Seroconversion time

[badtimeinmylife]

Hi Terri,

[Terri Warren]

I think you need to go back and try posting again. If you need help with that, please let me know.

Terri

[badtimeinmylife]

Found out last July that my partner tested positive for hsv2. I have a history of vaginal irritations. My gynecologist doesn’t see anything upon examinations and STDs are negative. He orders me nystatin/triamcinalone cream which resolves the problem. I started having irritation again in June/July 2014 and used the cream as I normally do, but this time it didn’t help, it actually burned a little bit. I was very concerned because it had always helped before. My boyfriend had been stating that he felt like his “jock itch” was coming back and that he usually uses antifungal spray which makes the rash/irritation go away, I didn’t really think much of it until one day he allowed me to look at his private and I saw the lesions and rash and I felt like it was herpes. He continued to use the spray and it cleared up. Just to be on the safe side, I asked him to get tested for STDs and herpes. His herpes test came back as “herpes simplex virus II-IgG- IgG detected. Evidence of antibody to herpes Simplex Virus II”. Other STDs negative. Stupidly, I did not wait to get either of our results back, thinking that since his skin was all clear, that maybe it was just jock itch. The last time we had sex was July 27th, and he got his positive test results on July 28th. The first test that I did was July 23, 2014. HSV 1 IgG Type Specific 56.80 high. (I’m almost certain that I have a history of cold sores but I can’t remember having them as an adult, if so, it was so long that I can’t remember). HSV 2 IgG type specific <0.91. Both IgMs type specific were <1:10 negative. These were my baseline tests. As a follow-up, I tested again on 11/13/14. Results were HSV Type 2-Specific Ab, IgG <0.91. IgM I/II Combination came back as 1.02 equivocal. They couldn’t tell me which type herpes triggered the equivocal since it wasn’t type specific. They retested that same blood, since the lab still had it, and both came back at <1:10 negative. I retested again on 1/26/2015 and my results were HSV 2 IgG Type Spec <0.91 negative, but the index value is 0.00-0.90. I am still having vaginal irritations such as stinging, burning, itchy, crawly feelings in my pubic area, and this has been going on since June/ July of last year, almost constant. Sometimes my vaginal area also feels irritated. The sensations may go away for a few days or a week, but they come back making me think that I do have herpes, but have not seroconverted. Most of the time when I examine, I see nothing, but I have in the past noticed a tear near my perineum and one small circular rash on my labia and another small rash near my perineum, not all present at the same time. I haven’t gotten the blisters, but I do get single pimples and stingy feelings on my buttocks and this also has been going on since last year. I have just read on the forum where one person was (-) at 3 months and now tests (+) and another who didn’t test (+) until 9th month. What do you think of my symptoms/test results/seroconversion? So confused!

[Terri Warren]

You read on this forum that someone didn’t seroconvert until 9 months after exposure?? Are you sure? I find these comments by individuals difficult to sort out. Did they take antiviral therapy? Was their positive a low positive? in which case was it confirmed by western blot? Was it HSV 1 for which the test is pretty poor and might miss it the first time but would get it the next time? It’s just too hard to make sense of what some random person says on the internet.

The HSV 2 antibody test that is commonly used for screening picks up about 97% of infections, according to the label, so I think the chances that it missed your infection is pretty low but if you really want to be certain you can have the western blot done. our clinic can order that for you to be drawn at a lab near you. It has been almost a year since the encounter that you describe and I think you could count on the results of testing now.

Terri

[badtimeinmylife]

I learned about the internet the hard way and now I exclusively read your forum. I have learned a lot about herpes through it, but I still have questions about my situation. I’m hoping that it is ok to refer to other posters since their identity is anonymous. The two posters that I was referring to in my first post are blackbowl and Miami1974. Both posters tested positive for hsv2. Neither mentioned ever being on suppressive therapy. Just a little history if I recall correctly…blackbowl just tested positive for hsv2 in June by a positive culture. She tested negative on a blood test on 3/5 and still negative on a blood test on 6/5 which is 3 months past her possible exposure. She has only been in her current relationship for < 6 weeks and her partner tests negative for hsv2 antibodies. Both of them may have recently been exposed, but I gather from her posts that that is unlikely and the question basically was why she hadn’t seroconverted by 3 months. With Miami1974, he had a possible exposure 9 months ago and has been testing negative for antibodies every 3 months, including the 6 month test, but he now has tested low positive of 2.3 at the 9 month test. His only other possible exposure was when he rubbed his penis against the vulva of another female in March (3 months ago). From what I am gathering, that one time encounter with the rubbing of his penis was very low risk, so it leaves the question of him taking from 6-9 months to seroconvert. I am not trying to invade their privacy by any means whatsoever, and if either are reading my post, I’m just trying to figure out what’s going on with me. These are my questions.
1. Is the 3-4 month waiting period still accurate, or are you seeing more cases that take longer to seroconvert even without antiviral therapy?
2. Based on what I have told you about my symptoms and results, do you think that it’s just taking me a long time to seroconvert, or do you believe the negative results are truly negative at 6 months post possible exposure? I have not taken any antivirals, but I still have the irritations, burning, stinging, itching or something going on down there almost all of the time.
3. What do you think of my very high HSV1 results of 56.8…they are extremely high…like off the roof high. I know that having HSV1 can delay seroconversion, but could my HSV1 infection cause my seroconversion to be longer than 6 months, based on what you know personally?
4. Do you have any other suggestions or comments about testing other than the Western Blot. My sister works for Quest and I understand HIPPA and all of that, but I can’t risk the chance of testing positive for herpes and her finding out from snooping around.
5. What do you think of my symptoms. They are definitely not the classical type, but I know that you can have atypical symptoms or no symptoms at all. Does this sound like herpes?
6. Will you please not count my first post of “Hi Terry”…please please. Lastly, thanks for your help!

[Terri Warren]

1. Is the 3-4 month waiting period still accurate, or are you seeing more cases that take longer to seroconvert even without antiviral therapy?
I’m not seeing more cases of delayed seroconversion, no, only with antiviral therapy.

2. Based on what I have told you about my symptoms and results, do you think that it’s just taking me a long time to seroconvert, or do you believe the negative results are truly negative at 6 months post possible exposure? I have not taken any antivirals, but I still have the irritations, burning, stinging, itching or something going on down there almost all of the time.

I would say the overwhelming probability is that you are truly negative. Herpes symptoms are not constant like you are describing yours to be.

3. What do you think of my very high HSV1 results of 56.8…they are extremely high…like off the roof high. I know that having HSV1 can delay seroconversion, but could my HSV1 infection cause my seroconversion to be longer than 6 months, based on what you know personally?

