[Question #1702] 13 Y/0 HSV IGM Positve

44 months ago

Update - my 13 year old daughter continues to deny sexual contact and is very adamant.  Today, she believes the ulcerations are returning.  She just started her period and has been using tampons.  Now questioning tampon allergy?  I have made an appointment with a new NP.  What is your recommending testing at this time to the open ulcerations to confirm or hopefully deny that she has HSV?  Any other testing recommended?


This was my questions several days ago--and is now closed

I am a nurse who worked at the STD clinic years ago, so I am somewhat familiar with STD's.  My 13 year old, honor roll, sports playing daughter, who does not have a boyfriend told me while I was out of town on business that she had developed vaginal ulcers on 1/13/17.  She did not want her sister or Grandmother who was caring for her to take her to the MD so she suffered (very painful, could not urinate) until 1/20/17 when she saw the NP at a local OB/GYN office.  The NP thought based on clinic exam, she had Herpes.  Started her on Acylovir 5x per day- she only took for 1 day as (mistake number 1)  because we initially we were told tests negative due to cultures (so she stopped taking it) and later told us positive due to blood tests.  Today, 12 days later ulcers are nearly healed.

Test results

HSV Type 1 AB IGG , S <0.91

HSV Type 2 AB IGG, S <0.91

HSV vaginal cultures for HSV1 and HSV2 negative

HSV AB IgM 3.19

(side note gonorrhoeae and chlamydia neg)

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
44 months ago
If there are open ulcers to swab test, and you were my clinic patient, I would ask for a PCR swab for herpes (NOT culture) and a general bacterial culture of the lesions.  Tampon allergy is an interesting concept here.  I think I would also encourage you to see a dermatologist when these are active to get their opinion about what is going on here.  These lesions should be swab tested as early as possible when they show up - if they are there now, get them swab tested NOW but be sure to ask for the PCR and if they don't know what that is, have them look it up in their lab book. 
I'm going to share with you what the codes are for PCR swabbing for LabCorp and Quest as many labs get sent to these two places in the US:

quest:  90570  An Aptima vaginal or unisex swab kit should be used to collect the sample.  If the wrong swab is used, they will reject the sample
labcorp:  188056  Again, an Aptima swab should be used..

I think it might be good to stop asking her about having sex.  If she seroconverts, there is plenty of time to talk about this later.  Just my thought.  It's not quite time to repeat the blood test yet.

I'm sorry you are still going through this!

Terri
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44 months ago

Thank you for the info.

We have stopped talking about the entire issue for the most part- and honestly I do believe her.  The last time she looked at me like I was stupid and said "I am not worried because if this comes from having sex, that isn't it!" So we dropped for the most part until today when it has resurfaced.

I will share this information with the provider tomorrow at the 8 a.m. appointment.  Thanks again.

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
44 months ago
You are most welcome.  I think I believe her also.  She's lucky to have a mom like you in her corner!

Terri
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