[Question #5672] Genital outbreak

22 months ago
About two months ago I had what I thought was  an yeast infection. I took Monistat  for it. Shortly after I developed a sore/blister underneath my skin in between my thumb and index finger (never opened),I also developed sores in my mouth and very bad irritation in my vulva.  Culture down there  came back negative for herpes. A week later I developed a cold sore which I figured would happen due to the stress of all the Above. 

Now the same thing happened again exact same symptoms as above hand sore, vaginal irritation and sores in mouth. I went to see my midwife she said most likely the sores on the  roof of my mouth was an oral outbreak and possibly a genital outbreak as well.  

What doesn’t make sense to me is the hand sore and also how I would get another “outbreak” two months later when I take  Famciclovir two times daily. I also took Valtrex 1 gram one night and another gram the next about two days ago.  I understand that it’s only a suppression but what are the chances ? Also what are common  symptoms people have prior to a genital outbreak? I had what seemed to be a yeast infection very  itchy and had clear discharge  now after using the OTC Monistat I’m having discharge that’s yellow.

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
22 months ago
Yellow discharge is not normal for someone having a herpes outbreak.
Was any swab testing done of the oral or genital area or hand? If she suspected genital infection, I surely hope she did swabbing to clarify this for you!
Have you had an IgG antibody test done to see what you may have in the way of herpes?  I think that would be wise, if it has not been done.  And you have a history of cold sores in the past, is that correct?  I can't tell much from your description of the areas involved. 
I look forward to your answers.

Terri
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22 months ago
I am not sure where the yellow discharge is coming from.  I had thought it was a yeast infection because I had a clear discharge with intense vaginal itching which is why I took the Monistat and one pill of diflucan

As far as swabs... when this happened last time  2 months ago, I had a vaginal swab done cause I had redness and very  irritated Underneath my Urethral opening that did bleed and burn with urination  and culture came back negative for herpes. 
This time  I had a swab in my mouth for the sores  =  negative for HSV1 & HSV2. The midwife said she didn’t see any lesions vaginally so she didn’t swab anything this time.  hand sore is not an open blister under my skin so no swab done there. 

 But the area that is bleeding vaginally now  (underneath my urethral opening) is the same exact area as 2 months ago and so is the hand sore same exact place. I was prescribed PO flagyl for the yellow discharge as obviously I had some of infection.  Still at a lost. HIV, hep c = negative .

I did some research on diflucan and did see ppl were having fixed drug irruption of blisters in their mouths  when I brought this up to my midwife she automatically thought it was an oral outbreak and not due to diflucan b/c i have oral herpes. It just doesn’t make sense on how this happening with suppression use of an antiviral and  valtrex.... I would think it would have helped a little but I don’t see any relief! What are your thoughts ? What are some of the common symptoms of genital and in the mouth herpes? 

Also what could the IgG antibody test show compared to doing a swab? Would it show exactly what type I have ?  What if I have hsv 1 orally and hsv2 genital ?  I am just lost.... 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
22 months ago
The IgG test, if negative, would just rule out that you don't have HSV 2 genitally - nothing else because you already know that you have HSV 1. 
If the mouth sores you describe test negative by swab test, then they are something else, similar to canker sores which are NOT caused by herpes.
Herpetic whitlow normally breaks the skin and presents with multiple significant blisters on a very red base.  Something that is just under your skin but does not break the surface is unlikely to be whitlow.  The other thing that suggest that all of this is not herpes related is your lack of response to antivirals.  Don't you agree?

Terri
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21 months ago
Yes I do. I have another question that I’ve been wondering about... I’ve never been on a birth control but recently I’ve been thinking about getting on one.  I do know that my oral outbreaks sometimes do come when I get my period. Could being on BC help or make me have more outbreaks? I’m clueless when it has to do with the different types of contraceptions. My gyne has been pushing for Iiud I want the implant but either way how would it effect my out breaks? A part of me thinks it would be worst cause I’m pretty much giving myself more hormones then another part thinks I’ll be regulated with my hormones? And then of course another part of me thinks I’m insane on thinking either or... any input would be Very appreciative!!!  
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
21 months ago
Great question.  Some people experience a change in outbreak frequency while on hormonal birth control but it isn't clear if it makes it better or worse - some of each!  I would recommend that you try it and either an IUD or implant is a reasonable thing to do.  Remember that with both, you can have some spotting between periods for a while - that is normal and expected. 

Terri
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