Yes, it is high but other than that it has no meaning except that your immune system is working great! I seriously doubt that you have delayed seroversion to HSV 2.

4. Do you have any other suggestions or comments about testing other than the Western Blot. My sister works for Quest and I understand HIPPA and all of that, but I can’t risk the chance of testing positive for herpes and her finding out from snooping around.

Hmmm. I believe we can work around this. Please set up a phone consultation with me to talk about this.

5. What do you think of my symptoms. They are definitely not the classical type, but I know that you can have atypical symptoms or no symptoms at all. Does this sound like herpes?

No.

6. Will you please not count my first post of “Hi Terry”…please please. Lastly, thanks for your help!

LOL, yes, I won’t count that.

Terri

[badtimeinmylife]

Hi Terri,
I am trying very hard to convince myself to move on and accept the fact that all of my tests were accurate for being negative for hsv2, but I guess with telling myself for almost a year that I contracted herpes from my ex who has genital hsv2, it’s been much harder to move on than I thought. I am not trying to convince myself that I have hsv2. but I do have some other questions. Last year I had an open ulcer to develop on the outside of my right pinky finger. It was not on my cuticle, but was right at the first joint from my cuticle. When I saw it, I didn’t get overly concerned until I was doing some reading about herpes and came across herpetic whitlow. I first begin to think that I might have caught herpes in July and I noticed the ulcer on my finger in September (I think), so I’m thinking that auto-innoculation was a possibility at that time. The ulcer healed leaving a white colored circular spot on my finger that will become tender every now and then, but doesn’t blister up. I can’t say for sure that it initially blistered last year. The reason herpetic whitlow and herpes is on my mind now is because I have developed a rash on my right wrist that itched really bad. I looked at it very closely and it had some tiny blisters. I first noticed this on Thursday, and today it seems to be almost gone although it did itch just a little bit this morning. In addition, my third finger is developing a white streak at the first joint, and it is a little tender, similar to my pinky finger.
1. Do you think that this rash on my wrist may be an outbreak associated with herpes or herpatic whitlow
2. I read that herpetic whitlow can return on any other finger, and not just the initial site of where if first occurred, but does herpatic whitlow effect any parts of the body other than the fingers, if so what parts
3. Does this white streaking and tenderness to my third finger sound like the beginning of herpetic whitlow.
4. Where do herpes outbreaks occur other than the boxer shorts area, or mouth/face, and fingers of course.

I guess that I’m really concerned about where outbreaks can occur.

I think that this is my last question on this subscription and I will have to renew for additional questions.

Thanks for your help.

[Terri Warren]

1. Do you think that this rash on my wrist may be an outbreak associated with herpes or herpatic whitlow
No, I don’t think so. Was it under a watch or a bracelet? Have you been outside where you might have come into contact with a plant allergen or a group of insects?

2. I read that herpetic whitlow can return on any other finger, and not just the initial site of where if first occurred, but does herpatic whitlow effect any parts of the body other than the fingers, if so what parts

I have seen herpetic whitlow on many surfaces of the hand, but I would say that most common place that I see it is on the part of the finer that is just below the first joint away from the tip of the finger.

3. Does this white streaking and tenderness to my third finger sound like the beginning of herpetic whitlow.

Nope.
4. Where do herpes outbreaks occur other than the boxer shorts area, or mouth/face, and fingers of course.

The vast majority of outbreaks are in those locations. I have seen a herpes outbreak on the arm and of course we see them on the breast (mouth to nipple contact). And then whitlow on the hand. I’ve also seen them in various locations on the body of wrestlers (herpes gladitorium).

Terri

[badtimeinmylife]

Hi Terri,

1.I have requested PCR swabs to try and see if this recent irritation to my mouth is HSV 2. I do have oral HSV1 but I believe this may be HSV2. If I do not have an irritated area on my lips or on the inside of my mouth at the time I do the swabbing, will the test still be accurate, or will I have to wait until I feel an area of irritation to do the swabbing?

2. I haven’t developed full blown cold sores, but I do have some barely noticeable raised bumps, not fluid filled on my lips. Am I able to swab those dry areas, or does fluid need to be present.

3. If this is an initial hsv2 oral outbreak, what is the recommended dosage of antiviral medication to take for this outbreak and future outbreaks? And what is the recommended dosage for suppression?

4. How long will it take to receive the results of the PCR testing?

5. How does it normally work when one of your patients tests positive for HSV2 and need a prescription for treatment?

6. Do you do IGG testing for HSV2 or do you just do the Western Blot? If you do the regular IGG testing, is it the same process as with the Western Blot?

7. I’m confused about HSV1 transmission. I think that I have read that oral hsv1 is passed on through intimate kissing, french kissing and not casual pecks or kisses, but I have also read that a lot of people acquire HSV1 during childhood. Will you please clarify this for me?

Thanks for your time.

[Terri Warren]

1. If you are going to do swabbing, I would wait until your have a symptom to be swabbed.
2. You can swab anything – there does not need to be a specific sore to have swabbing done
3. Treatment for first episode HSV 2 is 1 gram twice a day for 7-14 days. The recommended dose for suppression is 500-1000 mg per day. Outbreak treatment is 500 mg twice a day for three days.
4. Just a few days after the specimen is received
5. If they are not an in person clinic patient, they will need to go through their regular provider to get a prescription
6. We have both available in our clinic. I’m not sure if you are talking about Portland or someplace else. You can order your own IgG test on line.
7. HSV 1 can be transmitted orally through deep and passionate kissing and not casual pecks, with or without symptoms. But it an also be transmitted when sores are present to children from adults.

Terri

[badtimeinmylife]

Hi Terri,
I have received my swabs from your office for PCR testing. I have a couple of questions.

I bit my l lip a couple of days ago, and since I am trying to stop worrying about every single thing on my lip being herpes, I did not look at my lip because I knew that my cut and irritation was from the bite. I did however, just examine my lip and I noticed a white bumpy area on my lip, not too far from the bite. This could have been there forever, I don’t know.

1. Since I do not know how long that bumpy area has been there, and since it is not irritated or bothering me, would you advise me to swab that area or would you suggest waiting until I actually feel a new site of irritation? I just want to swab when its most appropriate.

2. I think that I understand that if an area has swabbed over, then it is too late to do a swab. What is the timeframe from possibly noticing irritation to actually doing the swabbing in order for the PCR test to be accurate?

3. I received 3 vials for the swabbing, and I would like to swab three different areas if they are present. Is each swab test priced separately, or are the 3 vials one price?

