I need help and I’m really confused. I’m going to try and keep it super short: The last time I was tested for HSV 1 & 2 was in April of 2017, it was negative for both. I met my fiance in May and have been dating him since. I have an IUD so we don’t worry about protection.

Today, I have 4 clusters of small blisters across my bottom, sort of wrapping around from my panty line in the front, to the top of my butt in the back only on the left side. Only the one at the very top of my butt itches, the others don’t feel like anything. I have no symptoms of cold, fever, anything.

This is unusual because I am very susceptible to illnesses. I’ve been on strong immunosuppressive drugs for years for a chronic condition, and I had shingles a few years ago (I’m 38 yrs. Female btw), but they went across the top of my back on the left side, not my butt.

How likely is this HSV? Is it common for HSV to have several clusters of outbreaks in multiple places at the same time? 

I’m not sure if I’m submitting the correct way? Or if my question was forgotten?

This morning I feel the symptoms of the patches of clusters getting more sensitive. There are at least 5 clusters of tiny, fluid filled blisters, with red rash around them, all different sizes, and all on the left side of my body. One is at the very top of my butt, close to the spine, then one slightly below it. One is in the front on the edge of my genital area (underwear line), and then a trail of them running down my lower butt to about mid thigh.

 I have had shingles before and it feels the same, but it was on my back, not my butt/leg/genital region. I used to test repeatedly for HSV when I was single, and 1&2 was always negative my whole life. I’ve been in a monogamous relationship with my fiancé for 2 years, and I’ve had no symptoms like this (neither has he, he was also neg for HSV). 

Because my immune system is lowered with medications, if this were a HSV original outbreak, wouldn’t it typically be more severe with flu like symptoms? And does HSV typically have this many separate clusters of blisters, in totally different regions at once? (Upper butt, genitals, back of thigh)?

If I got blood tested for HSV 1&2 now, would it tell me anything? Which blood test would you recommend?

You only posted your question 19 hours ago - we have 24 to 48 hours to respond. 

If the clusters are feeling more sensitive I strongly suggest that you get these swab tested right away.  And ask for PCR vs. culture swab test  if that can be done.  The sooner you have the cluster swab tested, the more accurate it will be.  And if you have any antiviral medicine left over from your shingles episode, I would encourage you not to take it before you have the swab test done.

The IgG test misses 30% of HSV 1 and 8% of HSV 2, compared to the gold standard herpes western blot.   so it is possible that this is herpes and a recurrence or possibly a new infection if the test missed an infection in your partner. 

If you want the best herpes antibody test, it is the herpes western blot done at the University of Washington

Terri

My initial and primary question was overlooked and not addressed. Is this typical for HSV... to have several lesions spaced out from my lower back down near my knee? Or does it sound more like shingles? And since I’ve never experienced HSV before, wouldn’t it be more pronounced with other “flu-like” symptoms since I have such a weak immune system? 

Also, my fiancé and I tested negative several times before and have been monogamous for 2 years, and you are saying there’s no validity to that?

I know I can’t pick who answers my question, but Terri seems aggravated at me and did not answer my initial question at all (I asked this question twice). I was given a generic response. 

I'm not aggravated at you - I was just trying to point out that it had been less than 24 hours since your post had appeared on the board.  I'm sorry if it seemed like I was aggravated - I am not.  Let's try again.

It is not usual for lesions to be spread out as you describe, but then, herpes can present in many ways and I don't think you can rule herpes out simply because they were spread out. 

Shingles is also even less likely to be spread out, I think, than HSV.  The flu like symptoms may or not appear with a new infection - since about 70% of people who have HSV 1 are not aware of their infection so it is possible to be infected and not have any recognizable symptoms, though most people actually do have symptoms but they are unrecognized, not completely missing. 

Were you able to get in and have your lesions swab tested?  That's the very best way to know what's going on with them.

I am not saying that your testing is not valuable but I'm saying that it isn't perfect, particularly the HSV 1 test.  And I'm certainly not saying that your exclusive relationship is not valuable - it is!  It just that if the test missed an HSV infection (more likely HSV 1) in either of you, it is POSSIBLE though not likely that this is HSV that you are describing. 

The best way to sort this out is to do swabbing of the lesions.  Alternatively, you and/or your partner could obtain western blot testing, it is the gold standard test for HSV . 

Again, I'm sorry if I came across as aggravated.  i can understand how you would feel that way but it was not my intention. 

Please let me know what other questions you might have.

Terri