[Question #8307] HSV Testing and Clarification

46 months ago

Hello,

I had an incident in June where I had protected sex (oral and penetrative)with two new partners a week apart from each other. About 3 days after the second partner (only oral sex) I developed severe pain and irritation.

I went to the doctor who did a full PAP, STD screen and blood test for HSV. The tests were all negative minus a bacterial infection which they prescribed antibiotics and it was working to clear it up. 2 days after that I was still in severe pain and developed a slight fever. Went back to the doctor who provided antivirals and aciclovir cream. After a couple of days this still didn’t resolve so I went back to the doctor. They then prescribed fusidic cream (antibiotic) which cleared it up right away and provided instant relief.

Fast forward and for all purposes I had another HSV blood test pulled on 20 September. The test came back positive (not sure levels or type because it’s a German doctor and the tech could only help me). She said that it was only slightly positive but couldn’t tell me if it was type 1 or 2.

I’ve been in contact with both of the men who now still say they don’t have HSV and have since been tested. I haven’t had any other outbreaks since the initial skin irritation in early July nor have I had any new partners.

My question is…is Fusidic ever used to clear HSV? I feel lost since they didn’t do a swab on the wounds to actually see what it was.

Since I live in Germany is there any way to get a Western Blot test here?

Appreciate your help. I’ve learned throughout this entire thing that everybody does truly have this and it’s not the end of the world but I would like to know for sure so I can disclose to future potential partners if warranted.

Terri Warren, RN, Nurse Practitioner

46 months ago

That medication is NOT used to treat herpes, no. It is a combination of antibacterial and a steroid type medication and would have zero impact on herpes.

You mention wounds - did you actually see ulcerations in the skin when you had this pain?

You also mention that you had protected oral sex - how did that work, exactly? Was there a barrier between your genitals and the person giving you oral sex?

Have you had any recurrences of this issue? Do you know if the partners were also tested for HSV 1 and well as HSV 2?

You can get a western blot done in the US if you know a provider who could draw your blood and spin it down. Then you would have to arrange shipment to the University of Washington. I've had people ship samples from China, the Netherlands, lots from England and Sweden. it is definitely possible but expensive, for sure.

Let me know the answers to these questions, please.

Terri

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46 months ago

The oral sex was unprotected (sorry for the confusion).

There weren’t small ulcerations like what my friends have described when they had herpes. It was more like large portions of my labia were raw and missing the skin and we’re white with infection. This explains why the antibiotic cream worked. It was also the worst pain of my life while they tried to find treatment. This lasted for about 10 days with the skin damaged and no improvement until I was prescribed fusidic.

I have not had any reoccurrence of this issue. The men stated they were tested for HSV 1 &2. however my test doesn’t differentiate between the two types on my report from July.

The second partner mentioned back in July when I first inquired that he had strep throat again for the 3rd time in 5 weeks. My thought was that this transferred and caused some weird extreme bacterial infection.

If this was an entirely new infection wouldn’t my test result be more than slightly positive?

I will fly back to the states in February to see my family. It might be easier to just have it done there instead of shipping the sample.

Thank you!

Terri Warren, RN, Nurse Practitioner

46 months ago

Your description of the skin basically being gone, doesn't really sound like herpes. Most people would describe herpes lesions as specific sores rather than complete raw areas on the labia.

Too bad they did a test that could not distinguish between HSV 1 and 2 - have you ever in your life had a cold sore on your lip?

If your value is low (and they wouldn't tell you what it was?) then this could indicate many things, including the possibility of a false positive result. The crude antigens test (which I believe you had done) has lots of problems, for sure.

It would certainly be easier to do the testing here in the US, no doubt about that.

Terri

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46 months ago

Ok I’m back with more answers.

They were an ELISA test IgM and IgG

IgM was 1.5 with a positive result being >=1.1

IgG was 50 u/ml with a positive result being >=22

It seems with both of these tests they were positive. Should I consider this a final diagnosis? Would it likely be HSV1 due to the oral sex? Is this still considered slightly positive and therefore could be a slight positive?

I’ve never had a cold sore before.

Terri Warren, RN, Nurse Practitioner

46 months ago

The IgM is not useful and should not have been done. The IgG is strongly positive, not slightly positive, and indicates that you are infected with HSV 1. We cannot know the location of your infection, but given your description, and no history of cold sores, this may well have been your first outbreak of herpes. Had you had a blood antibody test when you first had symptoms and it was negative, and now it is positive, we would have known that was your first infection. But apparently that wasn't done, so now we really can't know for sure if your symptoms were due to genital infection or not, though I suspect they were. I'm not clear why the medication would have cleared it up so quickly, but perhaps the antivirals kicked in around the same time you used the other cream.

If you have another outbreak, please have it swab tested right away, when it first shows up, to determine for sure if your infection is oral or genital. However, if this was HSV 1 genitally, you may not have another outbreak or they could be very far apart.

Terri

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