4. Is treatment for HSV1 and HSV2 the same? if not, what is the recommended treatment for HSV1?

Thanks

[Terri Warren]

I would wait until you actually feel irritation to swab
It is not too late to swab with PCR even if it is scabbed over.
Swab with a different vial each location.
The treatment can be the same, yes

Terri

[badtimeinmylife]

Hi Terri,
I understand that once you have an established hsv2 genital infection, you are immuned to acquiring an hsv2 oral infection, but lets just say that it did happen.

1. If I already had hsv2 genitally and later aquired hsv2 orally, would that new oral hsv2 infection, since it is at a new site be considered a first episode? Or if I already had hsv2 gentially, would the newly acquired oral hsv2 infection be considered an outbreak, as far as treatment goes?

2. Is valtrex better than acyclovir? If so, can you please explain?

3. I know what the recommended dose is for acyclovir, but what is the recommended dose for valtrex in the treatment of hsv2 infections?

4. If a person has hsv2 orally and genitally, would an oral outbreak trigger a genital outbreak, and will a genital outbreak trigger an oral outbreak, since they are both hsv2?

This is my last post in this subscription. Hopefully this concludes all of my questions….but probably not.

Thanks

[Terri Warren]

1. If I already had hsv2 genitally and later aquired hsv2 orally, would that new oral hsv2 infection, since it is at a new site be considered a first episode? Or if I already had hsv2 gentially, would the newly acquired oral hsv2 infection be considered an outbreak, as far as treatment goes?

This wouldn’t happen, so there is technically no name for that happening. I would treat such a thing as a recurrence.

2. Is valtrex better than acyclovir? If so, can you please explain?

No, studies have shown that the two drugs, taken as directed, are equally effective.

3. I know what the recommended dose is for acyclovir, but what is the recommended dose for valtrex in the treatment of hsv2 infections?

Suppressive treatment with Valtrex is 500-1000 mg daily, once a day
Episodic treatment of outbreaks is 500 mg twice a day for three days.
New infection would be 1 gram of Valtrex twice a day for 7-14 days

4. If a person has hsv2 orally and genitally, would an oral outbreak trigger a genital outbreak, and will a genital outbreak trigger an oral outbreak, since they are both hsv2?

No, but if someone acquired HSV 2 orally and genitally at the same time (which is how that would happen if it happened at all), then a person could have recurrence of both at the same time, but an outbreak of one would not “trigger” an outbreak of the other, they just may occur at the same time due to some dip in the immune response.

Terri

[badtimeinmylife]

Hi Terri,

I think that I am one of your atypical cases. For over a year, I felt that I had contracted genital herpes from my boyfriend. I did not have the classical presentation of sores and lesions, but I had the areas of irritation to the vaginal, rectal and perineal areas. If I wasn’t experiencing those symptoms, I was having stinging, burning sensations in my pubic area. These sensations were almost constant for months and months. There was not a day that went by that I didn’t have some type of odd sensation down there. It was a daily nightmare/reminder. I know that research says that herpes doesn’t behave this way, that its intermittent, but I knew that something was wrong, and I got tested over and over again, and all IGG tests for HSV2 came back negative, even the one that I took just 2 weeks ago was negative, and this was one year after possible exposure. I decided to get the Western Blot from your clinic and it came back positive for HSV2. After receiving my Western Blot test results, I decided to get on treatment. I have a prescription for valacyclovir 1gm bid for 10 days and then 1 gm qd for suppressive therapy. I am on day 6 of the 1 gm bid.

It is my understanding that since I have HSV2 genitallly, and have had it for over a year, that I would be immuned to getting it orally. I just started treatment with valacyclovir 6 days ago, but in June, I performed oral sex on my current partner. I felt a rough area on the tip of his penis and immediately stopped performing oral sex. Almost two weeks later, I started to have oral symptoms, which I believe is HSV2. I have what I think is a sore on the bottom of my gum. It is painless, and I wouldn’t have known it was there if I weren’t intentionally looking. I have daily burning of my gums and lips and a clear fluid blister on the inside of my cheek that goes away, but keeps coming back. My hard palate, towards the front of my mouth is rough and burns, and little areas of irritation are recurring mostly to the inside of my top lip. I have these little itchy barely visible bumps above my lip, on my forehead, and on the front part of my scalp. I also have the sensation at times that something is stuck in my throat, which I now believe is probably a blister. I honestly think that I have hsv2 orally. This is baffling considering what research says about being immuned after 4 months. I also understand that hsv2 orally wouldn’t last this long, and wouldn’t be a constant sensation, but that is how my genital herpes presented itself (constantly). Here are my questions.

1. I have been on valacyclovir 1gm bid for 6 days, and my oral symptoms have not subsided, and have shown no signs of improvement. As I type these questions my lips, palate and gums are burning, and I have an intact clear fluid blister on the inside of my left cheek that goes away and comes back, but is currently present. These symptoms have been present for a very long time, weeks and weeks, but did not start until that encounter of oral sex.
My question is ….With me being on this medication, shouldn’t I be feeling some type of symptom relief by now from my oral symptoms. The clear fluid blister is what’s really pushing me to believe that this is HSV2.

2. Since being on the valacyclovir, I have had a genital outbreak, but again for me, they are not typical sores, but areas of open irritation to my labia, and tingling in my pubic area. With me being on valacyclovir, I don’t understand why things aren’t clearing up instead of me having more genital outbreaks. Is this normal?

3. Since I am not seroconverting by IGG, does that mean that my body is not building up antibodies the way that it should, therefore, I may have contracted oral HSV2 even though my initial genital infection was over a year ago?

4. How long does it take the medication to work. Should I have began to feel some relief by now either orally or genitally?

Thanks

[Terri Warren]

I know you have been concerned about having HSV 2 orally. The way to sort this out is to have these areas of irritation swab tested by PCR. Have you done those swabs? I can’t recall but I so. If you are taking medicine, it may cause these swabs to be falsely negative. The lack of recognition of your antibody by ELISA is about the TEST not about you. The western blot got it so they are definitely there. I do believe that if you have HSV 2 genitally that you are not having new HSV 2 oral infection. The trouble here is we have no positive swab from either your mouth or you genitals and that would tell us where the infection really is. I think if the medicine was going to work for you, it likely would be working by now but some people do take a little longer than others to respond. Give it a few weeks to see what will happen. And if you aren’t doing swabs and I got that mixed up, I think you should consider doing that.

Terri

[badtimeinmylife]

Even though I have not done genital swab testing, I’m certain that I definitely have genital hsv2. It was the genital symptoms that initially caused me to get tested over a year ago, and my oral symptoms just started in July and have been pretty much constant since then.

I have done PCR swab testing of the inside of my nose (because it was always burning on the inside), my lips (due to dry cracked lips) and my finger that was peeling some skin. All of those tests came back negative for hsv1 and 2.

