[Question #387] Herpes?

34 months ago
Exposure 7-12-15. Symptoms started roughly 2-3 weeks later. Have had DAILY itching, discharge, tingling sensation since symptoms started, EVERYDAY! Going on week 24.  Have had 2 fissures in clitoral hood area which is where all my symptoms are.  All STD tests came back negative. Have had a herpes culture of cervix (although I don't think there was an active lesion to culture) came back neg. recent blood work revealed exposure to HS1 but not HS2 but I've never had a cold sore orally. Everything I've read trying to self diagnos it points to genital herpes. Is there really no way to tell unless I have an active lesion to culture? Do some people never get an active lesion in their genitals? 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
34 months ago
So I'm wondering about a couple of things:
1) how long after the contact in July did you get the herpes antibody test?
2) Did you have the fissures swab tested?

Generally speaking, herpes is not symptomatic every day.  It is symptomatic intermittently.  I'm not clear there was any benefit in swabbing the cervix blindly but at least it was negative, which really doesn't mean much.  But if you had an IgG antibody test for HSV 2 at least three months after the contact and it was negative, that is very important and reliable.  The majority of people who are HSV 1 positive do not report either oral or genital symptoms so I'm not surprised at your lack of cold sore history.  Remember that oral herpes can also happen on the chin, in the nose, sometimes on the ear - all in the same basic nerve group.  Did the sexual contact involve receiving oral sex?

I have to say nothing you've described here in terms of symptoms sounds like herpes to me because herpes is not a continuously symptomatic condition , ESPECIALLY if it is HSV 1 genitally. 

Terri
---
34 months ago
Answer to your 1st question. I just had the herpes antibody test last week. So roughly 5 months post exposure. 
Answer to question 2. Not 100% sure if the fissure was swabbed. I went in when I thought I had a fissure but I'm not 100% sure if she swabbed it.  
Swab of the cervix was done because I was told initially that is was either gonorrhea or a case of cervicitis. Gave me a high dose of antibiotics because my "wet mount" pap had a lot of WBC's. sTD culture came back negative for gonorrhea. So I was told cervicitis was the culprit. I also had a sore throat for a good month or 2 when symptoms started. The contact did involve oral sex         Nothing grows on my cultures. Been cultured at least 4 times since July. I have had a bladder sling placed Nov 2013. The intercourse was painful at times because he was well endowed. Any chance I have some type of nerve damage because of the sling? Primary care gyn does not thinks it's urine because she said I would smell bad. Like I said it has been consistent everyday tingling at the clitoral hood area. I have days my labia hurt they feel raw but look completely normal. Days I have a perfect dime sized spot of discharge in my underwear in clitoral area so much that it Hads gone threw my underwear onto my pants.  I've tried boric acid, and another steroid cream.(can't think of the name). But I've had symptoms daily for 22 weeks. I'm going crazy. I'm a runner and running with labial pain is NOT FUN!! 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
34 months ago
So you waited long enough for the HSV 2 antibody test to be done and it is negative and that test picks up about 98 out of 100 cases, so that's good news.
The problem with looking at WBC's in a wet mount is that you can't tell if they are being generated from the cervix or from the vagina itself (wet mounts are gathered from the vagina).  I am making the assumption that you were checked also for chlamydia and bacterial vaginosis and trich?  Was a urine culture done?  I am wondering now about the sling and nerve damage.  I would encourage that you consult with the surgeon that put it in about that.  The constant pain does make me wonder about some nerve involvement in the area of the pelvic floor. 
The short answer is that I doubt that this has anything to do with genital herpes, of either type.

Terri
---
34 months ago
Yes a urine culture was done and it was negative. I think I stated I was treated for gonorrhea (which came back negative) but I think I'm mistaken. I think she initially thought chlamydia. (Which was also negative) I was checked for bv and trich. When this all started I was out of state. So I called my Gyn (who is a friend) and said I think I have a yeast jnfection. She said treat it. I did and got no relief. Called back and said it isn't working. And so she said well you probably have BV but like I said I was out of state so I couldn't go in for culture. So she called in an oral antibiotic used to treat BV and Strep. No relief from that. Came home, went in for a culture and she said looks like bv you need to start flagyl. Started flagyl. Some relief. But all my cultures were negative for bv.  At this point my light goes off and I think it's herpes so I went to a family planning clinic (to see a doctor whom is not my friend) out of  embarrassment. That's who stated "it's prob chlamydia" and gave me high dose antibiotic. Few weeks go by. Still have the tingling and raw feeling. Make appt with another gyn for second opinion. She swabs me sends it in for herpes culture. Comes back negative. She thought with all the different meds that my ph was not right and that was the culprit. A week ago I had episode of itching so bad that I treated myself with Monistat. Same time I had the discharge that went threw my underwear onto my pants. Got relief from Monistat. Was seen a week later and that's when she said (my friend gyn because I don't think at this point it is herpes because of the negative culture) it sounds like it could be herpes. She did the blood work. At this point she wants to try valtrex to see if the symptoms surpress. Somedays if I move just right, the best way to describe it is it feels like hairs are poking me. Sometimes I feel like I can feel a bubble of fluid dripping. It tingles daily intermittently and sometimes it hurts so bad that I swear it has to have a fissure but looks totally normal. I was told if I see the fissure I need to come in immediately for a swab of it. Next step is to see the urogynecologyst who did my sling surgery. Just wanted to make sure I wasn't dealing with herpes first. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
34 months ago
Well, it sounds like you were not only tested but also treated for pretty much everything.  I agree that all the antibiotics may have thrown off your normal vaginal flora.  Has anyone mentioned the term vulvodynia?  I think this is something you might want to discuss with your friend who is the GYN.  I also wonder about the sling and if it has moved or is somehow causing this nerve type pain
But I really don't think herpes is the source of your problem - it so doesn't fit. 
It sounds pretty miserable and I sure hope you can get something sorted out here.

Best
Terri
---