Possible False Positive?

[Kratt76]

On 02/02/22, I went to my gyn (Kaiser) because I had a small vaginal tear I wanted to have checked, just to ensure it was healing properly. (I’ve had similar tears in the past from sexual activity, as I have vaginal scar tissue from a surgery many years ago.) I’ve never had an STI or any symptoms of one. My last full STI panel was in October 2021 (all clear).

My gyn swabbed the tear, said she found traces of Bacterial Vaginosis, and sent me on my way with an antibiotic. A few days later, she called me to say she had also tested the swab for HSV and it came back positive for HSV-2. She put me on a 7-day course of antivirals and basically dismissed all of my follow-up questions about symptoms, concerns about transmission, etc.

The diagnosis didn’t make sense to me as I’ve only had 2 partners: one for 10+ years (last contact in August 2021) where I was his only sexual partner ever, and my current one that I’ve been active with since November 2021 and who’s never had any symptoms of HSV. Both were/are monogamous relationships. I have had no blisters/sores or any other typical HSV signs at all.

I went to an independent testing site (LabCorp) for an IgG test on 02/11/22. It came back negative. I did a second IgG test (as well as a full STI panel) on 03/02/22, which also came back negative.

Is there any possibility that the initial swab test was wrong, considering I have no typical symptoms and I don’t believe the tear was related (and I also had a bacterial infection at the swab site)? My only other guess is that the infection could be new since my blood tests are showing no antibodies and maybe I just haven’t developed them yet? But then that would mean my partner would have had to be engaging in outside activity, since I’ve been exclusively with this individual for over 4 months and if he was already infected at the beginning of our relationship, I surely would have had something happen before now?

I’ve ordered a Western blot test and am waiting for it to arrive.

[Terri Warren]

Has your most recent partner been tested?
It is possible that you are newly infected – just because you’ve been having sex with this person for four months, doesn’t mean that he was necessarily shedding virus at any point during that time period until recently.
It is also possible that the previous “tears” were also herpes and you just didn’t know it.
A false positive swab test from an area of skin that is open are very very rarely wrong.

Terri

[Kratt76]

Thank you for the reply.

My current partner has not been tested. He was ambivalent about it because either (1) he is the one who transmitted it to me, or (2) if I was already infected, he is assuming he either already has contracted it or will, since we only have unprotected sex. I’m fairly sure that if I do have it, it came from him. He’s never had any genital symptoms. He said he’s had cold sores (orally) in the past but not for a long time.

Is it normal for herpes to present as tears? I’ve never had blisters or sores. I’ve seen some references to a “paper cut” type of lesion, but the photos I’ve seen of them don’t match what mine looked like.

I also am now questioning some other odd symptoms I’ve been having that my gyn said are unrelated to my diagnosis, but now I’m unsure. Several days after my exam/swab, I started getting a deep pelvic pain. (I had no pain or other symptoms prior to the exam; just the one cut that only hurt when probed.) The pelvic pain feels like it is in my bones or deep in my muscles, not in my skin. I feel it mostly in my sit bone area, but also frequently in my anal/perineal area and occasionally near my labial area. That has now lasted over a full month, coming and going in severity but never fully resolving. In the last week or so, I’ve also started getting some intermittent itching in my labia/vaginal area, though the skin looks fine. I wondered if this was prodromal symptoms, but it has held steady (not getting better or worse) and no sores/lesions/etc. have popped up to follow it like I’ve been led to expect from most of the literature. My gyn said prodromal symptoms wouldn’t last this long and neither would an initial outbreak. My initial 7-day course of antivirals made no difference in the pelvic pain and my gyn will not Rx more without further “obvious” outbreaks. Do these symptoms sound herpes-relates, or could it be another issue? My gyn has ordered a pelvic ultrasound for next week to “give me peace of mind.”

[Terri Warren]

Pelvic pain is not a symptom of herpes. And genital itching can be present for any number of reasons. Your GYN is correct that program would not last as long as her symptoms have lasted. It is also significant that your seven day course of antiviral medicine has made no difference for your symptoms. When you ask about a tear, I am thinking of a Papercut type lesion but you’re saying that’s not what you had. I’m not sure where to go from here if your partner will not be tested. The only thing that I can think of is to retest using the IgG test about 6 to 8 weeks from the time that you had your first symptom.
Terri

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