What to expect?

[abcdd89]

Hi Terri,

I had a small sore the size of a pencil eraser show up on the soft mucus membrane of my vagina 12 days after possible exposure with a new sexual partner. I got the sore swabbed and had my blood tested 14 days after possible exposure. 16 days after possible exposure the doctor called me and told me my tests came back negative for herpes and positive for bacterial vaginosis. She put me on antibiotics. She called me 4 days later and told me that my swab actually came back positive for HSV-2. (I have no idea why she wouldn’t have waited for the swab results before telling me I was herpes free.) By this time the sore was almost healed. It healed rapidly once on the antibiotics. Within 10 days of the sore first appearing it was completely healed and within 6 days of antibiotic use it was completely healed. I had negative blood tests at 14 days post possible exposure and 20 days post possible exposure which I know is quite likely too soon for the antibodies to be present. I guess my question is has a false positive ever occurred with a herpes culture test? Also, do my symptoms sound like HSV-2? The sore was painful for roughly 24 hours. I am just confused as to why the sore would heal so rapidly with the use of antibiotics since herpes is a virus. Thank you so much for your time.

[Terri Warren]

Yes, you symptoms do sound like a new herpes infection. A negative antibody test combined with a positive culture or PCR swab test indicates new infection – there was enough virus on the skin to make the swab test positive but not enough time has passed for you to have developed antibody, that the blood test looks for. The sore healed because you had a mild first infection, not because you were on antibiotics. The healing was just happening in the same time frame in which you were taking the antibiotics. I do not expect a false positive swab test COMBINED with a sore, no. the two together are most certainly accurate. Have you ever had a cold sore on your lip? If yes, then that may be one reason why you had a mild outbreak.

Terri

[abcdd89]

Nope, I have never had a cold sore. I’ve heard that the first outbreak is typically the most severe so can I expect any future outbreaks to be no worse than this one was? Thanks much.

[Terri Warren]

That is generally true, yes. There are exceptions of course, particularly when someone with herpes has taken an immunosuppressing medicine, for example, or if someone gets really sick and their immune system just isn’t up to par. But generally, the first outbreak is the worst, correct.

Terri

[abcdd89]

So some people just exhibit herpes differently than the “standard” of multiple blisters etc.? Mine was only one sore and it looked a lot like an aphthous ulcer or chancroid. My blood was negative for HSV 1 so I don’t believe I’ve had a cold sore before. Since the culture was positive for HSV-2 do you expect I will have multiple outbreaks each year even though this first one was so mild?

Thanks so much for your time Terri, what you are doing is really wonderful. Unfortunately, there is so much anxiety and many unanswered questions that come along with a herpes diagnosis for so many of us. Like many other people it came as a total shock to me.

[Terri Warren]

Yes, the presentation for individuals is very different from each other. Since 80% of those infected with HSV 2 don’t know they are infected, the typical presentation could NOT be multiple painful blisters, right? I would expect you to have recurrences in the future, yes but they likely will be mild.

Since the antibody test for HSV 1 misses 27% of infections, it is likely that you don’t have it but we can’t be certain.

Terri

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