[Question #2253] Herpes questions

45 months ago
One morning i woke terribly ill with chills, body ache, and tonsillitis; i rushed over to my PCP and he prescribed medication for my swollen tonsils. 5 days later I had what i thought was an upcoming yeast infection. I then noticed i had a lesion resembling a insect bite and another that looked like a giant scratch, both very painful, i could't shower or urinate without being in constant pain. My NP did a HSV cultural rapid shell vial and HSV1 & 2 AB type specific also prescribed Acyclovir for 7 days  . The cultural came back positive for HSV and the blood work positive for HSV1.  I asked my NP if i have genital HSV1, how often will i have outbreaks and how long should i take medication once my 7 days are up. She tells me:  "we truthfully can't say whether it's 1 or 2 that caused the outbreak. It might be a new infection of HSV 2. Only time will tell whether you'll breakout 'often' or not, not so much which virus it is. If you break out again 'soon' (within 3-4 months), then I'd start to take the medication suppressively ." My questions are:  if and when I outbreak again should i expect the lesions to return to the exact same location? Will the lesions look the same has my first outbreak or will they have the blister look? When should i do a second blood test to determine the type of HSV i have? Its been about 8-9 weeks since my first outbreak, I don't think I've had a second outbreak and if i did i wasn't aware because i didn't have any lesions or pain; will my future outbreaks be painful  like my first?  last week I had what looked like an ingrown hair (i wax my pubic area), It want painful, i squeezed it and white puss came out and i pulled the hair that was next to it out and it healed within 2 days, could that have been an outbreak? I get ingrown hairs from time to time because i don't always exfoliate the area like i should but nothing that looks like blisters or similar to my first outbreak, should i assume anything in my genital area  is a new outbreak?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
45 months ago
Your nurse practitioner should have ordered typing of the virus from the culture. She is correct that a blood antibody test may not show up as positive if you have a new infection. In order to determine what type of herpes you have, you could have another blood test now and see if you were positive for HSV-2. We normally like 12 weeks between and infecting encounter and a final IgG antibody test, but many people who have new infection Will be positive at 8 to 9 weeks post encounter.
If you do and I GG test now, and it is positive for HSV-2, you will know for certain that you had new infection. If you're negative for HSV-2, you can redo the IgG test in another month. Alternatively, the next time you get an outbreak, you should have another culture done and this time insist upon typing of the culture. Remember that if you take medicine for herpes prior to having a lesion swab tested, the medicine may cause a false negative result on the swab test. Usually, recurrent lesions and outbreaks are less severe than new infections. If your infection is HSV one, then you are likely to have few outbreaks in the future.

Terri
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45 months ago
Do all labs offer IgG testing? I am currently with Kaiser and i feel they only  do the bare minimum when it comes to most testing; I can reach out to my local health department or planned parent hood if they have testing that is more suitable to my needs.    Also, does all tingling or itching in the area mean a new outbreak is coming? I get lots of tingling but i haven't noticed any lesions. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
45 months ago
I believe that Kaiser will do IgG testing, yes, but it might depend upon the provider that you see - it varies.  Tingling can be present for so many reasons and herpes is way down my list of suspected causes.

Terri
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45 months ago
Thank you for all your help and addressing many of my concerns during these very difficult and confusing times . My NP is the one who referred me to this website and now I can see why , thank you again.   If I have any follow up questions I will be more then happy to purchase more questions.  
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
45 months ago
Perfect, so glad we can be of help!  Remember that if you want the IgG test and Kaiser refuses to provide it for you for some reason, you can order the test online yourself - you do not need a clinician order.  There are many places that offer this service, all over the country.  And yes, do feel free to renew if you have more questions, happy to help!

Terri
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