I just sent in 3 more swabs, and you received them Tuesday, and I am currently waiting on those results. I swabbed my gums, because they burn. I swabbed my hard palate because it has been tender and burning. I also swabbed a clear fluid blister that was on the inside of my cheek.

I think that these results will be more accurate than the first set of swabs that I sent in because I know that I was having active irritation at the time. I think that this last set of swabs will give me the answer that I need.

I was not on valacyclovir either time that I did the swab testing. I started the medication after I collected all of the swabs.

I am a little, well a lot concerned about your statement that IF the medication was going to work for me, then it would likely be working by now. Does this medication sometimes not work? Have you come across a case where valacyclovir doesn’t work, and if so, what else is there to do. I have read that acyclovir and valacyclovir are almost the same, with valacyclovir having a slight edge over acyclovir. If I am already using the best medication that I can, what else am I to do???

I’m at a lost.

[Terri Warren]

I should have been clearer about what I meant there – I meant actually IF your symptoms are herpes, then it would likely be working by now. There is always the possibility that these are NOT herpes symptoms, you know. I believe we’ve talked about the fact that infection orally after genital infection is highly unlikely and if you are worried that the medication is not working because you still have oral symptoms, I think the logical explanation from many points of view is that what you are dealing with isn’t herpes. Obviously, I can’t be certain about this. We’ll know more when we get your swabs back. Shouldn’t be long now.

Terri

[badtimeinmylife]

Good evening Ms Warren,

Thank you for communicating with me earlier today. I will resume my questions here on the forum. I hope that you remember me. I’m the one who believes that she has newly acquired oral HSV2 despite having acquired genital acquired herpes over a year ago.

Before I go any further, I would like for you to know that it is truly amazing to me how much time, heart and soul that you put into trying to help us that are wondering if we have HSV2 and for those of us who know that we have HSV2 and are just looking for answers from an expert…Thank you so much. I would truly be lost without you!!! And you may not understand the debts of what I mean when I make that comment.

Here are my questions from our last correspondence:

1. When you state that you do like the 500mg twice a day dosing when people are not suppressing with the 1 gm daily, do you mean that that you like the acylcoovir 500mg twice daily or the valacyclovir 500mg twice daily?

2. This is embarrassing, but since learning of my HSV2 diagnosis,, I drink alcohol every day…not a day missed. I’m not drinking hard liquor, but I drink some type of alcoholic beverage every single day…mostly Clubtails which contain about 10% alcohol peer can (I’ll drink one or two) and on a bad day, I will drink a Margarita or two, whatever it takes to calm my nerves. I know how you feel about irrational thinking and behaviors which may be considered obsessive, and your thoughts on behavioral counseling, BUT, as far as you know, does alcohol have any effects on the effectiveness of valacyclovir. As I have mentioned, my symptoms have not improved at all since being on the valacyclovir, orally or genitally, but the diagnosis of HSV2 is definite. I woke up this morning feeling wonderful, and I had convinced myself that the valacyclovir had magically started working overnight because I didn’t have any discomforts when I woke up, but as the morning and hours passed, the oral burning , along with genital discomforts that I thought had gone away, came back with a vengeance….and I was thinking positively, and not anxious, so I know that this is not an anxiety thing that is causing these symptoms. What do you think about the alcohol? I know that alcohol in and of itself is not the answer and can cause a whole new set of health problems for me, but does it interfere with the effectiveness of the medication????

3. I have scheduled an appointment with the dentist for Thursday, and I will see if he can offer any answers as to what it might be that’s causing all of these oral discomforts (which didn’t start until after the oral sex encounter). I’m not sure if I am going to tell him about the oral sex because that’s just not something that you can just talk about, and not feel somewhat nasty about. But hopefully he can do an inspection and give me his opinion. Besides herpes, do you have any idea of what could be causing this burning of my lips and gums, these small bumps that have been on my top lip for at least a month (inner lip…not top of lip), this clear fluid filled blister that comes and goes consistently to my left cheek, and severely chapped lips that have been present since July??

I don’t have any further questions at this time, and I know that I will need to re-subscribe for additional questions.I have accepted this diagnosis, but my mental state would be a whole lot better if I didn’t have to deal with these symptoms everyday. Any advice with getting these symptoms/outbreaks under control would be greatly appreciated.

Again,
Thank you!!

[Terri Warren]

1. Sorry, valacylovir. Acyclovir comes in 400 mg and 200 and 800 mg.
2. Alcohol does not interfere with these medicines in any way, not at all. I laughed a little when I read that you have drunk alcohol every day since your diagnosis – I thought to myself, I’ve drunk wine every day since your diagnosis too! we are in the wine regions of New Zealand. Sorry, I know this isn’t funny.
3. People forget that when they have a close physical encounter with someone else (oral sex or intercourse) that there are other germs involved that they might have that you don’t – staph, strep – things like that. I think its a good idea to see your dentist but they may not have too many ideas – we shall see. Good thing to schedule that appointment.

Terri

[badtimeinmylife]

Hi Terri,
Your last post about the alcohol was really funny. It literally made me laugh out loud…..hadn’t done that in a long time.
You were right about the dentist. He was not able to provide me any information on my oral discomforts, and they do not do throat swabs for streph.

Unfortunately 2 days after the appointment, I had felt what I thought were blisters on the roof of my mouth, on that hard lump towards the back. When I got home, I took a light and looked in my mouth at the areas and saw about 3 small scabbed over areas. One had a red base, but I wasn’t able to see the other two as clearly.
They didn’t itch or tingle, but were sensitive and irritated when drinking. The following day, I didn’t feel the scabbed over areas anymore and when I looked in the mirror, the scabs were gone, but the area looked dark purple, almost the color of a bruise. This morning, there is a very faint discoloration., hardly anything present and no discomforts.

1.Does this sound like herpes?? If not, what would be your best guess?

I plan to go to the doctor to see if this tingling, burning, itching, stinging and areas of irritation could be related to anything besides herpes. I have tested negative for chlamydia, gonorrhea, trichomonas, bacterial vaginosis, and yeast.

2 .What else is there to test for that is causing these genital and oral symptoms that I mentioned above….besides staph and strep? And what I read about staph doesn’t really fit my symptoms, I don’t think.
I will ask the doctor to check for staph infection, but since my issues are on my pubic area, and external, how would that be cultured? Is the procedure to swab externally on my pubic area, or is this an internal swab, although the symptoms are external?

3 What type of doctor do you think is best to go to…a gynecologist or a dermatologist? Do dermatologist look at the vagina, pubic and perineal areas? or just stick with the gynecologist. What do you think?

