would encourage you to follow up with your doctor about the discharge and have any further symptoms evaluated in person
Terri
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No, not normal. I can’t say that it never happens but that is certainly not the normal course of events.
I also think the fact that you had a 2.5 index value on your test two weeks after the encounter suggests that you do not have new infection. The soonest that I have seen someone have a positive antibody response was 10 days after the encounter, and it was only 1.2. I’m sure others may have seen something different but I have not.This is your final post on this subscription. If you have more questions, feel free to renew.
Terri
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I seriously doubt that you would have a new herpes outbreak for 6 weeks especially with no lesions.
You could have a PCR done of vaginal fluid but I’m guessing it will not be useful.
If you want to get a script, you should talk to your doctor about that.
I think you are worrying unnecessarily.Terri
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Yes, I think you are worrying too much in proportion to the symptoms that you have described for me. I cannot tell you that you don’t have genital HSV 1 because you are testing positive (although in the low positive range that needs confirmation), and we don’t know where that infection is. But does this sound like a primary genital HSV 1 infection? Not in my opinion. Your flu symptoms came well after the symptoms started and usually with new herpes the flu symptoms come before and concurrently with genital lesions.
Trri
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The viral culture is helpful, yes and good that it was negative.
My experience with infectious disease docs is that because genital herpes is a very minor medical problem, they focus a whole lot more on diseases that are medically serious and tend not to have as much accurate info about genital herpes. Again, I doubt that your symptoms are post herpetic neuralgia. I honestly don’t see that very much. Herpes would not cause weird feelings all over your body, either.Terri
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A 2.77 two weeks after a possible infecting encounter to me suggests old rather than new infection. The earliest I have seen a positive is 1.13 10 days after becoming infected.
NO, a Tzanck would not be helpful. That is an outdated old test.
Terri
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What is the likelihood that someone without a cold sore can pass the virus through oral sex in one encounter?
Really really low
The doctor did a PCR test a couple weeks ago that came back negative. Is this helpful? Or is the test useless unless you have a lesion?
The test isn’t useless without a lesion, but certainly more likely to be positive with a lesion
Is the fact that I’ve been sick for so long (8 weeks since exposure) a sign that it could be something other than herpes?
Of course, and I don’t think that herpes illness would last 8 weeks at all.If these symptoms come back at some point, would I be able to order a PCR testing kit from your clinic? If so, how would this work?
Yes, you could do that. We would ship you one and then if you have a symptom, you return it to us and we send it to the lab.
Sorry to ask for advice, but I guess I was hoping you could offer some guidance as to how I should move forward from this situation. I feel very alone in this; the doctors keep dismissing my worries, and my therapist does the same based on what the doctors have told me. I know you can’t give me an answer for whether or not I have it, but based on what I’ve told you, do you have any advice on how I should proceed? I know I have to accept the uncertainty, but I’d like to be able to feel mostly one way or the other.
If you are asking me if you have genital HSV 1, I would say we can’t know for certain, but the lip lesion that you had that lasted two week and burned could have been HSV 1 for sure. If you were my patient, I would suggest that you disclose to others exactly what we know – that you have HSV 1, the cause of cold sores, but you can’t know where on your body it is. The odds are in your favor that you will meet another person who also has HSV 1 and then you don’t need to worry about it anymore.
Terri
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Post herpetic neuralgia would not be all over your body like what you are describing, not at all. With genital infection, it is most often limited to the leg.
Again, I think it isn’t likely that you would have a 2.77 index value just two weeks after the encounter. The difference between the two index values is in no way significant. I think it is quite clear that at that level you are HSV 1 positive, yes, based on some new study data that we have but if you want to do a western blot to be quite sure, you sure can. It is certainly possible that you partner gave you HSV 1 earlier in the relationship, yes, but it would be very hard to prove given your index value – could have been any time in the past.
I think it might be wise to talk with your general doctor about your crawling under the skin feeling all over your body and see what he/she says.
Terri
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