Negative swabs & IGG Test but still symptoms?

[isitornot]

Hi. Me – male, 30, had mouth cold sores since I was a child. Almost 1 year ago I had a drunken 1 night stand, definitely protected penetration & received unprotected oral. I’d been partying a lot on the weekend & on the Monday morning I vomited & passed a really watery stool but this had happened to me before & put down to the effects of the weekend. I did feel a bit run down for 2-3 days early in week too. Sometime the next week I had 1 yellow spot appear on the right of my scrotum area, didn’t think anything as looked exactly like a normal yellow head. I popped it, puss came out, and it healed in 1-2 weeks.

Maybe 6 weeks later, 3 spots maybe 1cm wide just above the fold between my scrotum & leg appeared also on right hand side but little bit further down. they never scabbed but one did fill a little with puss and I squeezed it out 2 or 3 days later, which left a small crater like hole in the middle. These 3 main spots lasted approx 3 weeks, with a couple of smaller ones coming & going around the same area in this period. They weren’t painful.

Went to the clinic & had a full screen for all STDS and a swab on the lesion (maybe 2-3 days after I had popped it), all negative. Nurse said they didn’t look like typical herpe sores. I had been running every day for around 2 weeks before this, nurse said it was probably sweat spots. I did have some slightly swollen neck glands/lymph nodes during the potential outbreak & a bit of ezcema around the groin area too. I also noticed that almost each time a new batch of spots came up I’d get either some spots on the back of my neck, or the area either under my ear lobe (I think on a lymph node) or on the skin next to my ear where a side burn would be developed into a sore & then scabbed. I don’t usually get spots like this.

Maybe 10 days after, more spots appeared, no blisters or scabs, I could squeeze puss out of some of them. I got these swabbed too & again came back negative. They cleared up in 2-3 weeks.

[isitornot]

I took an IGG blood test at 14 weeks and received HSV2 negative (less than 0.5) and HSV1 positve (45). Had cold sores since child so expected this.

Since 1st lot of spots appeared skin on scrotum hasn’t felt right, r/h side always a bit ‘bumpy’ and hair follicles often red at base, gets worse if scratched, looks a lot like folliculitis. I’m sure my scrotum is more red than used to be, and I noticed some angiokeratemas on the underside of my scrotum, which never noticed before, doctor told me these were totally normal though. I noticed my face used to flush red quite a lot and top of my chest sometimes a little red too intermittently between march & september. I had a bad cough for a couple of days in September and my friend gave me a penicillin substitute tablet which kind of got rid of the redness on my face and chest. I also had ezcema & again what looked like folliculitis on my belly button three times over the year. I also get eczema under my armpits & back of legs quite a lot anyway. I had another couple of ‘bigger’ spots (looks more like a boil) than usual again in August that didn’t scab or puss.

Went to the GUM clinic again Nov as these symptoms still persisted, 2 docs again said not herpes and said looked like a fungal infection, I again tested negative for all other STDs (HIV, syphillis, chlamydia, gonorrhoea). Had another IGG test and again less than 0.5 for hsv2 & 44.3 for hsv1. I was given some anti-fungal cream which made the area look a bit better but didn’t really get rid of what looked like folliculitis. Then 2 weeks ago I remember scratching lots in my sleep, woke up and had red open sore which looked more like herpes than ever before. I was away for 3 days so wasn’t able to swab, it never scabbed or blistered but was quite moist for 2-3 days, a little tender to touch too.

I’ve basically had something going on for nearly a year now, docs say its nothing to worry about but anti fungal cream didn’t get rid of it, although reduced redness.

[isitornot]

My questions

1. Could this be herpes even though negative HSV2 IGG twice & I’ve had HSV1 for 25 years+?

2. Last big ‘outbreak’ was more like herpes than anything I’ve ever had. Didn’t blister but open sore which was oozing for couple of days, then healed up (no scab). It was very red around the open area too. If it was herpes why would this one seem the most herpes-like outbreak 12 months on?

3. what else could it be? Could it be bacterial & would this link to spots/scabs on side of face/neck that seem to accompany a bigger spot, & belly button rash? I’ve never had any antibiotics for it, only anti-fungal cream.