I have been on valacyclovir 1gm bid x14 days, then 1gm bid x4 days, and 500mg bid x 4 days… today will be my 5th day on 500mg bid. I’m still having the same symptoms orally, genitally, and the inside of my nose burns like crazy….lots of boogers too.

4 Can I up the dosage and give it a bang to see if it will knock out these symptoms that have been going on since last year for the genital, and for the last two months with the oral? And if I can up the dosage, what would you recommend and for how long. I plan to continue daily suppressive therapy of 500mg bid for while longer, even though I think it should have worked by now.

4. Have you ever had anyone that just didn’t respond to the antiviral medication, and if so, what did they do to get rid of the symptoms or reduce the number of outbreaks. What else can be done???

Any help would be greatly appreciated!!!!

[Terri Warren]

This does not sound like herpes to me, no
I have definitely seen both staph and strep cause symptoms of this kind in the genital tract.
swabs would be most beneficial if they were a combination of internal and external collection
Upping the dose is something that is up to you and your doc. If you were my patient and had taken all of that and didn’t respond, I would tell you that I didn’t think your symptoms were herpetic and that a higher dose would be unlikely to help and if you did take that and the symptoms were better, it might be just because whatever caused it was getting better for some other reason.

I have not had a patient not respond at all to herpes medication if their symptoms were indeed herpetic in origin.

Terri

[badtimeinmylife]

Hi Terri,

This is my last post on this subscription, ironically even though my issues of almost constant symptoms have not resolved, either genitally or orally, I am at a lost, and have almost ran out of questions. I did go back to my gynecologist and she would not do any type of testing for strep or staph stating that these bacteria normally exist on the skin and to test would be of no benefit. She did however give me a new prescription for valacylovir 500mg bid. I have been on this dosing for almost a week, and no improvement as of yet. I actually have genital tearing/abrasions/irritations at the present moment and have had the pubic area stinging and itching all week.

So……I have been on valacyclovir for almost a month but I have no relief of my symptoms. I know that you have stated that if the medication isn’t working, then it may be that my symptoms are not related to herpes. I just read that although rare, a number of strains of HSV are resistant to acyclovir, valacyclovir, and famvir. Maybe my symptoms are related to herpes and the valacylovir that I am taking is resistant to the strain of HSV that I have.

Here are my questions:

1. How do I go about finding out if the strain of HSV2 that I have is resistant to these medications? (all of my IGG tests have been negative, even the one that I took 14 months past being exposed…so if the IGG test is negative then I’m thinking that this route would not show if I am resistive to these meds since it doesn’t even identify the infection. I did do the Western Blot through your clinic at the end of July which is what identified the infection. Can further tests be ran through the Western Blot technique to find out if the strain of herpes that I have is resistive to these meds?

2.If not through the Western Blot technique, how do I find out if I have one of the strains of HSV that are resistant to these drugs? This is so important to me

3. Are there any effective alternative/homeopathic treatments that you know of that are good at reducing genital or oral outbreak….any vitamins, herbs, etc.

At this point, it seems that I am a lost cause. I have done all that I know to do..

Any additional advice/information would be greatly appreciated

[Terri Warren]

1. How do I go about finding out if the strain of HSV2 that I have is resistant to these medications? (all of my IGG tests have been negative, even the one that I took 14 months past being exposed…so if the IGG test is negative then I’m thinking that this route would not show if I am resistive to these meds since it doesn’t even identify the infection. I did do the Western Blot through your clinic at the end of July which is what identified the infection. Can further tests be ran through the Western Blot technique to find out if the strain of herpes that I have is resistive to these meds?

In order to look for resistance, you need a positive culture from a lesion to do that. The very best way to do that is to not be taking medicine as that can impact whether the culture is positive or not.

2.If not through the Western Blot technique, how do I find out if I have one of the strains of HSV that are resistant to these drugs? This is so important to me

I know it is, but you need VIRUS to look for resistance, not antibody

3. Are there any effective alternative/homeopathic treatments that you know of that are good at reducing genital or oral outbreak….any vitamins, herbs, etc.

There are not any of these things that have been proven to aid with herpes symptoms.

At this point, it seems that I am a lost cause. I have done all that I know to do..

Any additional advice/information would be greatly appreciated

I know you are so frustrated. I would disagree with your doctor that all staph and strep strains are normal in that area. I have seen patients who have herpes-like symptoms who actually grew out pathogenic staph or strep that could be treated with antibiotics and the symptoms resolved completely. Perhaps a dermatologist?

Terri

[badtimeinmylife]

Ms. Warren,

I have some swabs from your clinic for PCR testing. I plan on coming off of the valacyclovir for at least 7 days before swabbing what I suspect to be outbreaks. I know that you have told me many times over that maybe the reason that I am not responding to the valacyclovir is that my symptoms are not due to herpes, so please don’t think that I am not hearing you. I have scheduled an appointment with a dermatologist, but they can’t see me until the 14th. My gynecologist dismisses the fact that I could have a staph or streph infection and would not do any testing, and if the dermatologist dismisses me and refuses to test me, I really don’t know what I am going to do. I am going to be devastated. I have accepted the fact that I have HSV2, but it is a daily torment to be on a medication and to continue to have the constant symptoms that I do. I feel like a leaper, not because of the diagnosis anymore, but the fact that I can’t get any relief from my symptoms, and I am afraid that I am always contagious.

1. How do I know when I am or am not contagious since I am always having symptoms, both genitally and orally???

2. I have been doing some research about groups of people who may be resistant to hsv2 meds, however, I am HIV negative. I have had two partners in the last 4 years and they also both test negative for HIV. If the swabs test positive for the HSV2 virus, will you be able to order additional testing of the swabs to see if I am resistant to the valacyclovir???

Maybe I am just not responding to the generic version, and need the brand name. I have read where people were doing fine with the brand name Valtrex, but when put on the generic version, they started to have breakouts. But on the other hand, I have also read that the generic version has worked well for others. I just don’t know!!! I am now on valacyclovir 500mg bid with no help. I have priced the brand Valtrex, and I can’t afford it. It was like $600 for a month’s supply.

3. I have read of a lot of people having issues with the generic mylan (not sure if I spelled that correctly), but I am on generic actavis. Is there a generic maker that you know of that has good results with their valacyclovir?

4. Maybe I should try acyclovir 400mg bid. Do you think that it might work better for me??

I don’t know what other questions to ask, I just need help and guidance.

[Terri Warren]

1. How do I know when I am or am not contagious since I am always having symptoms, both genitally and orally???

Let’s see how the swabs turn out before I answer that, Ok?

2. I have been doing some research about groups of people who may be resistant to hsv2 meds, however, I am HIV negative. I have had two partners in the last 4 years and they also both test negative for HIV. If the swabs test positive for the HSV2 virus, will you be able to order additional testing of the swabs to see if I am resistant to the valacyclovir???

