[Question #636] Should I test for herpes?

43 months ago
I am a 36yr old married female who had unprotected vaginal sex and gave and received oral stimulation with someone other than husband, whom was also is in a committed relationship.  That evening I had tingling in the vagina and woke the next morning with what felt like I had been cut by fingernail or razor in the rear.  A week later I was seen for the discomfort, as my vagina felt irritated, no discharge or burning on urination, and my rear still felt like a cut from shaving.  Was swabbed for gon, chlym, trich, BV, and yeast and BV came back positive and prescribed Oral Flagyl for 7 days.  She looked at my rectum and said it appeared to be healing from whatever irritation it was from.  Experienced awful GI side effects from flagyl and developed thrush a week later and was seen by Primary Physician who also checked my rear as it still had a burning sensation, she said it may be hemhorroid or fissure causing it and suggested fiber, probiotics, and aquaphor.  Still no relief at 11.5 weeks, had a period of 5 days where there was relief but it returned, there are good days, but never resolved. I've also experienced some razorn burn 10 weeks out that left bumps in pubic area but no oozing or pus.  1 bump on labia which was evident of a pimple as it was hard and popped without any open sore.  After rapid blood test for HIV at 7 weeks and Oraquick at 11 weeks as well as speaking with the  person whom I slept with who assured me that they never experienced any herpes symptoms before and have been tested for the military every 6 months I tried to relax and resume sex with my partner once and this brought discomfort again in the vaginal area and burning in rectum still continues along with irregular bowel movements.  The burning irritation seems to radiate beyond the rectum at times (reaching just outside the lips) which concerns me and leaves me questioning if herpes is of a concern and wondering if I should put myself through the testing. I just want to move on from this csre
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
43 months ago
It would be surprising to have herpes symptoms last for as long as yours have and it would also be surprising to have herpes symptoms show up on the same day as your contact with this new partner.  It's too bad you weren't seen sooner that a week later.  Are you able to be in touch with this other person to see if they have any history of herpes?  Have you ever in your life had a cold sore on your lip?  Since you are almost 12 weeks out, I think it would be fine for you to get an IgG antibody test for HSV 1 and 2, just to know more clearly what is going on here and to help understand your continued burning sensation.  You could also pass on the testing (though it really is just a blood draw).  About 5.5% of people who do the IgG test for HSV 2 come up with what we call a low positive = that is an index value on the test that falls between 1.1 and 3.5.  Those test results are less clear but that they can be sorted out if that happens to you.  It would be unusual to contact genital herpes at a single encounter but definitely not impossible. 
Let me know what other questions you might have for me.

Terri
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43 months ago
As mentioned, I did speak with this partner and was told they have never had symptoms of herpes and are tested biannually and cleared of any STI for military purposes.  I myself have never had cold sores on my lip but have had breakouts on the corner of my mouth that I attributed to an acne condition, husband however does get cold sores and has for years, been over 13yrs together.  I want to believe that my risk of infection is low on a single encounter but with this rectal burning, and occasional skin irritation symptoms continuing to come and go over 12 weeks now, it has me anxious that its attributed to that encounter.   My obvious lapse of good judgment has me afraid of opening a can of worms that may not need to be opened.  I'm just wondering if what I'm experiencing is consistent with herpes to even consider. Would herpes outbreaks be back to back, or lingering like that? Would 7 days from encounter have been too late for OB to see signs of herpes outbreak, even with feeling burn/sting irritation? As she said she saw no signs of herpes, nor did Primary at 2 weeks, or PP at 6 weeks.  Would herpes present genitally after over 13 yrs with husband who has cold sores but avoided oral sex at those times?  Would it be beneficial to test if symptoms don't fall in the "consistent, classic" category? If he says he has never experienced symptoms is there some sort of assurance in that? Its all confusing, as I've had no fever, no oozing, no scabbing, which seem to sound like what happens, yet on the other hand they say some don't know they are experiencing an outbreak at all.  Just ready to feel relief and move on from this
43 months ago
I'm not sure if maybe my response somehow got lost along the way so I'm just following up, since I have pretty much moved forward with testing for HSV 2 by IgG test and waiting on results.  I'm currently experiencing some red spots, as small as a pen point, that are scattered in various areas of the inner crease of my legs that sting when touched, which continues to have me worry, though the burning in rectum area has somewhat subsided, and only seems more noticeable upon friction of some kind such as wiping or clothes rubbing.  Really hoping this is nothing more than some sort of skin irritation.  If the test were to come back positive, would I be able to tell by the numbers if it was a recent exposure as the cause vs. a prolonged one, seeing as I've only had one partner for several years.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
43 months ago
I honestly don't think that your symptoms are consistent with herpes.  Herpes symptoms come and go, they don't stick around for a long time as yours have.  and 7 days after an encounter would have been the approximate time that symptoms would have shown up from a new herpes infection.  The average time from infection to symptoms of new infection (if symptoms are going to show up) is 5.5 days.  In terms of the chances of you acquiring HSV 1 from your husband with cold sores giving you oral sex - this could happen, for sure, and if it did, it might be many years between outbreaks, if you had outbreaks at all.  But I do not think that you could have acquired HSV 1 from your husband then at this particular time, all of a sudden started to have these long duration symptoms.  If you want to test to see if you have HSV 1, you could certainly do that and if you are positive, you would be able to take that concern off your worry list. 
I hope that your IgG testing will give you some clarity on these issues.  Looking back at your original post, it looks like it has been just about the required 12 weeks since the encounter. 
Are you certain that the military tested for you herpes?  They might have but before you jump to any conclusions, should your test results happen to be positive for HSV 2, be sure to check.  I don't think that is usual, but it could be.  If your test happens to be positive and the military did not test you for HSV 2, you could have been infected for many years and didn't know it.  We're a bit ahead of ourselves, but I want you to know that just in case it is positive and you get very worried right away.  Is there a way you can check on that?  Let me know what other questions you might have, Ok? 
Terri
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