4. what should next step be – just wait for another outbreak & get swabbed as IGG test won’t tell me anything I don’t already know? Docs don’t care & don’t seem worried but sure if I’d got to docs in time with last sore they would have thought herpes. I’ve abstained from sex for nearly a year in fear of passing something on. I’ve never had any issues like this before genitally & in my mind this has to be related to last sexual encounter because of the timings. I’m in Uk so cant do western blot test.

thank you

[Terri Warren]

1. Could this be herpes even though negative HSV2 IGG twice & I’ve had HSV1 for 25 years+?
The screening test normally used misses 2 out of 100 cases that the gold standard test, herpes western blot, picks up. So it seems very unlikely to me the testing missed it

2. Last big ‘outbreak’ was more like herpes than anything I’ve ever had. Didn’t blister but open sore which was oozing for couple of days, then healed up (no scab). It was very red around the open area too. If it was herpes why would this one seem the most herpes-like outbreak 12 months on?

Having not seen this, I can’t say how likely or unlikely it would be that this is herpes. It would be unusual to have a first recurrence a year later.

3. what else could it be? Could it be bacterial & would this link to spots/scabs on side of face/neck that seem to accompany a bigger spot, & belly button rash? I’ve never had any antibiotics for it, only anti-fungal cream.

I think it could definitely be bacterial, yes, and that’s kind of what folliculitis is – a small bacterial infection of the hair follicle

4. what should next step be – just wait for another outbreak & get swabbed as IGG test won’t tell me anything I don’t already know? Docs don’t care & don’t seem worried but sure if I’d got to docs in time with last sore they would have thought herpes. I’ve abstained from sex for nearly a year in fear of passing something on. I’ve never had any issues like this before genitally & in my mind this has to be related to last sexual encounter because of the timings. I’m in Uk so cant do western blot test.

You actually can get the western blot – we ship kits to Great Britain not infrequently. I”m not sure how else to resolve this. You could chose just to go with the antibody test results for now and if you get another lesion get in and have it swab tested right away. Not sure what else you can do!

Terri

[isitornot]

Hi Terri

So since we last spoke I went back to the docs and told her pretty much the above, she said she didn’t think it was folliculitis but gave me some penicillin tablets anyway to see if it worked and some aqueus cream to wash down below with instead of shower gel etc. Kind of made it look a bit better but then 3 days ago the below popped up on my left hand side scrotum, thought it was eczema at first but two tiny sores appeared (with a hair follice in the middle of each), it was kind of sore to touch and a small amount of liquid on the surface layer. I’m sure this must be herpes, I discussed on another forum and they basically said because I’ve tested negative on IGG for HSV2 and already had HSV1 for decades (with a very high score of 44 on IGG test for HSV1) and the fact I tested negative twice on the swab test that it can’t be HSV but I can’t think what else it could be and feel I must be in the small percent that either don’t show up on an IGG HSV2 or have caught HSV1 genitally despite having it orally for a long time already. What else could it possibly be though – I feel like I’m stuck in limbo. I can’t get to a clinic for a swab as working away right now, I’ve attached images if you don’t mind looking.

Please let me know what you think could be going on.

Thanks

[Terri Warren]

With two negative swab tests and negative antibody tests for HSV 2, you have done everything that you can to determine if these lesions are HSV 2. I do not believe that they are HSV 2.

Has anyone done bacterial cultures from these sores? sometimes a staph or strep can cause skin ulcerations. But then I think the penicillin would have helped unless it is something that is not sensitive to penicillin.

I’m sorry, but I don’t believe that I can offer you and more information on what might be going on with you.

Terri

[isitornot]

Hi Terri

Need some more advice please…

Had this going on for nearly 2 years now and still none the wiser

Seen about 15 docs, most said not HSV, last doc I seen I showed some pics I took (attached) and she said did look like it could be HSV, said it look quite classical symptoms. I sent to first derm online and they said biggest probability is HSV1 genital, even though I’d had HSV1 oral for 20 years + and had very high antibody score on IGG of 44 for HSV1, which shows previous infection / antibodies from a long time ago right?

I’ve noticed outbreaks occur most when I’ve used steroid / hydrocortisone cream or basically any cream down there docs have prescribed other than aqueous cream or dermol cream, these both helped. Also normal shampoo or shower gel seems to increase whatever happens down there. The last 3 months I’ve had more outbreaks (almost continous for 3 months, one after another) than I’ve had in last 18 months, I also keep have quite outbreaks just below both ears (parotid lymph nodes it seems) where the skin goes sensitive, then either cracks or goes like a broken sore.

I’ve now had 3 IGG tests, all neg HSV2 but pos HSV1, and 2 neg swabs, but think the timing wasnt great on these.

1/ Any link at all between herpes genitally and sores / spots below ears – can this be linked? It 100% happens anytime anything ever happens downstairs. If not, is there an STD where this happens? I’m negative for all other STDS.

2/ 3 months almost of something going on – is this characteristical of herpes?

3/ Does the use of normal shampoo / shower gel result in increased herpes breakouts?