No, we will do PCR testing from the swabs, not culture. You need a culture to do resistance testing. If the PCR swabs are positive then I would recommend that you stay off the meds and let your regular clinician do a culture (which we would expect to be positive) and then do resistance testing on that.

Maybe I am just not responding to the generic version, and need the brand name. I have read where people were doing fine with the brand name Valtrex, but when put on the generic version, they started to have breakouts. But on the other hand, I have also read that the generic version has worked well for others. I just don’t know!!! I am now on valacyclovir 500mg bid with no help. I have priced the brand Valtrex, and I can’t afford it. It was like $600 for a month’s supply.

Research suggests that acyclovir 400 mg twice daily is as effective as Valtrex. Have you considered that instead?

3. I have read of a lot of people having issues with the generic mylan (not sure if I spelled that correctly), but I am on generic actavis. Is there a generic maker that you know of that has good results with their valacyclovir?

No. There are no generics that I know of that are better or worse

4. Maybe I should try acyclovir 400mg bid. Do you think that it might work better for me??

There you go! I do think you should consider this, yes, definitely, but let’s see what the PCR swabs show first.

Terri

[badtimeinmylife]

Hi Terri,
It was my intention to get off the valacyclovir until my appointment with the dermatologist so that cultures could be done to see if I have a staph or strep infection which may be causing me to have these continual symptoms, or to see if virus was present on the culture so that I could find out if I had resistance to the medications. I have been off the valacyclovir for only a couple of days. Yesterday I felt Ok…no overwhelming discomforts, but today has been a miserable day of oral and genital discomforts. I was going to try to start acyclovir after all of the additional testing was done, but I had to call my doctor today and go ahead and request the acyclovir, so now I have switched over and I am praying to God that this acyclovir will help me.

1. Considering my history of symptoms, how much do you think I should take initially? I’m thinking that I need more than the suppressive dosage of 400mg bid, but what do you think?

2. Since my symptoms are so widespread, does this sound like I may have a disseminated infection, and if so, is there a different treatment, or is the treatment all the same?

3. I just read on one of the drug pages for acyclovir that acyclovir is the oldest drug used for the treatment of herpes, but that research shows that it is not as effective as it used to be. I could have pooped in my pants when I read that, and I definitely stopped trying to do anymore research…..BUT, is it true about acyclovir not being as effective as it used to be?

4. To make sure that I understand your answer in the last post, are you saying that a PCR test detects antibodies and not virus, therefore a PCR test could not show if I were resistant to a medication.

5 Also, is a PCR a culture??

6. Are you saying that I just need a regular culture, and from that regular culture, if virus is detected, that’s when additional testing can be done to see if I am resistant to the medications?

7. Don’t cultures miss a high number of infections?? If so, isn’t this going to be hard to test my resistance if the test misses a lot of the infections? I may never find answers.

This is exhausting in so many ways. Thanks for your help.

[Terri Warren]

1. Considering my history of symptoms, how much do you think I should take initially? I’m thinking that I need more than the suppressive dosage of 400mg bid, but what do you think?

I do not think you should take more than the usual dose, no, because I am not at all clear your symptoms are herpetic. Have you not received all negative swab results? I’m not in the office so don’t know for sure.

2. Since my symptoms are so widespread, does this sound like I may have a disseminated infection, and if so, is there a different treatment, or is the treatment all the same?

I definitely do not believe you have disseminated herpes!

3. I just read on one of the drug pages for acyclovir that acyclovir is the oldest drug used for the treatment of herpes, but that research shows that it is not as effective as it used to be. I could have pooped in my pants when I read that, and I definitely stopped trying to do anymore research…..BUT, is it true about acyclovir not being as effective as it used to be?

No, that is not true. According to my most recent article, the rate of resistance to acyclovir remains steady and is not different between people who have taken meds and those who have not. May I ask for the citation to which you refer?

No, PCR detects virus particles but you have to have GROWING virus, which happens in a culture, to test for resistance.
No, a culture is a culture and a PCR is a PCR. They are both swab tests, if that what you are asking

6. Are you saying that I just need a regular culture, and from that regular culture, if virus is detected, that’s when additional testing can be done to see if I am resistant to the medications?
Yes, that is what I am saying

Cultures are not as sensitive as PCR correct but that’s what you need to test for resistance so you need to hope that you have a great outbreak for a positive culture.

terri

[badtimeinmylife]

Yes, I have done PCR cultures orally before starting treatment and they all came back negative, however there seems to be variation in accuracy of PCR testing with timing it just right, until I”m not sure that the results are accurate. One thing that is for certain with me is that when things get bad for me in the genital area, they also get bad orally, leading me to believe even more so that I have HSV2 orally and genitally. The site that I was on that stated that acyclovir is not as effective as it used to be is everydayhealth/drugs/acyclovir.
1. While you were away, did you find out any new information on the treatment of HSV2. I have been on valacyclovir and I am currently on acyclovir, neither of which are helping, and I feel I am currently having an oral and genital outbreak, triggered by protected vaginal sex last night, no oral. Other than my symptoms not being related to HSV2, why am I not responding to treatment?
2. If this is not HSV2 related, doesn’t the fact that both my oral and genital symptoms flared up this morning following sexual intercourse lead you to believe that my symptoms are HSV2 related?
3. I had a small red area on my hand that I noticed yesterday. about the size of an eraser or smaller. I rubbed my hands in alcohol hand sanitizer, and it didn’t sting so I didn’t think much about it, but later that evening, it looked like it had a couple of very minute blisters. I again rubbed it with alcohol, and it didn’t sting. I covered the area with a bandaid and today it is brown, with maybe dried blisters (hard to say, .still doesn’t sting when alcohol/sanitizer applied). I didn’t have the bandaid on yesterday when I picked up the baby, but if this was an HSV2 area, could I have passed the virus to the baby by picking her up? If no, why not?? I am sure that I had herpatic whitlow on my pinky finger last year, that’s why I am wondering about this area and transmitting HSV2 to her. It seems herpes travels nerve roots and can end up anywhere.

[Terri Warren]

Yes, I have done PCR cultures orally before starting treatment and they all came back negative, however there seems to be variation in accuracy of PCR testing with timing it just right, until I”m not sure that the results are accurate.

I don’t know what you are talking about here – can you clarify please?

The site that I was on that stated that acyclovir is not as effective as it used to be is everydayhealth/drugs/acyclovir.
I don’t know where they get their information but the scientific literature indicates that there is less than 0.3% of samples resistant to acyclovir and there are equal numbers of people in both treated and untreated groups, suggesting that resistance does not have to do with treatment or lack of treatment. Perhaps you could get them to cite their reference on this. I don’t use lay websites for my medical information and even most medical websites when it comes to herpes.

