[Question #893] Understanding how I was infected

53 months ago

My husband and I finally had sex after abstaining for about 5months (because of pregnancy & childbirth) & about 3 days later I started feeling uncomfortable which continued to worsen with the most excruciating pain while urinating. My midwife examined me, said I had lesions and I was totally raw. She sent me to a lab, had a gram stain and culture done.

Gram stain showed "bacilos pleomorficos gram negativos ++++" "diplococos gram negativos +++" " polimorfonucleares ++++"

Culture was completely negative, which I knew was possible because the lab didn't have the right medium for chancroid. Both husband and I received an injection of ceftriaxone which seems to have given me complete relief.  We live in central America where chancroid is present.

My culture swab (PCR) for herpes has come back positive, but I don't know yet for hpv 1 or 2. Tomorrow I will receive the results of igm & igg (I opted to do both). My husband will do both igm & igg next week. We are trying to gather as much info as possible.  During my two pregnancies (4 year old and 5 month old children) I had TORCH bloodwork done with no problems.

My husband does not remember having any lesions or sores. We have supposedly been monogamous for about 8 years. He says the only way he could have cheated is if it was while black out drunk.

*Could he have had HPV the whole time we've been together and only have passed it to me recently? We have both been under a lot of stress so I can imagine our immune systems are being affected. Basically our main concern is knowing if it is most likely my husband cheated on me and was infected while black out drunk, or if this is something that one of us could have had in our systems since before we got together.

*Why did I have relief from antibiotics if it is herpes? Or was there also a bacterial infection?

*Do we now need to be careful not to kiss our children on the face?

*Is there any benefit to taking antivirals now that I feel better? (I breastfeed)
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
52 months ago
So you had a positive swab test, do you know the typing yet?  I was hoping you might have it and post it here so my response could be a bit more on target.  The IgM is quite a useless test and even the CDC says to not use it, so please ignore those results when they come in. 
Were you the receiver of oral sex during this encounter?   Have you ever in your life had a cold sore on your lip?  If you did receive oral sex and you've never had a cold sore, you may well have new HSV 1 infection  When you say HPV, I think you mean HSV, correct?  Are you certain that the TORCH testing you had done included herpes testing?  Even if the answer is yes, and I think you should confirm that, it is possible that it missed an HSV 1 infection. 
So to answer your question, yes, he could have had it for years and just gave it to you. 
It is very difficult for me to interpret the results of your bacterial culture, but you did write that it was negative.  You may have gotten better because the herpes does naturally heal itself with each outbreak, and you did not improve due to antibiotics, rather you just improved because the herpes was resolving. 
You don't need to worry about kissing your children on the face if you only have genital herpes.  If you have ever had a cold sore, best not to kiss them on the lips when you have one.
Let's see what the typing of the virus shows - if you have HSV 1, it is not likely to recur often and thus you probably won't need antiviral therapy.  HSV 2 will likely recur more often.
In terms of your husband cheating on you while drunk and passed out.  It seems really unlikely to me that he would have a sufficient erection while that drunk to complete intercourse with someone, don't you think?

Terri
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52 months ago

I waited to respond until my husband and I had our labwork back.  We continue to be confused with this whole situation and the doubt is causing a lot of damage to our marriage.  After speaking with a therapist we are certain that there is the possibility that he cheated while black out drunk, it is possible to have intercourse while blacked out.   

I tried to make the test results a little easier to understand......after doing some research and having all these results back it seems like either 1)I was infected orally-genitally by my husband with type 1 but my antibodies are not strong enough to show up on blood work. 2) The PCR swab was a false positive and it was really a chancroid infection which was cured by antibiotics.

The thing I don't understand if it was herpes, is why did I have such a strong presence of bacteria?

Thanks so much!

 

Me

June 12

Gram Stain

Gram stain showed

bacilos pleomorficos gram negatives ++++

diplococos gram negatives +++

polimorfonucleares ++++

Suspected chancroid, treated with Cetrifaxone, started probiotics and applying natural sugar free yogurt at night. Total relief from pain after 3 days. Redness totally went away and the lesion spots became more visible because the general redness went away.

 

June 17

PCR Swab Positive on lesions, test was not type specific

 

June 21

HSV Type 2 IgM Negative .567 u

HSV Type 2 IgG Negative .481 u

 

June 27

HSV Type 1 IgG Negative .0028 u

HSV Type 2 IgM Negative .294 u

 

Husband

June 27

HSV Type 1 IgG Positive 2.77 u

HSV Type 2 IgG Negative .109 u


Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
52 months ago
So your husband has HSV 1 infection and could certainly have given this to you, without being at all unfaithful.  Has he ever had a cold sore on his lip?  If he the giver of oral sex to you?  When you get herpes, it takes a while to make antibody - sometimes up to 16 weeks.  And the IgM is useless and should never be done so forget that test.  And the IgG test, the good test, misses 30% of HSV 1 infection.  So if you have HSV 1 genitally, then it might never show up here.  The thing is, unless he also has brand new HSV 2 infection and not enough time has gone by for him to make antibody, then he doesn't have HSV 2 so you couldn't get it from him.  Do you see what I mean?  Are you still waiting for typing of the swab test or was it never done?  If it was never done, that was a significant error and will complicate issues here. 
It is certainly possible to have both a lot of bacteria AND herpes at the same time, I wouldn't be concerned about having both present. 

Terri
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