4/ Does steroid cream etc result in increased herpes breakouts?

5/ Chances of HSV1 genital after HSV1 oral for 20years + and high IGG antibody score?

6/ Does aqueous / dermol cream improve herpes conditions?

7/ Do pics look like herpes?

8/ I get rashes on belly button sometimes too, any links to herpes breakouts?

[Terri Warren]

I have removed the pictures you posted – we don’t allow pictures on this site.

1/ Any link at all between herpes genitally and sores / spots below ears – can this be linked? It 100% happens anytime anything ever happens downstairs. If not, is there an STD where this happens? I’m negative for all other STDS.

If the spots below your ears are herpes, and this happens to be herpes, it would not be unexpected to have them recur at the same time.

2/ 3 months almost of something going on – is this characteristical of herpes?

Not really – herpes is usually more intermittent

3/ Does the use of normal shampoo / shower gel result in increased herpes breakouts?
No

4/ Does steroid cream etc result in increased herpes breakouts?

Yes, sometimes it does

5/ Chances of HSV1 genital after HSV1 oral for 20years + and high IGG antibody score?

It’s very uncommon – I can’t say it’s impossible.

6/ Does aqueous / dermol cream improve herpes conditions?

I don’t honestly know about this product so I can’t accurately comment

7/ Do pics look like herpes?

One does, the first one, somewhat.

8/ I get rashes on belly button sometimes too, any links to herpes breakouts?

First, we don’t know that these are herpes outbreaks and since I don’t know what the rash looks like, I cannot accurately comment on that rash.

I think you should ask your provider for swabs to take home and gather a PCR when you first notice this the next time.

Terri

[isitornot]

Hi Terri

Thanks for your answers. I will get a PCR swab and hope for a chance to catch it!

questions…

1. re: If the spots below your ears are herpes, and this happens to be herpes, it would not be unexpected to have them recur at the same time.

Can you actually catch herpes under your ears? How does this work as there is no way that touched anything where herpes could have been ever? Is it possible this is a ‘by-product’ of a herpes outbreak down below, in the same way that some people get leg twinges etc? The spots / sores used to occur on the back of my neck etc too but seem to not be as severe now if that makes sense.

2… I’d read that if you have hsv1 oral it’s very hard to catch HSV1 genital, and the fact I’ve had 3 neg IGGs for HSV2 and 2 negative swabs what do you think chances are this could be herpes based on story & pics? Science seems to tell me very very small chance but syptoms say otherwise?

3. is there anything else STD wise this could be or has similar sypmptoms, or anything maybe non STD even?

4. other previous symptoms – red blotchy chest and face, greyed scrotum, angiokermas on scrotum – can these be related to herpes infection?

5. what do you think this is?

[Terri Warren]

If you have herpes behind your ear, it is because you have oral herpes and we know you do because your have a history of cold sores. Sometimes the cold sore virus can move to other places on the head to recur.It simply travels along a slightly different nerve to get to the surface of the skin
It is correct that is is very unusual indeed to have HSV 1 in one location for a long time and then get it at a new location subsequently. We’ll see what the PCR says
Sometimes bacteria can cause these kinds of lesions – you might ask about a bacterial culture
None of what you described in question 4 has anything to do with herpes.
I don’t know what it is, sorry about that.

This is your final post on this subscription

Terri

[isitornot]

Hi Terri

Update on this..

I was given a home swab PCR test in Decemeber from the doctors after a visit there. I had what looked like an outbreak in February (kinda same as always looks) swabbed on the second day of outbreak (Sat AM) (I gave it a real dig around to make sure I got whatever was there), then dropped the sample off 3 days later at the docs(Tues AM, couldnt get there any earlier).

Got my results today, negative for both HSV1 and HSV2.

1..Would the timing of the swab or the 3-day window period before dropping off affect the sample at all?

2.. I don’t have much knowledge of PCR testing and it’s reliability, how should I take this result? Can I take this as fairly conclusive? I’ve had 2 swabs previously (don’t know if these were PCR or something else, suspect something else) and two IGGs (neg for HSV2, pos for HSV1 but had oral cold sores all my life, really high IGG score for HSV1).

3… Anything else I could do to close this episode in my life once and for all?

[Terri Warren]

1. No. The PCR is incredibly stable – we’ve had patients gather swabs at home and kept them for 2 months before running them and have gotten positives, so no worries there.
2. You should take this result as a negative.
3. the next step is just to start believing all the results you have obtained. Sometimes that is the hardest part for people – believing all their negative tests when they have made up their mind that they really do have herpes.

Terri

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