1. While you were away, did you find out any new information on the treatment of HSV2. I have been on valacyclovir and I am currently on acyclovir, neither of which are helping, and I feel I am currently having an oral and genital outbreak, triggered by protected vaginal sex last night, no oral. Other than my symptoms not being related to HSV2, why am I not responding to treatment?

I did not find out any new information at all about HSV 2 treatment, except that the Genocea treatment vaccine is very effective and more trials will be coming on with that in 2016.

2. If this is not HSV2 related, doesn’t the fact that both my oral and genital symptoms flared up this morning following sexual intercourse lead you to believe that my symptoms are HSV2 related?

It does not.

3. I had a small red area on my hand that I noticed yesterday. about the size of an eraser or smaller. I rubbed my hands in alcohol hand sanitizer, and it didn’t sting so I didn’t think much about it, but later that evening, it looked like it had a couple of very minute blisters. I again rubbed it with alcohol, and it didn’t sting. I covered the area with a bandaid and today it is brown, with maybe dried blisters (hard to say, .still doesn’t sting when alcohol/sanitizer applied). I didn’t have the bandaid on yesterday when I picked up the baby, but if this was an HSV2 area, could I have passed the virus to the baby by picking her up? If no, why not?? I am sure that I had herpatic whitlow on my pinky finger last year, that’s why I am wondering about this area and transmitting HSV2 to her. It seems herpes travels nerve roots and can end up anywhere.

And how were you diagnosed with herpes on your little finger?

Herpes cannot travel on nerve roots anywhere on your body; it only travels within the sacral nerve group if it is genital and the trigeminal nerve group if oral. Neither of those nerve groups innervates the hand.

Terri

[badtimeinmylife]

I am going to try and clarify my last post.
1. As far as PCR testing, part of my understanding is that it is best to do PCR testing as soon as symptoms appear, and if you are not able to do PCR testing within 48 hours, the results may not be accurate. Is that correct?
2. The other part of my understanding is that PCR testing may show virus even after an area has scabbed over. Is this correct? If so, isn’t that conflicting my first statement above? This is what I meant when I stated that the timing of PCR testing has to be “just right”.
3. I want the Genocea treatment. How do I go about getting it? Am I a candidate for this treatment?
4. I diagnosed myself with herpetic whitlow, it all fits. Newly acquired HSV2 infection, and then this open ulcer on my pinky finger within 4 months. I was wondering if I had remembered blistering to that area prior to the ulcer, and I really don’t, but I do remember some blisters “around” that time. Also when I was having the genital irritation, I was constantly checking down there without gloves. I’m sure its herpetic whitlow
5. Will you clarify your last statement. I had read on a post on this site where someone had an outbreak on the ankle that was confirmed by swab to be HSV2. From your post, you clarified that he/she had an outbreak on the ankle because it followed the sacral nerve group. So does that mean that a genital outbreak can occur not only in the boxer short area, but anywhere on the lower extremity? My wording wasn’t correct earlier, but this is my thought pattern.
6. If you have HW on one hand, can it show up on the other hand, or does it just stay on the hand that initially had the outbreak?
7. Can an outbreak from herpetic whitlow of the finger recur as an outbreak on that ARM or does it just stay on that hand
8. What nerve group does whitlow innervate,please break that down for me? If I did/do have healed herpetic whitlow on my right pinky finger, besides my right hand/pinky finger, where else can this outbreak recur

[Terri Warren]

1. As far as PCR testing, part of my understanding is that it is best to do PCR testing as soon as symptoms appear, and if you are not able to do PCR testing within 48 hours, the results may not be accurate. Is that correct?

That is true for culture, but not PCR.

2. The other part of my understanding is that PCR testing may show virus even after an area has scabbed over. Is this correct? If so, isn’t that conflicting my first statement above? This is what I meant when I stated that the timing of PCR testing has to be “just right”.

Yes, there is far more flexibility with the PCR and timing than the culture.

3. I want the Genocea treatment. How do I go about getting it? Am I a candidate for this treatment?

You are likely not a candidate for the study because you have symptoms so often and yet none of them are swab test positive. You’ll have to wait until it gets FDA approved, if it does.

4. I diagnosed myself with herpetic whitlow, it all fits. Newly acquired HSV2 infection, and then this open ulcer on my pinky finger within 4 months. I was wondering if I had remembered blistering to that area prior to the ulcer, and I really don’t, but I do remember some blisters “around” that time. Also when I was having the genital irritation, I was constantly checking down there without gloves. I’m sure its herpetic whitlow

OK, your call. I still think a swab test would be best to prove this. Lots and lots of people believe they have whitlow when most truly do not.

5. Will you clarify your last statement. I had read on a post on this site where someone had an outbreak on the ankle that was confirmed by swab to be HSV2. From your post, you clarified that he/she had an outbreak on the ankle because it followed the sacral nerve group. So does that mean that a genital outbreak can occur not only in the boxer short area, but anywhere on the lower extremity? My wording wasn’t correct earlier, but this is my thought pattern.

Yes, herpes can show up on any branch of the sacral nerve group. You can download a dermatome map and see where that is exactly.

6. If you have HW on one hand, can it show up on the other hand, or does it just stay on the hand that initially had the outbreak?

It could show up on either hand IF you have it.

7. Can an outbreak from herpetic whitlow of the finger recur as an outbreak on that ARM or does it just stay on that hand

It could show up on the arm

8. What nerve group does whitlow innervate,please break that down for me? If I did/do have healed herpetic whitlow on my right pinky finger, besides my right hand/pinky finger, where else can this outbreak recur

C6, C7, C8. Please refer to a dermatome map

[badtimeinmylife]

This is interesting but not in a good way. I looked up the dermatome map. My initial site of self diagnosed herpetic whitlow was on my right pinky finger. Since then, I have developed these whitened areas on my thumb and middle finger. The area of the thumb is circular, and the one on the middle finger is streaky, both at the first joint. Both are white and both are under the skin. Both get tender often, but the middle finger moreso. Where the open lesion was on my pinky finger last year, is now a white circular area which also gets tender from time to time, but this is the way the area has looked and felt since the lesion healed last year, which resembles my middle finger and thumb.
1. If these are manifestations of whitlow in an atypical manner, and they are not open sores, am I contagious from the hand or arm?
2 These areas seem to be permanent markings, as they have been here for a couple of months with no change, other than getting tender often when pressure or heat/steam is involved. Even though they are not open, do I need to keep them covered?
3 My biggest concern is transferring HSV2 from this whitlow to the newborn baby. This is why I keep asking if I am contagious. I am really afraid to hold her, and when I do, I try to make sure that there is no skin to skin contact. I am afraid that if my skin touches her, that I may transfer the virus to her through shedding. PLEASE advise me on what to do about this.
4 Yesterday the baby had on clothing that covered her entire body(arms, hands, legs,feet). I really felt good about handling her because I knew that my skin wasn’t going to contact her, but her little mouth brushed across a small area of my hand, and today her little foot touched my hand. No open areas on my hand. Could I have transferred HSV2 to her through shedding?
5 How do I get an official diagnosis of herpetic whitlow? Do I have to wait until there’s an open area, or can I PCR swab the intact skin on the suspected areas that are tender to touch?

