timeline conflicts with outbreak

[Tricky Timeline]

Thank you for this vital link to your experience and medical insights. It has helped tremendously in a very difficult time. This is my situation. I had a sexual encounter on November 19th. Before hand we discussed our histories and neither of us had any STDs that we were aware of and neither of us had any sores. Neither of us had much of a sexual history. (I have taken a urine test for std and it came back negative) We used a condom. A few days later I travelled to my family”s home for the holidays and was there for six weeks.

On December 24th I noticed a small sore on my labia with a black dot in its center and a very small cluster (1/4″) of what looked like cauliflower. I went to an urgent care clinic a few hours later and sores had appeared on my labia. The Doctor didn’t know what the sores were and said she didn’t have any experience diagnosing herpes. She thought it was a bacterial infection so scraped the sores and did a bacterial culture which came back negative.

At first the sores were not very painful but within two days the whole area was very painful especially when I urinated. I had a “foggy brain” feeling as well. On Friday December 26 I went to my gynecologist and she made a visual diagnosis of genital herpes. She said she was 100% sure it was genital herpes. I took a blood test for both IGG and IGM, both came back negative. The doctor would like me to take another blood test after four weeks when my body would have had time to produce anti bodies. I did use an over the counter cream- Abreva, which seemed to help. My partner said he would take a blood test to check his status.

I am very confused and beside myself because I have not had ANY sexual encounters or ANY sexual activity since November 19th. If I in fact do have genital herpes that means that 1) my partner would have had to have been having viral shedding and 2) the incubation period for the infection would have to have been 35 days, which seems quite impossible. Or 3) I picked up a std without having sexual contact.

A female relative did stay with us for seven days over the holidays and she has had genital herpes for over ten years. She has not had an outbreak in over a year. She does not take any viral suppression meds. We do have a bidet toilet seat that has a heated seat and the temperature of the seat ranges between 86-104 degrees. I do not know if because the seat is heated if the virus could live on the seat and I could have had been exposed to the virus that way.

The second week of December I went to the doctor’s office to discuss birth control options. I decided on the nova ring. The doctor took it out of its package to show me the put it back in the package and gave it to me. It was in the refrigerator for 3-4 days before I inserted it as directed. I did shave my entire pubic area two days before I went to the doctor’s office. I did not take off my clothes nor did I have a pelvic exam at the doctor’s office.

So given all of the above:
1) could this be anything other than genital herpes?
2) is it possible for herpes to have a 35 day incubation period?
3) could I have gotten the virus from a heated toilet seat that I shared with a herpes positive person if she had viral shedding?
4) I plan to take my four week follow up blood test next week is there anything else I should be tested for?
5) can you think of how any combination of the above information could have led to my infection?
6) which herpes test do you suggest that my partner takes?
7) which herpes test do you suggest that I take?

Thank you again for providing this forum for people who need some answers to help understand their situation.

[Terri Warren]

1. It does sound like genital herpes to me but the timing is a bit weird. Did that person give you oral sex? Have you ever had a cold sore on your lip?
2. No, but it is possible to not have symptoms with a first infection but to have it later, though more unusual.
3. Remember that viral shedding does not happen from the buttocks and that is what sits on a toilet seat, not the labia which is where shedding might happen. Most of us do not drag our labia over the toilet seat as we leave 😉
4. No, I don’t think so. And skip the IgM for heavens sake. Only do IgG.
5. Not really without a little more information about the sexual contact.
6. IgG antibody for HSV 1 and 2.
7. Same

Did anyone diagnose a genital wart from the cauliflower looking thing?

Terri

[Tricky Timeline]

1) No, we did not have oral sex just vaginal. Yes I have had a cold sore. As well as I can remember it was around December 21, I had one on my lip and one on my tongue. I may have had another cold sore a few weeks earlier but I cannot remember.
2) The cauliflower was more like a curved chain of three close together cream bumps. The nurse did not think it was a wart but she did scrape it for the bacterial culture on the 24th which was negative.
3) do you think the nuva ring could be a contributor?
4)To clarify one point the first sore was very dark pretty much over its entire surface.
5)In answer #2 you said it was possible to not have symptoms with first infection but get them later. I thought that the “igg” test would have detected anti bodies from an infection +/- 5 weeks prior. Do you agree?
6) What does the ig m test for. Is it not reliable?
7) Do you have any other ideas?

Thank you again.

[Terri Warren]

1. Are you saying that you have had cold sores before the sexual encounter on Nov. 19th? Or are you saying that you never had a sore on your lip before the sexual encounter?
2. OK
3. NO
4. could that have been a scab?
5. The IgG test can take up to 16 weeks to be positive – 5 weeks may not be long enough to make antibody
6. The IgM test, for other disease states, can indicate new infection if it is positive, but for herpes, that is not the case and there are many false positives on the IgM test so I don’t want you to take that test.

My impression is, given all of this, that you likely have herpes, thought I have no idea what type or how long you have had it. Was any swab testing done from the lesions at your OB’s office?

You have one more post to make.

Terri

[Tricky Timeline]

1)yes I have had cold sores before when I was younger. (Starting in the Preteen years)
4) the sore was round with uneven edges and very dark grey in color. It started out as a small dark spot then morphed into the larger dark grey uneven edged sore. It was never crusty like a scab, more like gooey.

Unfortunately no swabs were done in gynocogist’s office. Because I went to the urgent care clinic first and a swab was done (even though it was bacterial and not herpes) the gynecologist didn’t do a herpes swab. In hind sight that would have been extremely helpful because I would have received my results and would know my status. Now it seems that I will need to wait before I can truly know.

A) when do you suggest that I have a second blood test? I am scheduled for an appt. This Friday which would be four weeks from outbreak, and almost eight weeks from sexual encounter.

B) is the dark grey sore typical of herpes? Or anything else you are aware of?
C) what is the connection between having a cold sore on my lip and herpes on my vaginal area? How does one affect the other. If I have cold sores on my lips can I infect my genitals?
D)just to clarify you said it is possible to not have symptoms with a first infection but to have it later. It seems that this is a fairly robust outbreak which matches first time outbreaks. Can a later outbreak be fierce like mine was?
E) I have not had any sexual encounters for ten months prior to the one on November 19 th. So I am assuming, because the IGG test came back negative I did not have a prior infection. Do you agree?

Thank you again for your forum and your invaluable information.

[Terri Warren]

If you did not receive oral sex and you have had a cold sore on your lip when you were younger, I think this effectively eliminates genital HSV 1 infection.
Yes, a swab would have been exactly the thing to do. The negative IgG indicates that you were not infected with HSV 2 four months ago and backwards, which is useful in sorting this out.
I have not seen herpes sores that I would describe as gray, no.
The best blood test would be an IgG done 16 weeks after your last sexual encounter.
It is possible to not have symptoms at first and yes, to have them later, and they can be fierce yes.
I agree that you did not have prior infection ,yes.

We are now out of questions but you can renew your subscription if you have more questions.

Terri

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