Very confused with my HSV 2 diagnoses

[hulkstones]

9th Oct 2020: Possible exposure I had with a handjob and 5 min sex with protection of condom and I think she was herpes +ve, she avoided me after that
10th Oct 2020: Developed red patches all over penis head and 3 white spots
11th Oct 2020: 1st viral culture swab at ER: positive HSV 2
13 Oct 2nd viral culture swab after 2 days at primary care: negative HSV
14th Oct 2020: No white or red patches, everything clean, got new skin back but now got bad yeast infection which went away with antifungal cream in a week.
25th Jan 2021: Blood test HSV 1 & 2 both IGG negative < 0.91 after like 100 days now

This is so confusing, I had the so called outbreak (second day after exposure) lasting only like 2-3 days (3 white spots) after that I had very bad yeast infection (had completed two weeks of antibiotics so it killed lot of good bacteria)

Since that day, I dont have any pain or itching or outbreaks since that time, also no flu symptoms or lesions

Also, I am not on any antivirals so I assume that IGG should have gone up by now, I am so confused, do I have herpes or not? Do you recommend further western blot test? In fact what do you recommend?

[Terri Warren]

Interesting. The IgG test does miss 8% of HSV 2 infections compared to the western blot so it could be missing it but the timing and symptoms don’t fit perfectly with what I would expect here. If this was me, I would definitely pursue the western blot for the correct answer. Cultures are very infrequently false positive but I have seen it twice in my career. I am assuming you have a report of a positive HSV 2 culture – and it was culture, not PCR?

Terri

[Terri Warren]

You just emailed a question to me – are you seeing my response?

Terri

[hulkstones]

No I am not, also, I dont see anything that I posted

[hulkstones]

yeah I am scheduling an appointment with you for western blot, I do have quest diagnostic report copy, my positive was HERPES SIMPLEX VIRUS CULTURE W/RFL TO TYPING, it came HSV 2 isolated while the negative culture was done with “without any typing” at labcorp

I have always been IGG negative on both HSV 1 and 2, I dont have any new sexual partners beside on that day, the last time I was IGG negative was in May 2020, no new sexual partners till oct 2020

I was having stomach issues with H-pylori bacteria, I had completed 2 weeks of antibiotics on 9th Oct, according to my doctor, I first had HSV outbreak then Yeast infection because he thinks my white spots are clear herpetic lesions, but now he is confused too with the recent IGG results, he said it could take more time for seroconversion in some cases (I looked online but only in patients who are chemotherapy or who are on antivirals seroconversion takes times)

Have you seen false negative in IGG by 3 months with no antivirals and confirmed symptoms,? I mean have you come across people with 8% who are always negative on HSV but positive on western blot?

Here are the picture on the first, second and third day of outbreak, after this I had bad yeast infection

Handjob was after the intercourse and it was very rough for 30 mins, so when I first got the spots I thought it was just because of the friction and by the time I was told positive, everything was cleared up in 4-5 days

[hulkstones]

Hi Terri, can you help take a look at my question when you get a chance?

• This reply was modified 1 month ago by hulkstones.

[Terri Warren]

If a swab test was positive AND typed, it is very likely to be correct.
I would believe a swab test that is positive over the IgG test any time. But given the timing here with sexual contacts, I believe a western blot is a good idea, just to be sure.

Terri

[Terri Warren]

we are just waiting for your blot now, correct? I know you shipped off your sample this week.

Terri

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