[Question #320] Herpes (HSV)1 & Herps (HSV) 2

35 months ago
70 year old female (had hysterectomy) 40 years ago.  Same male sexual partner for past 20 years.  September of this year felt discomfort in pelvic area, flu like symptoms, and swollen lymph nodes (groin, arm pit, back of head and especially under jaw).  This lasted for about a week.  Than a week later all symptoms came back (only worse), also had slight abrasion on labia at that time, which lasted about a week.  Found out partner had not been faithful.  Had a "wellness" check (blood and urinalysis) done with complete STD blood work.  Wellness analysis came back with only two (2) issues:  LEUKOCYTE ESTERASE was "abnormal" (2+); and MCHC was "low" 31.6).  STD tests came back clear with the exception of HSV1 (1.10 being positive, my came in at 1.96); HSV 2 (1.10 being positive, mine came back 2.11).  Did a a lot of research as the symptoms have been ongoing now (since mid September).  Figured that as a complication I had "viral meningitis" which would clear up in time.  About two weeks ago I developed a lesion (looked like poison oak in same area as original abrasion), which lasted about a week.  Than I started experiencing discomfort down the back of my "right" leg (same side as abrasion and lesion).  Mainly the discomfort is with sitting (not pain, just discomfort).  Last week I developed two lesions in my mouth and had a sore throat.  These have now cleared up.  Still has swollen lymph nodes (only improvement with lymph nodes is swelling under jaw on right side has gone down, and somewhat on back of head).  Still have flu like symptoms, fatigue, shortness of breath, and discomfort in pelvic area and right leg.   Have NOT had any physical relationship with partner since Mid-September (not even kissing).  Your opinion and suggestions ?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
35 months ago
HI Charles (is that right, and you're female?)  Just making certain.
I'm sorry about the experience of your partner being unfaithful to you - that you can be very painful.  So you had white cells in your urine (Ieukocyte esterase).  Did they tell you that you had a urinary tract infection?  Have you ever in your life had a cold sore on your lip or in your nose?  That would account for you HSV 1 test being positive at 1.96.  The majority of people your age have an HSV 1 infection.  The HSV 2 index value of 2.11 is in what we call the low positive range.  At an index value of 2.11, there is a 50-50 chance that this is a false positive result.  You need a herpes western blot to confirm that value.  You cannot obtain that test from your regular provider - you can get that in one of two ways.  You can contact the University of Washington laboratory to have them send you a kit to have blood drawn by your provider and shipped back to them or our clinic (Westover Heights Clinic) can order the test for you to be drawn at a lab near your home and they will ship it back to the University of Washington.  I must say your "abrasions" worry me in terms of herpes.  Also your description of the poison oak type rash and pain down your leg may well be consistent with genital herpes.  It's not a slam dunk, but all of that is concerning to me.  If you do have genital herpes, it is possible that it was new to you in September, but there is no way to know for certain.  Do you know if your partner has ever been tested for herpes?  Have you discussed these symptoms and test results with him? 

I do not think that the fatigue, shortness of breath and discomfort in the pelvic area necessarily have anything to do with possible herpes. 

By the way, if you do the western blot, I would ask that you not do it until 16 weeks have passed since your last sexual encounter with your partner.

Terri
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34 months ago
Hi.  Actually my first name is Sally.     But I submitted and paid for question under Charles's name.   Charles did have a test done for  HSV 1/2  Combined Ab Sorn, IgG         Reading was 22.40       HSV 1 and/or 2 Antibodies, IgM by ELISA   Reading was 0.53  .....
 
What does that mean.     His doctor told him that he tested POSITIVE ? 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
34 months ago
It is impossible to know anything from looking at a combined IgG.  It has to be a type specific test that separates HSV 1 and 2.  The combined test could be positive just from a history of cold sores, he definitely needs a different type specific test if he wants to know specifically about HSV 2.

Terri
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