[Question #231] Warts

94 months ago

I was diagnosed by a walk in clinic doctor of having genital warts on March 10, I had gone to her for pelvic exam as I had stepped outside my marriage and was worried; I had not seen anything, however wanted a check up.  I started Aldera; I used four packages (and all parts of my vagina swelled and burned). I was diagnosed with pneumonia on March 18 and didn't use the aldera until I resumed on on March 30 for six treatments. I returned to the walk in clinic to discuss the progress (I had never seen a wart... Even under extensive inspection) she was genuinely unnerved by the bad reaction I had take aldera.. I then decided to get a second option from an std clinic dr (April 14) who said emphatically that I did not have warts.  I have been seen 14 times since and there have never been any symptoms is warts. 

My question is: 

1) is it possible that this was misdiagnosis? 

2) If I know the exact person who gave me HPV, how likely would it be that I would be the only one who got warts? He didn't, his wife or my husband. 

3) my husband is unaware of my indiscretion.. He has had had a sinus blockage that antibiotics is not working for.. Is there any chance it is related to this or just a coincidence?  
H. Hunter Handsfield, MD
94 months ago
Welcome to the forum. Thanks for your question.

I'm pretty sure you do not and never did have genital warts. The expertise in recognizing warts is likely greater for an STD clinic physician than an urgent care or general physician. Second, having such small warts that you couldn't see them yourself is very unlikely. Third, my guess is the timing is wrong. You don't say when your non-marital sexual encounter took place, but my guess it wasn't long before the March 10 clinic visit -- but it takes at least 2 months and an average 3-9 months before visible warts appear.  To your specific questions:

1) I think misdiagnosis is likely. Having not been there at the time, I can't say for sure you didn't have warts. But it seems unlikely.

2) This is a theoretical question and probably not helpful. It is certainly possible for someone to have unnoticed warts, or to transmit a wart-causing HPV infection without having visible warts him- or herself. But this doesn't really matter one way or the other in your case.

3) HPV certainly cannot cause sinus congestion or anything like it. Your husband's symptoms are unrelated to your other sexual partnership.

My final comment concerns "been there 14 times". Really 14 visits to the STD clinic? Or some other doctor? It's time to stop! If you don't notice warts yourself, you can be confident you don't have any.

I hope this has helped. Best wishes--  HHH, MD

94 months ago
Thank you for your reply! So just a quick follow up:

My one time affair happened on August 8th and the diagnosis was on March 10th. She said it was "two small lessions inner labia" would I have been able to see them? 

So as I also understand; if it wasn't misdiagnosis after this length of time it is unlikely that they would return?

As you can imagine my self hatred for this situation is unimaginable and I thank you for your time and expertise.

Thank you so much! 

H. Hunter Handsfield, MD
94 months ago
The timing is consistent with diagnosis of warts in March from an exposure 7 moths previously. And I'm not sure I correctly understood the timing when I replied above, specifically didn't fully realize you had already been treated with imiquimod (and had an inflammatory response to it) when the STD specialist first examined you. If you had warts on March 10, they could have cleared up a month later. That doesn't mean you had warts, but at this point it probably isn't ever going to be possible to know for certain.

Most persons with genital warts can easily see them, especially if they are attuned to their genitals and what's normal for them, as you may be. (This varies a lot from one person to the next.)

Most of the time, if warts are going to recur after treatment, they show up within a couple of months. With no warts at this time (8 months), recurrence is unlikely. It sometimes happens years later, but that's quite rare.

As for your "self hatred", I think you are overreacting. This is pretty common; genital warts have a "yuck" factor for many persons. But it's really an inconvenience, not a health threat; extremely common (almost everyone has genital HPV at one time or another, and at least 20% of all Americans have had genital warts, maybe even 25-30%) -- so you're not exactly alone! And if you had warts, you didn't necessarily acquire them from your non-marital sexual exposure last year; for all you know, your husband was the source, or it was a delayed recurrence from an infection you acquired in the distant past. Finally, if you had warts, it is by no means certain your husband will develop warts himself, or any other evidence of an HPV infection; and if it happens, it doesn't necessarily imply a sexual indiscretion on either your part or his. So all things considered, "unimaginable" self hatred really isn't warranted!
H. Hunter Handsfield, MD
94 months ago
Dear Peppa:

It has been almost two weeks. If you have any final follow-up question or concern, please post it now. Otherwise this thread will be closed in a couple of days.