[Terri Warren]

1. If these are manifestations of whitlow in an atypical manner, and they are not open sores, am I contagious from the hand or arm?
not unless the skin is broken
2 These areas seem to be permanent markings, as they have been here for a couple of months with no change, other than getting tender often when pressure or heat/steam is involved. Even though they are not open, do I need to keep them covered?

No
3 My biggest concern is transferring HSV2 from this whitlow to the newborn baby. This is why I keep asking if I am contagious. I am really afraid to hold her, and when I do, I try to make sure that there is no skin to skin contact. I am afraid that if my skin touches her, that I may transfer the virus to her through shedding. PLEASE advise me on what to do about this.

I would advise that you stop worrying about this and be with the baby.

4 Yesterday the baby had on clothing that covered her entire body(arms, hands, legs,feet). I really felt good about handling her because I knew that my skin wasn’t going to contact her, but her little mouth brushed across a small area of my hand, and today her little foot touched my hand. No open areas on my hand. Could I have transferred HSV2 to her through shedding?

No
5 How do I get an official diagnosis of herpetic whitlow? Do I have to wait until there’s an open area, or can I PCR swab the intact skin on the suspected areas that are tender to touch?

Yes you need to wait for an outbreak because virus is not shed from intact skin in the places that concern you.

Terri

[badtimeinmylife]

I was waiting to use my last post until I had something significant to ask, but after reading one of the recent posts, I really need clarification. I have been struggling with worrying about transmitting HSV 2 to the new baby. There was a dad asking a question about transmitting HSV2 to his daughter but he doesn’t know that he has HSV. He stated that he may have touched or rubbed an area in the genital region without realizing and then changed his daughter’s diaper. You said that although many parents worry about it, that they can’t transmit the virus by changing diapers or by baths. I don’t mean to be stupid, or for it not to click, but…
1. I thought that if a person touched the area of an outbreak, and didn’t wash their hands so that the soap could kill the virus, then they could indeed transfer the virus to someone else’s genitals, mucous membranes, or open areas on their skin. I thought that this is one way the virus was spread to others. Will you please clarify this for me?
I really began to be concerned about atypical presentations of HSV2 after reading ASHA’s website. They stated that some people don’t recognize the symptoms of herpes because they can appear as mild irritations, insect bites, abrasions, yeast infection, jock itch, chapped lips, etc. I don’t have the typical outbreaks, that’s why I never know if something is an outbreak or just the simple things listed above. I know that the only way to know is to have swab testing, but I’m scared to get off my antivirals even though I don’t think they are helping. The only open ulcer/sore that I have ever had was on my pinky finger last year. I have not been able to find out much about whitlow or atypical presentations of HW being rashes, so I have been worried that every rash that develops on the back of my hand may be an outbreak.
2 IF I have HW, should I expect that the outbreaks would appear like the open ulcer on my finger last year or could an HW outbreak present as a simple rash or area of irritation

[Terri Warren]

The thing is, it takes a certain amount of virus to infect another person. I seriously doubt that anyone would actively rub and rub and genital outbreaks then actively rub a babies bottom while changing a diaper. The kind of contact that he describes was very slight and minimal and that kind of contact does not transmit herpes. Period.

Yes, people with herpes can have what we talk about as atypical (which is probably more typical). If you want to stay on antiviral medicine, despite the fact that it isn’t helping you, then you may serious difficulty recognizing an outbreak. We really have no idea if the thing on your finger was whitlow or not. Whitlow does present, in my experience anyway, as a group of water blisters that are very obvious and most often painful. I have not seen whitlow present as anything sort of mild but then I am only speaking from my personal experience.

Terri

[badtimeinmylife]

I have genital hsv2, acquired last year, but was just diagnosed this year by WB. IGG tests negative even after a year. I think I’m having continuous HSV2 outbreaks/symptons in my genital area. You stated that herpes doesn’t behave that way, that everything that goes on down there isn’t always due to herpes, yet I continue to have this almost daily stinging, burning, itchy sensation in my pubic area. I also feel areas of rawness in my anal area/back there, despite being on medication. A few months ago, I started having burning of my lips/gums, burning inside my nose, chapped lips, and other oral symptoms. I feel I acquired hsv2 orally this year. I did get a bacterial culture of my nose to see if staph or strep infections were causing these continual symptoms. The nose culture showed moderate growth of staph, not MRSA, and I was started on bactroban ointment to the inside of my nose and keflex 500mg 3x/day for 7 days. The nasal burning went away but the antibiotic did nothing for the mouth or genital discomforts which I continue to have. She later did the genital swab and it was negative but symptoms still present.
1.I don’t know what’s causing these symptoms? What do you think? Could it be herpes behaving this way and if so, am I cont. contagious?
I think the ulcer I had on my pinky finger last year was HW. I have not had another ulcer, but I do get red itchy rashes on the back of my hand which I am wondering if they are outbreaks. I am still on antivirals and experiencing outbreaks.
2. If I sent in PCR swabs of my most recent rash on my hand which is really red and itchy, and of the irritated area from my genital area, how likely is it that it will pick up the virus with me being on meds?
3. BIGGEST CONCERN. I look at my hands very closely before picking up the baby, but I missed a rash and I think her SHEDDING hand brushed against it. Could she have caught my HSV2? She has facial acne and I question every little bump or pimple wondering whether I gave her herpes?

[Terri Warren]

I know you are still agonizing over this and I feel so badly that you are unable to get answers to your questions.

I have ZERO concerns that you infected the baby by her brushing against a rash on your hands that sounds nothing whatsoever like herpes to me.
You could certainly send in PCR swabs of anything that you think might be herpes – that is not a problem at all for us. But you need to know clearly that being on medication will influence the accuracy of the results
I seriously doubt, very seriously doubt, that the symptoms you are continually having are due to herpes infection. If they were I think your herpes would improve with medication which it has not.

As long as you stay on medication it will be nearly impossible to know what is being caused by herpes and what is not.

Terri

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